Mouth Guards and Tooth Wear
Tooth wear is a common problem that occurs in patients who experience parafunctional habits such as bruxing. Bruxing is the dynamic, repeated grinding of teeth against teeth that causes wear facets, loss of tooth height and thickness, cracked teeth or restorations, loose teeth, un-cemented restorations, muscle spasms and tenderness upon awakening, limited opening, clicking and popping in the jaw joint, etc.
Clenching is another non-functional habit that generates constant, static force on the teeth without any lateral movement. Clenching and grinding are usually subconscious and occur mostly at night, but can sometimes happen during the day. Only a small fraction of patients are aware of their nighttime parafunctional habits, because symptoms of jaw pain and discomfort appear in less than 10% of patients.
There are preventative and corrective measures that can be taken to minimize the effects of grinding and wear. Mouth guards (aka nightguards, occlusal guards, bite splints) are custom fitted appliances, worn at night that take the shock out of this parafunctional habit and protect the teeth and supporting structures from the excessive forces generated during grinding. Parafunctional habits can generate forces of up to 1000 psi; as a comparison, the average force measured in the 1st molar region of dentate person is 150-250 psi, and in an edentulous patient wearing complete dentures about 50 psi. In addition, mouth guards improve jaw and bite alignment, thus relaxing the musculature and deceasing any TMJ related symptoms.
When tooth wear is excessive, and tooth structure is compromised, corrective measures may be indicated in addition to a mouth guard. These may include bondings, full coverage restorations such as veneers or crowns, crown lengthening surgery, root canal treatment, and/or realignment of the teeth with orthodontics.