Notice a change in the shape of your teeth? Do you think you could be clenching or grinding?
I'm a teeth grinder. In my sleep I grind my teeth.
I didn't know this for many years. Growing up, I always brushed assiduously twice a day, especially after I had to have a couple of fillings placed and then got braces during my adolescence. What truly motivated me to keep up on my oral hygiene, though, was what I saw while waiting for a ride home from the senior citizens' center my pop directed. All around me, the consequences of poor dental care were all too apparent in the startling array of dental appliances the senior center regulars were forced to use when consuming anything denser than tapioca pudding. Not me, I thought. Whatever it takes, I don't want to have to deal with that - ever. And my strategy seemed to pay off, as after those childhood run-ins with tooth decay, I didn't need another filling or any other dental treatment beyond regular cleanings for well over a decade.
It was a good run, but one spring day it came to an end as I was eating a bowl of French onion soup at a café in the Latin Quarter of Paris. (Where better to eat French onion soup?) As I swallowed a spoonful of the rich, cheesy liquid, I realized that something in my mouth felt wrong. Rushing to the men's toilette, I bared my teeth at the mirror and was crestfallen to see that about a third of my right front tooth had fairly shattered. The whole event was baffling; after all, I hadn't been chewing on ice or tearing away at spare ribs. I was eating a food that even denture wearers can consume without trouble.
Don't Think About It, It Won't Feel BadOnce I returned Stateside, I made an appointment to have the broken tooth repaired and asked my dentist what might have gone wrong. He shrugged and said that I'd probably weakened the tooth by biting down on some hard food earlier and the fracture just chose that moment to work itself loose. Okay, fair enough. The doctor was slightly concerned about signs of erosion around the bases of a number of my teeth, but chalked it up to overzealous brushing habits developed in childhood (not me, not ever) and my, er, enthusiastic consumption of carbonated caffeinated beverages. I promised him I'd try to tone both down and went on my way, contented for the moment with my fracture-free smile and dismissing the incident as a one-time fluke.
Unfortunately, my problems didn't go away. In fact, they only worsened over the course of the next eight months. When I'd arise in the mornings, my mouth, neck, and head would often ache, and when I ate hot or cold foods certain teeth would tingle sensitively. On particularly bad mornings, my teeth would even feel slightly loose - though I usually managed to rationalize that away as a figment of my imagination.
Finally, one of my molars fractured as I was eating a wheat cracker. (A wheat cracker!) This second broken tooth had been previously repaired with an old fashioned metal amalgam filling, and fortunately the fracture didn't cause me any additional pain, but this was a clear message that something was definitely wrong. I hadn't had any dental issues since high school and within less than a year I pop up with two broken teeth? If things continued at this rate I'd be in denturetown with the senior citizens before I got within twenty years of retirement age.
As soon as I was able, I scheduled an appointment with a new dentist and explained my situation. He took one look in my mouth and asked, "Have you been under a lot of stress lately?"
"I would kill for a good night's sleep."
"Do you grind your teeth in your sleep?"
"Uh...I don't think so. I mean, not that I know of. No one's ever said anything to me about it, anyway."
"Well, you see here...and here...and here where the bases of the teeth are worn? That's probably from clenching your teeth and grinding from side to side in your sleep. Plus, the locations where these fractures occurred are exactly where your bite comes together." He called my significant other in from the waiting room and asked, "Have you ever seen him grind his teeth in his sleep?"
"Oh yeah, definitely. He does it all the time."
My head whipped around as I asked, "Why didn't you ever mention it to me?"
"I figured you already knew. You didn't know you grind your teeth?"
No, I Didn't Know I Grind My Teeth
Fortunately, my new dentist was able to make some recommendations to help halt the progression of damage and control my nocturnal bruxism (or nighttime teeth grinding). I immediately began wearing a custom-fitted mouth guard designed to protect my teeth from the forces of grinding each night as I slept. The improvements were almost immediately noticeable: first, that bizarre "loose teeth" feeling in the mornings went away, and then the dull ache in my teeth that had gradually become like constant background noise in my head began to fade. My teeth were less sensitive to temperature, allowing me to eat a wider range of my favorite foods without discomfort once again, and unexpectedly (to me, anyway), my headaches and neck pain also began to lessen.
My dentist explained that, while doctors don't currently understand all of the causes of bruxism, a number of factors have been identified as contributing to teeth grinding. In children, the condition is thought to be related to the growth and development of the jaw, as teeth may not fit together as comfortably due to the rapid growth spurts that occur during childhood and adolescence. In adults, bruxism has been associated with misalignments between the upper and lower teeth; side effects from antidepressant medications such as Zoloft® or Prozac®; consumption of alcohol or caffeine; sleep disorders; psychological factors, including a hyperactive or hypercompetitive personality, high levels of stress, and suppressed frustration or anger; and other conditions including Parkinson's disease and Huntington's disease. When left unchecked, teeth grinding can not only lead to severe tooth wear and damage, but may also cause head, neck, or back pain and disorders of the temporomandibular joint (TMJ).
Whichever bruxism treatment is used, arresting the condition may be only half the battle. By the time the condition is diagnosed, many teeth grinders have already suffered significant tooth damage. Depending on the nature and severity of the damage in your case, your dentist may recommend placement of porcelain crowns or veneers to restore damaged or badly worn teeth, orthodontic treatment to correct a misaligned bite, or other cosmetic dental treatments designed to restore the appearance of a healthy smile.
In my case, after two years of dental bonding treatments and placement of new tooth-colored fillings, I'm finally back to the point where I see a smile I'm happy with in the mirror each morning. I replace my mouth guard when necessary, I try to keep stress to a manageable level, and I've cut caffeine almost entirely out of my life. Still, I keep a close eye on my teeth for new signs of wear, and I make sure to visit my dentist regularly for cleanings and checkups.
I'm a teeth grinder - but I don't have to let bruxism turn me into a toothless wonder before my time.