Every day, I talk with patients that tell me they don’t clench or grind their teeth, but their teeth tell a different story. Tooth chips, cracks and wear are all signs of a destructive habit, most times unknown to the patient. Although there are many causes of tooth wear, I want to share more about clenching and grinding - also called parafunctional habits.
Parafunctional habits are jaw movements that serve no purpose, unlike when we speak or chew.
Teeth clenching, as defined in this article, is the voluntary or involuntary squeezing together of the teeth with force beyond what is needed for normal function. Clenching can be caused by physical or mental stress, poor occlusion (bite), sleep breathing disorders or by the central nervous system (the way people are “wired”). Certain medications will also cause or make clenching worse. Chronic clenching patients will present with very large jaw muscles which may or may not cause regular headaches, thicker bone on the inside and outside of the jaw bone, and a history of tooth fractures or chips. If clenching is the only issue, teeth will usually have very little to no visible wear. On closer exam the surface of the teeth will show numerous surface crack and fracture lines much like the surface of an old porcelain cup. The crack and fracture lines can get deeper and lead to the tooth cracking and breaking.
Unlike clenching, grinding is a much more destructive movement. When patients grind their teeth, the jaw moves excessively from side to side, forward and back. The movement and wear is much more pronounced resulting in teeth that appear flat and short. The signs and symptoms of grinding are very similar to clenching with the exception of visible tooth wear. Grinding can have the same causes as clenching. However, I find it to be more related to central nervous system hyperactivity – or the way someone is “wired.” Interestingly enough, I find these patients often do not complain of jaw pain and headaches as often as patients that clench even though is looks as if they should have pain.
Treatment will depend on the underlying cause of the clenching and grinding. Poor occlusion and bite can be treated braces to improve the way the teeth fit together. Stress can be treated with diet, exercise and in some cases medication. Sleep disorders are treated with CPAP machines or dental devices that stabilize the airway at night. In cases where facial pain and headaches are an issue a dental splint can be made to wear between the teeth to help relax the jaw muscles and protect the teeth from breakage and wear.
If you suffer from anything mentioned in this article give us a call - (225) 926-4203 - or reach out to us for more information.