Many patients are surprised when I make them aware that they are grinding their teeth. Why is grinding detrimental? Excessive force on the teeth in a repetitive action will accelerate tooth wear. Although enamel is one of the hardest known substances, teeth have a finite amount of enamel on the biting surfaces or edges of the front teeth. The amount of a tooth's enamel when it first erupts into your mouth is the most enamel that there will ever be.

The potential for greater damage occurs when the enamel is worn through to the dentin. Another important sign of grinding is the canine (eye) teeth. A healthy intact canine comes to a point. The canines protect the back teeth in the chewing cycle. When an individual has been bruxing (grinding), the canines wear down first and the obliteration of the normal pointed anatomy will be visible. If this continues, the dentine is exposed and this progresses to the other front teeth. It becomes a domino effect and the dentin becomes exposed on the incisors.

Grinding places a great deal of stress on the temporomandibular joints which could result in joint wear and damage, joint pain and muscle discomfort around the jaw and head. This is TMD (Temporomandibular Dysfunction).

Some people grind while awake. The vast majority are night grinders. In rare cases grinding has caused such significant destruction to the entire dentition that a total reconstruction of all the teeth, requiring crowns, is needed. For the majority of the population, teeth grinding is intermittent, of short duration, not predictable in its time frame, and easily managed with a night guard.

The night guard, which is worn over the teeth at night prevents further tooth wear and protects the joints. It is a conservative approach, is easily made and is usually all the treatment that is required. It does not cure the grinding, but controls the wear on the teeth.

For most patients the wear on the edges of the teeth can be restored with a tooth colored material (composite). This will seal off the dentin and also restore the esthetics of the teeth. If the teeth have been reduced in height, they can be restored with veneers.

If diagnosed early, bruxism has minimal long term effects on the teeth and joints and can be treated conservatively. 

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