How does my dentist know I’m grinding or clenching my teeth when I don’t?

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Many people do not know that they grind or clench their teeth throughout the day or night. Often during the night people will not notice their own habit of clenching or grinding and as not all conditions are accompanied by the sound of grinding it may not be brought to the attention of another person in the household until a significant amount of damage has been done to the teeth.

For a clinician there are many signs that indicate a patient is either currently clenching and grinding or has a history of doing so, these include:

  • Wear on the incisal/occlusal (biting) surfaces of the teeth
    • Tooth on tooth wear is referred to as attrition or bruxism this wear can range from being mild due to occasional grinding or clenching to severe where there may be a loss of vertical height of the teeth. Loss of height of the teeth can affect a person’s appearance and the way someone eats and speaks.
    • A flat biting edge or chipping on the edges to the teeth are a common outcome of attrition.
  • Linear alba
    • This is keratinised (thicker) tissue that is formed at the side of the cheek due to the muscles at the side of the mouth forcing the tissue between clenching or grinding teeth. Over time the soft tissue will become harder to prevent trauma to the cheeks.
  • Scalloped tongue
    • When active clenching and grinding is occurring often the sides of the tongue will show a scalloped shape around the edge due to being forced next to the teeth as they bite heavily together.
  • Muscles of mastication
    • Muscles can become sore or tired due to not receiving adequate rest and the intensity of the motions that each muscle goes through while clenching and grinding.
    • The muscles can even change shape with prolonged clenching and grinding, which may affect the appearance of the face.
  • Radiographic evidence
    • When viewed on an x-ray some teeth may show a widened space between the tooth and their supporting structures.
  • Head or neck ache
    • Due to the tension in the muscles when clenching and grinding people may find that they wake up or develop headaches throughout the day or night.
  • TMJ (jaw joint) problems
    • Prolonged or severe attrition may have a lasting effect on the jaw joint making it painful or difficult to open the mouth.

Treatment of grinding depends on frequency, severity, age and medical history. Unfortunately for children grinding is difficult to treat due to mixed dentition. In adults a dentist may recommend a grinding/bruxism splint to mitigate the effect of it has on the teeth. If left unchecked the damage due to grinding and clenching can lead to very extensive dental work required to rectify the bite and appearance of the teeth.