This post follows on from my last article "The Nightly Grind", which discussed the signs and symptoms of bruxism (the habit of grinding your teeth together). It's a very hot topic in dentistry circles, and there are a lot different health professionals who will have their two cents to share as well.
Bruxism seems to me to be a very complex area. We don't know why some people grind while others don't. We don't know why some treatments work for certain people and not for others. It's not even cut and dry for an individual person, there may be multiple factors such as jaw joint dysfunction, posture problems, stress, and sleep disorders all going on at the same time.
As you can imagine, this makes management a bit of a minefield. Anyone who has watched House knows that you can't give the correct treatment without the correct diagnosis, and trying out various treatments "just in case" as the cantankerous TV doctor does is not always practical. At the end of the day though, regardless of the reason for your bruxism, your teeth still need to be protected. Wearing a custom made occlusal splint while you sleep is a sure-fire way to prevent excessive tooth wear and breakages. Is there anything else that can be done though?
Bruxism has been linked to stress. If you're one to get worked up about things, or if you have stressful things in your life which are out of your control, your teeth may benefit from a bit of relaxation. This may be as simple as starting a yoga class or taking time out for a long bath regularly. For more stubborn stress and anxiety, a psychologist s is the professional to see. There is a fantastic Medicare mental health program which your GP can assess you for, so that's the place to start.
Take a pill
The evidence for pharmacological management of bruxism is still cloudy. Some people may benefit from antidepressant/anti-anxiety medication. Like any treatment, particularly when it comes to drugs, the benefits need to be weighed up against the risks for the individual. While they can provide good relief for some, these drugs also have potential side-effects. A common one is decreased salivary flow, which can actually make tooth wear happen faster if the bruxism is not controlled.
There is a theory that having things out of alignment can encourage the bruxism habit. If your teeth don't bite together evenly, they can be added to or adjusted down so the force of your bite is distributed nice and evenly across all your teeth. If your spine and posture are out of alignment, a chiropractor can provide assessment and adjustments to get you back on the straight and narrow. Unfortunately there's still not definitive evidence for or against either of these treatments, so they also fall into the category of "might work for you, probably won't work for everyone".
A lot more research is required before we understand bruxism properly. I'm really looking forward to the day we know the answer, because it's a very common problem. In the mean time, your dentist's role is important to help protect your teeth from wearing away, and in referring to a specialist for management where necessary.