Problems with Grinding and Heavy Bites


People with stressful jobs frequently show signs of tooth grinding. Upon dental examination, these patients may have jaw muscle pain, a sore joint (the TMJ of temporomandibular joint), worn teeth, cracked teeth, very sensitive teeth, gum recession, mobile teeth. Wow!

One of the simplest solutions is to have the patient wear a bite guard. Usually it’s fitted on the upper OR lower teeth, although there are some that fit on both arches. The idea is that instead of grinding in your sleep, frequently waking up your partner with screeching noises, you get to grind into a plastic material that will absorb the shock. This is the most common and easiest treatment for these patients.

Cracking teeth is not a good symptom. If you break a small amount of tooth off, a filling is recommended. If you break a large amount of tooth off, a crown is frequently required as the filling won’t hold up when a lot of tooth (roughly over 50%) is missing. If the crack goes into the nerve area, a root canal may be necessary prior to placing a crown. In those rare instances when the fracture goes down to the root surface, the tooth is considered to no longer be restorable and the tooth needs to be extracted. Then evaluation for an implant is the usual course of action. As you can see, I do not taking grinding and tooth cracking very lightly!

On occasion the patient may have a lot of pain in the jaw from grinding. A simple bite guard does the trick much of the time, but on occasion the pain does not subside. Treatments for larger problems include pain medication and physical therapy. Some oral surgeons include surgery on the joint as one of their subspecialties if there is an anatomical problem that requires that kind of treatment. There are always new intraoral devices that are made to help patients with TMJ problems depending on the cause. The temporomandibular joint is quite complicated as it can move in many different directions, not just opening and closing. Fortunately the bite guard does work quite well in a large number of patients and no further treatment is required.