Jaw Clenching and Teeth Grinding

Clenching & Grinding

Involuntary grinding or clenching of the teeth, also known as Bruxism, leads to harmful destruction of the teeth and ultimately leads to TMJ disorder.  Most people that clench and grind are unaware because it usually occurs while sleeping.   Jaw muscles generate tremendous amount of force causing wearing of the enamel, fracture, and malocclusion (misalignment) of teeth.  With repetitive jaw clenching and grinding, patients will start to develop pain in the neck, cheek, face, and temporal region, headaches, migraine, ear stuffiness or fullness, tinnitus, and dizziness. 

Typical treatment consists of root canal, tooth implant, Botox injections, and night guards made their dentist.  However, these treatments only address symptoms NOT the root cause. While most night guards can prevent enamel wear by avoiding direct teeth contact, it does not prevent grinding and clenching.  In some cases, night guard promotes activity of the muscles that clench and this makes jaw pain worse.

In a normal TMJ movement, a disc cartilage is between the condyle and the temporal bone.  It provides cushion and allows the condyle to glide along the temporal bone. As the jaw opens, the disc stays between the condyle and temporal bone.  Without this cushion, the two bones will wear each other down causing degeneration of the bones.  And if the disc is out of place (also known as disc displacement), the jaw clicks, pops, locks, and causes pain.

In most cases of TMJ disorder, the disc is displaced and causes pain, clicking, popping, and/or lock jaw.  A simple night guard does not assist in placing the disc into the correct position.  Some night guards have uneven contacts from front to back teeth or side to side to side, causing uneven muscle activation which leads to more clenching and grinding, and TMJ pain.  One of the worse types of night guards is the over the counter type because it is virtually impossible to adjust and precisely fit it to your unique bite.  Improper fitted night guards can misalign your bite and shift your jaw in the wrong position to create more TMJ problems down the road.

Fortunately, there are special oral appliances/splints that are designed specifically to position your jaw so it can unload the irritated TMJ joint and relax some of the jaw muscles.  However, this only addresses half of the problem.  There is a direct relationship between head/neck position and the jaw position.  Whenever we slouch or slump, our shoulders round forward and our head comes forward and the skull rotates up.  This position increases activity of the muscles that clench the jaw.  Another cascading effect of forward head posture is that the jaw moves back and eventually displaces the disc, causing clicking, popping, and TMJ pain.  Furthermore, it shortens the muscles in front of the neck and decreases the airway space leading to sleep apnea and swallowing impairments.

You can experience this influence of the head/neck position to the teeth by the following movements.   Sitting up straight, tap your teeth a few times to feel the contact of your teeth.  Now, tilt your head back and look up at the ceiling.  Tap your teeth a few times and observe the difference in where your teeth contact. You can clearly feel the difference in the two positions.  

Mouth breathing, obstructive sleep apnea, snoring, and upper airway obstruction has been linked to jaw clenching and teeth grinding at night.  When we limit nose breathing and breath through our mouth, the sympathetic nervous system overrides the parasympathetic nervous system and cause a stress hormone called cortisol to rise.  Therefore, patients who suffer from clenching and griding suffer from stress, anxiety, and difficulty sleeping.   

We identify and address underlying causes of jaw clenching and teeth grinding.  Solving the root cause results in relief of symptoms.   

If you are experiencing teeth grinding, jaw clenching and TMJ pain after wearing a night guard, fill out the form below to find immediate relief.