TMJ Disorder

//TMJ Disorder

Many of us work through their problems subconsciously. Stress at work is one of the main reasons for teeth grinding. Neck pain, tense jaw muscles and headaches can all be caused by teeth grinding.

Our upper and lower teeth are supposed to glide together smoothly, touching only when we are chewing food. Unnatural grinding or clenching can cause wearing and cracking of the teeth, as well as serious jaw impairment.

The reality is that all of us grind our teeth on occasion – when we are angry or anxious, for instance, or when our sleep is disturbed. But when we grind our teeth on a regular basis, we have a condition called bruxism (from the Greek bryx, meaning a “gnashing of the teeth”).

If bruxing persists, as it does in an estimated 20 percent of the population during waking hours and 8 percent during sleep, it can have a negative effect on tooth enamel, bone, gums and the jaw.

In the past, grinding (sideways movements of the jaws, with the teeth just touching) and clenching (clamping the uppers and lowers together) were believed to be caused by malocclusion (a bad bite). However, the latest research sees lifestyle reflexes – our ways of dealing with anxiety and stress – as the primary cause, with sleep disturbances and malocclusion serving as secondary and tertiary causes.

How serious is bruxism?

Bruxism starts early in life while the teeth are still in the process of developing. An estimated 15 percent of children reportedly grind or clench their teeth. Although the condition eventually wanes, with only 3 percent of the elderly continuing to brux, it takes a toll during the intervening years.

While enamel subject to normal stresses wears down at the rate of .3 millimeters every 10 ten years, it is not uncommon for bruxers to experience two millimeters of enamel erosion by their mid-twenties. What’s more, nighttime bruxing can occur as often as 40 minutes for every hour of sleep, producing up to 250 pounds of force per square inch. That’s enough pressure to crack a walnut.

The consequences of bruxism

Over the years, the accumulated toll of bruxing can produce a wide range of damage that includes:

  • Front teeth worn down so they are flat and even in length.
  • Micro-cracks and broken fillings, eventually leading to nerve damage.
  • Teeth ground down to the dentin, causing sensitivity to heat and cold.
  • Gum recession, due to pressure on the gum line.
  • Loose teeth, caused by the rocking effect of bruxing, and gum pockets, also produced by the back-and-forth rocking effect.
  • Headache and aching jaws due to overuse of muscles.

Bruxism treatments

While there is no cure for bruxism, the condition can be managed through treatment. If you suspect that you clench or grind your teeth, consult your dentist to undergo a bruxism evaluation. Your dentist is in the best position to evaluate the extent of wear and tear on your teeth, gums and jaw, and to provide a practical remedy to offset further damage. Additional treatments are:

  • A custom-fitted oral appliance that treats airway obstruction, to be used as an alternative to the bite plate. This therapy should be supervised by a physician who does regular sleep studies to make sure the oral appliance is effective.
  • Orthodontics, when misaligned teeth are part of the problem.
  • Stress reduction via psychotherapy, biofeedback, yoga, meditation, vacations, et al.
  • For extreme cases, muscle relaxants or botulism toxin (Botox) to minimize spasm in overworked jaw muscles.
  • An adjustment to your medications, arranged by your physician in consultation with your dentist.


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