An acquaintance described the growing anxiety she’s been feeling when confronted with the news these days. She has cracked two of her teeth from grinding at night, even with a mouthguard, and her dentist mentioned that another looked like it was on its way to being cracked. I wrote a former dentist friend of mine for advice on her behalf, and he shared this great feedback. I thought I would share it here, too.
I’m sorry to hear you are suffering from bruxism and the resulting condition of your teeth. Being aware of it, and not being able to control or minimize the effects can be incredibly frustrating!
Wear and attrition secondary to parafunction (function outside of the normal range of motion) or bruxism is seen so very often. And yes, given the times we are living in today it is hard not to feel increased stress and anxiety just by reading the headlines or watching the news. If one is prone to anxiety…this daily intake of negative information and energy can without a doubt contribute to increased bruxism and the secondary effects on your dentition.
A great resource is the UCSF TMJ Disorder Clinic which is part of the UCSF School of Dentistry on Parnassus:
As it is a clinic associated with the dental school…my understanding is they have a wide range of treatment options and modalities including physical therapy. [EDITOR’S NOTE: when following up, my friend learned that UCSF does not accept insurance of any kind, and the initial consult alone is $500. So this approach is good if you live in SF and are loaded…and that’s about it.]
Even though you may not be experiencing pain related to your bruxism as many TMJ patients…the secondary effects on your teeth definitely need to be addressed and is part of a comprehensive approach to treating TMD (temporal mandibular disorder)
I am aware that a number of SSRIs can contribute to increased bruxism…
Since you are not taking them now, it may be a consideration to talk to your medical doctor about short-term low doses of anti-anxiety meds such as xanax during the day and/or perhaps a muscle relaxant such as flexeril at bedtime?
Muscles have memory…and with the continued grinding habit…even when you may not feel stressed you may still find yourself grinding…or your jaw moving. I have found that a number of my patients benefited from muscle relaxants at bedtime…which in a way diminished the muscle activity of the TMJ…and with that and other relaxation techniques your muscles can be re-trained so to speak.
Your occlusion…how your teeth come together…can definitely contribute to bruxism as well. Upon examination, it may be a consideration for you to see an orthodontist to determine if your occlusion needs to be adjusted to a more idealized position which can also limit the amount of attrition or wear on your teeth. Wearing an occlusal guard not only at night can also work. If you are not in a position or working where you are talking to people or with them all day, wearing your occlusal guard during the day can also be a good deterrent to bruxism and the attrition/wear on your teeth.
For my patients that could not wear their guard during the day…I would have them try a simple biofeedback technique that is easy and completely non-invasive. Place a color coded dot or or sticker on something that is in your view space most of the day…for most it is the computer screen or an object on your desk. Each time you look at the dot or marker…check yourself or remind yourself not to clench or grind. If it works, over time, the dot becomes a subliminal “nudge” to stop grinding. It’s worth a shot…
I too have suffered from bruxism and have worn a number of different occlusal guards over the years…
What I found to be most effective and most comfortable was a combination hard/soft guard that was fabricated to fit the lower arch. I and most of my patients found it to be more comfortable and less intrusive to wear since they tend to be smaller than the upper guards. And it tends to soften a bit due to the warmth of the mouth. The material I had my laboratory use is called BRUX-EZE.
There are obviously a number of approaches to treating patients with chronic bruxism. Given your detailed history…I would recommend you start with the TMJ clinic at UCSF. It will be the most comprehensive and could be a great resource to you.
Thank you to the wonderfully talented healer who shared this insight! I hope it helps you, too.