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The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Why it Happens and How to Stop
Raphael V. Goldstein, DDS
Managing Partner, Goldstein Dental Group, PLLC 23895 Novi Road | Novi | MI | 48375 https://goldsteindentalgroup.com
Telephone: (248) 374-2273
About The Author
Dr. Goldstein earned his undergraduate degree with honors and high distinction in 1985 from Michigan State University, Lansing. He then completed his Doctor of Dental Surgery degree in 1989 from the University of Michigan – School of Dentistry, Ann Arbor. He completed his post-graduate hospital general practice residency training at Ravenswood Hospital & Medical Center in Chicago, Illinois. He subsequently was invited to serve as a hospital attending medical staff member for four years before deciding to return to the metro Detroit area. He is a skilled practitioner and loved by his patients of all ages. Dr. Goldstein takes pride in offering his patients outstanding oral care in a very comfortable environment.
Dr. Goldstein remains on the cutting edge of dental medicine and regularly participates in continuing education programs. His past and present professional affiliations include membership in the American Dental Association, Michigan Dental Association,
American Academy of Cosmetic Dentistry, Oakland County Dental Association, Dental Organization for Conscious Sedation, Academy of General Dentistry & the Alpha Omega Dental Society.
When not practicing dentistry, Dr. Goldstein enjoys spending time with his three children. He also enjoys riding motorcycles and has climbed to the summit of Mt. Kilimanjaro in Tanzania. He is an exceptional chef and truly loves to cook… A joy he inherited from his Italian mother.
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
Contents
About The Author 2
Contents 3
Introduction 4
What is Teeth Grinding 5
An epidemic 7
Symptoms 8
The Reasons Behind Teeth Grinding 10
The Health Impact of Grinding Your Teeth 17
How to Stop Grinding Your Teeth 20
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
Introduction The jaw pain. The grating headache. The degraded teeth. There are
many ways both daytime and nighttime teeth grinding can adversely
affect your health and wellbeing.
Research suggests the grinding problem may be fairly common, with
somewhere around 10 to 15 percent of the population affected,
though these statistics are hard to verify because patients may be
unaware they have a problem. Though many people may clench
their teeth from time to time when they're in pain or under acute
stress, it's the persistent grinding that can cause pain and tooth
wear. This ebook will cover why teeth grinding occurs, its effects on
your health, and how to alleviate the problem.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
What is Teeth Grinding?
Bruxism is the formal name for teeth grinding and clenching. People
with bruxism unconsciously clench and grind their teeth either while
awake or asleep.
Nearly 80 percent of teeth grinding cases are sleep-related. Sleep
bruxism is actually considered a sleep-related disorder and is
associated with other sleep disorders such as snoring and sleep
apnea.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
Though less common, daytime teeth clenching (and to a lesser
extent grinding) still happens unconsciously and is associated with
extreme concentration or stressful situations.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
An Epidemic
As the stress of our modern, uber-connected world builds, teeth
grinding cases may be rising with it. You can develop bruxism at any
age (including during childhood), but adults especially develop it
when faced with life challenges or chronic stress.
And because it's not easy to spot in the beginning, you could be
doing a lot of damage and not even know it. The good news is that
teeth grinding is treatable.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
Symptoms
If you sleep with a partner, they may be the first to notice nighttime
grinding due to the noise it creates.
People who grind their teeth may also be affected by anxiety,
depression, eating disorders, and insomnia.
Because grinding tends to happen during sleep, symptoms may be
the worst after waking and subside during the day. If you have any of
these symptoms, or suspect you may be a grinder, a dentist can
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
Signs and Symptoms of Teeth Grinding Include
• Flattened, chipped, fractured, or loose teeth • Worn enamel • Increasingly sensitive teeth • Jaw and face pain • Pain around the ear area (not an earache) • Dull headache • Damage to the inside of the cheek from chewing
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
usually determine if there's a problem by assessing the wear on your
teeth and checking for jaw tenderness.
Getting a dental exam can also help you rule out problems with
similar symptoms including ear infections and other dental disorders.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
The Reasons Behind Teeth Grinding
1. Stress, Anger, and Frustration
Though the causes of bruxism are not entirely understood, stress is
often the leading trigger for this problem. If you live a life defined by
stress, anger, anxiety, frustration, and other high-tension emotions,
you may be more likely to clench or grind your teeth.
Stress is a normal body reaction to a situation your body and mind
deem harmful. Back in humanity’s early days, we would have used
this stress and adrenaline to deal with intense situations (think:
hunting mammoths). But in our modern society, the stresses of work,
money, and family can stay with us day in and day out. According to
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
the American Psychological Association's 2014 report, 75 percent of
Americans reported at least one symptom of stress in the last month.
This chronic, unrelenting stress is affecting our mental state and our
physical health.
Stress can manifest itself in many ways: trouble sleeping, irritable
behavior, poor eating habits — and teeth grinding.
It's often hard to get away from your stressors during the day when
computers, email, and phones seem to crowd our lives. What's even
worse is when we take that ever-connected technology with us to
bed — a space meant for relaxation and rest. Many Americans sleep
with a mobile phone within arm's reach of their pillow. Besides the
beeps and buzzes the phone could emit during the night, the
subconscious knowledge that the device is right there can add
stress to your sleep routine and contribute to teeth grinding.
2. Hyperactive and Aggressive Personalities Just like stress can cause teeth grinding, both hyperactive and
overly aggressive people may find themselves more likely to grind as
a result of these strong feelings.
A hyperactive mind may cause bruxism due to an inability to relax. If
your mind isn’t letting you relieve yourself from the stress of daily life,
you may suffer some stress-related side effects.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
Aggression is similar in that extended, habitual anger can cause
tension and stress in your body. Anger management programs can
help people realize their aggression problems and work to correct
them. People with this personality type should pay particular
attention to signs of bruxism.
3. Misaligned Teeth Poorly aligned teeth (called malocclusion) is a common cause of
teeth grinding in children and adults. Children's mouths are
constantly changing and they usually outgrow grinding, but adults
with misaligned teeth could be setting themselves up for future tooth
damage.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
During the day, poorly aligned teeth aren't a huge problem because
the brain can realign your bite so your mouth still functions to its best
ability. At night, grinding can happen when the brain keeps trying to
align your bite over and over.
Fixing a misalignment can be easy, (grinding down a small part of a
tooth) or more complicated (braces or other corrective measures).
Properly aligned teeth can alleviate teeth grinding in many people.
4. Concentration
Though sleeping bruxism is more common, many people suffer from
clenching or grinding while under periods of deep concentration. For
many people, this clenching is a subconscious action that you may
not even know is happening, just like grinding during sleep. For
others, this is a bad habit formed over time.
Since you are awake, it is possible to catch yourself clenching and
practice releasing the muscles. Practice relaxing the jaw muscles
throughout the day to help train your brain to relax. You may be able
to train yourself to stop clenching by positioning the tip of your
tongue between your teeth.
5. Sleep Disorders
Bruxism is categorized as a movement disorder that happens during
sleep, which places it in the same category as snoring, restless leg
syndrome, and sleep apnea. Teeth grinding is very strongly
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
coordinated with sleep apnea, which is a common disorder where
you have one or more pauses in breathing while you sleep. It can be
dangerous if left untreated.
If you fail to get a good rest night after night, teeth grinding may
occur along with other sleep-related disorders.
6. Malnutrition
A poor diet can lead to the lack of key nutrients, including those that
help your body manage stress. If you're missing some of these
vitamins, you may be less able to deal with daily stress, which can
contribute to teeth grinding.
B-complex vitamins, especially B5, have been shown to help control
teeth grinding. A lack of this set of vitamins has been linked to
severe stress, panic attacks, and depression. You can either
supplement with a quality B-complex vitamin or eat more foods that
are high in these vitamins, such as dark-green leafy vegetables,
almonds, pecans, salmon, potatoes, shellfish, yogurt, avocados, and
egg yolks.
Vitamin C, so essential for fighting colds, is also an important mood
moderator and plays a role in our body’s stress-related adrenaline
chemicals. Vitamin C is fairly easy to supplement with, but it's also
found in broccoli, berries, citrus fruit, bell peppers, and dark leafy
greens.
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The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
Calcium and magnesium plays an important role in how your body
controls its muscles. A deficiency could cause cramps and muscle
tension, including in the jaw. Find calcium in dairy products,
almonds, green beans, and broccoli. Magnesium is rich in avocados,
bananas, nuts, seeds, fish, and beans.
7. Pain Response
When your body is stressed, muscle tension can be a subconscious
reflex reaction — it's your body's way of protecting itself against
injury.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
Similarly, when we're in pain, your body may feel like it has to brace
itself for any future pain, and your muscles will tense up. Especially
severe or long-lasting chronic pain can cause this tension, too.
Spending hours fighting pain can affect your sleep and lead to teeth
grinding. Many people may clench their jaw while in pain either
during the day or while sleeping. Children suffering from an earache
or teething pain may clench or grind in response.
8. Health Complications
Disorders including Huntington's disease and Parkinson's disease
can factor into bruxism cases. Teeth grinding can also be a side
effect of some psychiatric medicines, including those for depression.
Lifestyle factors like drinking excessive alcohol, smoking, caffeine
level, and recreational drugs can also be a factor in teeth grinding.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
The Health Impact of Grinding Your Teeth
Extended teeth grinding and clenching can have a lasting impact on
the health of your mouth.
Tooth damage
Teeth grinding leads to the wearing down of enamel, the protective
coating that keeps your teeth strong. Enamel is the hardest
substance in the human body, which makes it great for chewing
tough foods. But when you're chewing, your teeth rarely touch
together. Grinding your teeth at night is like spending hours chewing
without the food, and teeth aren't really built for that. Grinding can
wear down the enamel and expose the sensitive dentin. Enamel
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
doesn't grow back, so it's important to stop the grinding as soon as
possible.
Enamel can be brittle, which means grinding and clenching can also
cause pieces to break off, resulting in a chipped or cracked tooth.
When a tooth is very badly damaged, it may have to be replaced
with a dental bridge or implant.
Jaw pain
Extended clenching and grinding can also lead to disorders of the
temporomandibular joints (TMJ), which is the hinge that connects
your jaw to your skull near the ears. A disorder of this joint may
sound like clicking or popping when you open and close your mouth.
The pain can make it hard to chew, talk, and move your mouth.
Gum Recession Though bruxism isn't the cause, teeth grinding and clenching puts
your mouth under constant pressure that can sometimes make pre-
existing gum health concerns (periodontal disease) worse. If your
gums are already inflamed and in poor health, the grinding pressure
may worsen receding gums. The pressure may increase the
breakdown of periodontal ligament and bone. Even in the absence
of inflammation, recession very often occurs resulting in the need for
gum surgery. Additionally, notches near the gum line (abfraction
lesions) can also develop due to the added stress on teeth.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
Headache and migraine
The tension related to stress and the grinding response can lead to
headaches and migraines, especially emanating from the temple
area. The low-grade, background headache that is often associated
with bruxism is a result of the muscle tension surrounding the
grinding act.
Hearing loss
The jaw pressure and tension can even cause a ringing or buzzing
noise in your ears called tinnitus. In some cases, loss of hearing can
occur on one or both ears mostly likely caused by muscle spasms in
the ear.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
How to Stop Grinding Your Teeth
What may work to control your teeth grinding may not work for
another person, so you may have to try a couple to find what works
for you. You’ll want to talk with your dentist about some of these
options, while others can be done safely at home. Find something
that works for your lifestyle that eliminates the pain and damage of
bruxism from your life.
Get a custom mouth guard
Dental mouth guards are custom-made appliances worn at night to
protect teeth from the wear caused by grinding. These guards are
made by creating a mold from your actual teeth — so it fits like a
glove!
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
The guard, made from a cured acrylic resin or sometimes a soft
material, usually fits over either the upper or lower teeth. Getting the
right fit for a night guard is important, so talk to your dentist if the
guard seems to be affecting your bite or sleep.
Generic sports mouth guards aren't recommended to deal with teeth
grinding. Sports guards can actually cause additional discomfort
because they're not made to be worn overnight and are not built for
your unique mouth.
The guard method may not stop the root cause of bruxism, but it will
protect from the teeth-on-teeth grinding associated with enamel loss
and pain.
Change how you sleep
Practicing good sleep habits can help stop teeth grinding because it
creates a calm, restorative environment where tension is removed.
Part of creating a good sleeping environment is finding your ideal
sleep position.
There is some evidence of a link between teeth grinding and
sleeping on one's back, but more evidence is needed to say for sure.
If you're a grinder, try switching up your sleep position and see if you
find any relief from jaw pain or headache the next day. A new
position may help relax tense muscles.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
Change your diet As mentioned earlier, there may be some nutrition issues behind
bruxism that can be fixed with a few dietary changes.
Focus on getting foods or supplementing with B-complex vitamins,
Vitamin C, magnesium, and calcium. Many of these vitamins can be
found in vegetables and fruits, so make sure your diet has the
recommended five to nine servings of them. As a bonus, the
minerals and vitamins contained in these foods can help keep your
teeth strong and healthy, which may be needed if you're a long-time
teeth grinder.
Relax
You're more likely to clench and grind your teeth if you're stressed,
anxious, or angry. Many times, stress management techniques can
help alleviate teeth grinding. Different people employ different
techniques for stress reduction. Try these stress-relieving activities:
• meditation
• yoga
• taking a walk
• playing with a pet
• taking a bath
• exercising
• listening to music
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
A simple deep breathing exercise can help: breathe in for 4 seconds,
hold for 5, and breathe out slowly for 6. Repeat this pattern a few
times for full effect.
It will help to avoid stimulants like caffeine right before bed. Besides
hampering sleep, stimulants can contribute to grinding.
If your bruxism is caused by extreme anxiety, medication or cognitive
behavioral therapy may be able to help. Talk to your doctor about the
possibilities.
Clenching during the day is somewhat easier to catch when it's
happening, but it's still a subconscious action. Along with relaxation
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
practice, habit-reversal techniques may be helpful combating
daytime clenching. For example, pay attention to when you notice
yourself clenching and write down the time and what you were
doing. You may notice patterns of clenching at times of
concentration or stress. When you become aware of these
moments, practice relaxing your jaw muscles by opening your mouth
slightly or placing your tongue between your upper and lower teeth.
Stop Sleeping With Your Mobile Phone
Your bedroom is a place for restful sleep. Removing technology
including computers, TVs, and especially phones will create a
restorative environment and reduce nighttime stress that can lead to
teeth grinding.
High mobile phone use has been associated with disturbances in
sleep and symptoms of depression in both men and women. The
concept of being accessible at any hour is also associated with
depression and sleep problems.
With phones right next to us as we sleep, we’re never really
unconnected to the world. We’re conditioned to jump at the slightest
noise or vibration. For true relaxation and restorative sleep, eliminate
these distractions. Stop making grinding worse and remove your
phone from the bedroom. This is a simple way to help calm your
mind during sleep and can combat stress-related grinding.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
The Definitive Guide to Teeth Grinding Raphael V. Goldstein, DDS
Ask Your Dentist If you think you may be grinding or clenching your teeth while
sleeping or during the day, see your dentist as soon as possible.
There are several treatment options and you can try a few to see
what works for you.
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© Copyright 2016, Raphael V. Goldstein, DDS, All Rights Reserved
Goldstein Dental Group, PLLC 23895 Novi Road | Novi | MI | 48375 https://goldsteindentalgroup.com
Telephone: (248) 374-2273