Do I suffer from bruxism?
In the States it seems that this word has entered into the patient’s vocabulary but few people in the UK know its meaning. It basically means the unconscious habit of clenching or grinding the teeth, usually manifested during the sleep.
Several studies suggest it may affect up to 1 out of every 3 adults. This would go more or less along my personal (probably biased) observation. Throughout the patient’s life it can have catastrophic consequences, specially if undiagnosed. And quite commonly the patients are not aware of the problem, even if the wear if as substantial as the one in the picture.
Mind you, tooth wear is in a way a natural process of ageing but we should look into increased wear. A few centuries ago people’s teeth would wear down at a much faster pace due to mainly sand or dirt mixed with the food. Naturally tooth wear doesn’t bother anyone if life expectancy is short. We need to look into the fact that we are likely to live longer and longer so any signs of increased wear are to be noticed.
We don’t fully understand the mechanisms associated with bruxism, but it seems stress is our main suspect. The most common consequences are felt on teeth are restorations: wear, fractures, cracks, early failures of dental treatment. It can also cause significant muscle pain and temporal-mandibular joint disorders, which are in a way harder to treat.
We know how to deal with bruxism though and we’re quite efficient with that: providing the patient with an occlusal splint commonly know as night guard works 100% of the time, as long as it is worn regularly.
There are different types of these guards, but the only ones that I strongly recommend are Michigan splints. These are hand made by a very skilled technician so that they fit perfectly on the patient’s teeth, not too tight, not too loose, and are carefully adapted to his/her bite. This is an essential aspect in making it comfortable to use, long lasting and also safe. A badly designed night guard can actually cause irreversible modification on the bite and joints.
Not everyone who suffers from bruxism needs a splint, the dentist needs to evaluate the individual case, how bad the grinding is, and help the patient to decide to have one of these or not.
When teeth have already suffered significant wear, rehabilitation is always possible. In the case here (see picture above) we chose veneers, as a minimally invasive strategy which delivers long lasting results. Below is a picture of how I bond the veneers to teeth.