Teeth Clenching and TMJ-TMD cause Tooth Fillings, Root Canals, Implants, Gum Disease?
Research has proven that tooth clenching and grinding at night is one of the leading causes of need dental work such as fillings, crowns and root canals. While teeth are getting clenched, cracks develop in the surface of teeth. Bacterial gets into the cracks and causes cavities and tooth infections. Often the cracks involve the nerve of the tooth. At this point, teeth need root canals or extractions and dental implants.
Tooth clenching and grinding is also one of the leading causes of gum disease. The gums support the teeth and cover and protect the roots of the teeth. When clenching occurs in cases of TMJ, the fibers that attach the gums to the roots of the teeth are torn loose and the gums lower leaving the roots of teeth exposed to the mouth. Loss of gum tissue is termed gum recession. The pressure from TMJ clenching also causes inflammation in the bone and periodontal ligament. Long term inflammation in gum tissues results in bone loss. Deterioration of the gums leads to root cavities, fillings by the gum line, food trapping in between teeth and ultimately tooth loss.
Treating and correcting TMJ-TMD issues is of paramount importance to curbing the need to large amounts of dental work on a recurring basis. People who correct TMJ find that they save money and spend a lot less time in the dental chair getting fillings, crowns, tooth removal and implants.
The two leading causes of tooth clenching and bruxism are night time airway issues such as upper airway restriction syndrome/obstructive sleep apnea and bite misalignments. Past orthodontics can also play a role in bruxism. Especially in cases where so called extraction-retraction braces have been done. Tooth clenching seems to be related to cases where orthodontics was done for long periods of time and where treatment outcomes were not good. Especially in cases where braces and extractions and retraction were used. If you you clench your teeth, you should be evaluated by a TMJ dentist. Most dentists are not trained in diagnosing clenching problems from the standpoint of correcting it. A qualified TMJ expert will diagnose the problems and treat the condition so the teeth grinding habits cease and do not occur anymore. Novel treatments correct the underlying cause of the TMJ problem and do not involve wearing a night guard or other dental TMJ appliance forever. In short, a cure for TMD is possible in many cases and lifetime night guards and clenching should not be accepted.
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Restorative dental treatment aims at the restoration of damaged or lost natural teeth, diseased gums, normal chewing, biting and eating for your improved general well-being. Your teeth, gums, bone around the sockets and joints are parts of head and neck which need to be healthy for proper functioning of mouth. Individual consideration must be given to all these components for achieving satisfactory treatment outcomes. Improper bite between your teeth, stress induced teeth grinding and TMJ disorder can produce an imbalanced functioning of teeth and jaws which can result in serious complications causing failed dental treatments. You need to visit and re-visit your dentist from time to time ultimately losing all teeth. Simpler treatments fail and need for advanced treatments becomes necessary without understanding and evaluating need for removal of the cause of problem.
What is meant by bruxism or clenching and grinding of teeth?
Bruxism is the forceful grinding, clenching and gnashing of your teeth most often due to anticipated stress, anxiety and depression. Most of you will never be aware of this condition as it most often occurs unconsciously during sleep hours at night. Your spouse or family members will usually observe this habit. Your dentist will diagnose the condition during examination of teeth and gums as bruxism will badly affect teeth and oral tissues.
What is TMJ disorder?
TMJ disorder is the condition in which your TM joint exhibits misalignment and does not guide your lower jaw to meet the skull bones. TMJ condition can also develop during stress and anxiety when your teeth start grinding and clenching unconsciously during sleep hours.
How much common is the habit of teeth grinding in US?
Recent research shows that clenching and grinding is causes most often by two things: 1) upper airway restriction syndrome and obstructive sleep apnea 2) a bad misaligned bite. Due to anxiety and stress in the modern life of competition and hard work, approximately 30-40 million young children, teenagers and adults are suffering from teeth grinding among US population.
How will my dentist diagnose my habit of teeth grinding?
Your dental health care provider will thoroughly examine your teeth, gums and tongue after taking complete history of stress and anxiety. Following conditions in your mouth will point out towards the diagnosis of teeth grinding and clenching habit.
- Worn teeth with flat grinding surfaces,
- Yellowness of grinding teeth surfaces due to enamel loss and exposure of underneath dentine,
- Sensitivity of teeth to hot and cold on applying air or water jet during examination,
- Fractured or chipped teeth cusps,
- White line can be seen where teeth meet inner side of your cheeks,
- Marks of teeth on the side of tongue sometimes,
- Hardness of teeth as the muscles grow in size and become hard after teeth grinding for a few years.
- Scalloping of the tongue
- History of braces and tooth removal
- What are the different symptoms of teeth grinding and clenching?
Symptoms associated with teeth grinding and clenching habit can be
- TMJ pain and discomfort,
- Severe headache and dizziness,
- Pain in the ear and temples,
- Muscular pain and tenderness in the head and neck area,
- Sleep problems,
- Tooth wear leading to complex dental treatments failures and eventual tooth loss,
- Sensitive teeth,
- Clicking noises from TMJ,
- Reduced opening of mouth,
- Grinding sound of teeth during sleep,
- Locking of jaws especially during early morning soon after waking up from sleep.
Why teeth grinding or bruxism is damaging to teeth and TMJ?
Bruxism or teeth clenching is an alarming condition and needs to be managed as soon as diagnosed.
- Unchecked grinding of teeth can cause wearing of tooth enamel of all teeth exposing sensitive dentine,
- Pain and discomfort occurs in the start which may goes off when damage becomes extensive as the living pulp is exposed to the environment,
- If no definitive management is performed, eventually teeth will be removed and dental implants will remain the only option for restoration of lost structure and function of your mouth.
What needs to be done as soon as Bruxism is diagnosed in my teeth?
Over the counter night guards should be used at night during sleep if you are unable to get an immediate dental consultation appointment. Night guards will help in reducing the damage caused by wearing of teeth due to grinding and clenching. Visit your TMJ dentist for complete check up and treatment planning to prevent damage to your teeth and TMJ in future. Non surgical treatments are available to correct the underlying cause of bruxism and clenching.
Which dental treatments will become necessary as Bruxism or teeth grinding progresses along with TMJ problems?
You can save your teeth by consulting your TMJ dentist during early stages of teeth grinding. You will be advised to reduce anxiety and stress as much as you can. Worn off and damaged teeth will be restored through dental fillings or root canals and provision of crowns afterwards.
However, if teeth grinding progresses unchecked, your general dentist will need to keep providing you with dental treatments such as dental fillings and root canals without addressing the root cause of problem. Teeth damage will become extensive and expensive. Dental problems from clenching will recur as necessary fillings, crowns and root canals will fail and need to be redone as clenching and grinding continues.This will lead to loss of natural teeth, bite problems and the need for placing dental implants. These can be summarized as,
- worsening of temporomandibular joint pain and dysfunction,
- Clear and loud TMJ clicking sounds,
- TMJ dislocation abnormalities,
- accelerated tooth surface loss, wear and sensitivity,
- Muscular hypertrophy especially in the masseter muscle,
- Painful and tightening of muscles,
- Severe headache and lethargy on waking up in the morning,
- Failed dental restorations and fillings due to continuous grinding and mastication stresses,
- Failed dental implant supported prosthesis,
- Gum injuries.
Is it safe to place porcelain crowns over my work or damaged teeth during Bruxism?
Metal free and tooth colored cosmetic restorations are popular these days. Advanced dentistry provides pleasing, functional and long lasting porcelain crowns for boosting your smiles and confidence at work. However, these porcelain crowns have the side effect of wearing natural tooth enamel when teeth grinding occurs. Porcelain or ceramic crowns must be avoided if you are suffering from Bruxism or teeth clenching. Zirconia is a much better material choice.
Proper evaluation of oral health conditions involving your TMJ and tooth contacts during function and rest is essential before including these restorations in the treatment. Consult a specialist TMJ dentist in this regard. Furthermore, continuous contact and grinding can result in chipping off and breakage of ceramic crowns due to their brittleness.
Can TMJ disorder develop the habit of teeth grinding?
Yes. Mal-alignment in teeth which develops TMJ pain and discomfort can result in the occurrence of teeth grinding or bruxism.
What should be done in bruxism?
Management of bruxism involves,
- Treatment of the root cause i.e. stress, anxiety or mal-aligned teeth,
- Custom made and fit night guard fitting your teeth must be worn during sleep hours,
- Jaw exercises,
- Avoid biting and chewing hard foods,
- Relax your face muscles.