What is bruxism (teeth grinding) or clenching of the teeth?

Teeth grinding is a condition that occurs at night during sleep and can cause serious problems such as gingival recession, broken teeth, joint dysfunctions, etc. if no action is taken.
Teeth grinding occurs when the daily stress manifests itself during sleep at night in the form of teeth unconsciously grinding against each other.

What are the problems caused by teeth grinding or clenching?

It causes problems such as erosion and even breaking of the teeth, gingival recession, and thus heat and cold sensitivity, joint diseases due to excessive load on the jaw joint, and disturbing the people around because of the noise.

How is teeth grinding or clenching treated?

Soft or hard occlusal splints prepared by taking the impression of your mouth to be worn at night during sleep are recommended. These splints should be replaced periodically. Also, being subjected to less stress in daily life is important for the success of the treatment.

Do I clench my teeth only at night?

Contrary to popular belief, the habit of teeth clenching happens not only at night but during the day as well. The individual can try to prevent it by being wary of this situation.

What are jaw joint disorders?

They are disorders observed in the bony and soft tissues of the jaw joint that connects the lower jaw and the upper jaw. In such cases, several symptoms can be observed, from simple symptoms such as jaw popping to serious ones such as jaw lock. They can occur because of many reasons (accidents, wrong treatments, stress, habits, etc.). Jaw joint disorders gradually deteriorate over time. Therefore, the sooner the treatment starts, the more the treatment is successful.

What are the problems caused by jaw joint disorders?

• Eating loudly,
• Jaw popping or jaw lock,
• Ache,
• Restriction in opening the mouth.

What are the symptoms of jaw joint disorders?

• Jaw joint disorders not emerge overnight. Symptoms are seen over time and if treatment is delayed, these symptoms may lead to more serious disorders over time (Jaw lock, dislocation of the jaw, inability to open the mouth, etc.)
• Clicking noise while opening the mouth
• Jaw lock while yawning
• Difficulty in opening the jaw in the morning
• Pain around the ear while eating
• Neck and back pain (especially in women) are the general symptoms of jaw joint disorders.

What are the causes of jaw joint disorders?

These reasons can be divided into three main groups:
1) Reasons related to dental treatments:
Keeping the mouth open for a long time in procedures such as the extraction of the wisdom teeth,
After orthodontic treatment,
Poor dental crowning and filling.
2) Personal habits:
Lip biting,
Sleeping face down,
Chin resting on hand
Chewing for long,
Exposure to wind for long (especially for motorcycle divers)
Slouching.
3) Individual being under stress:
It causes jaw joint disorders more than other factors. As the individual under intense stress constantly contracts the facial muscles, the jaw joint is subjected to more pressure than usual.

Will my jaw dislocate if you don't have my jaw joint disorder treated?

In the advanced stages of jaw joint disorders, permanent deformations occur in the tissues and structures in the joint area, and the jaw may dislocate during engagement and shift forward. The main problem here is not jaw dislocation. Jaw can be put back in its place with the help of simple joint movements, but the main problem is if this occurs frequently over time and is accompanied by severe ache.

I have a jaw joint disorder, what should I do?

• Follow a soft diet for three weeks
• Avoid excessive stretching
• Do not lay face down
• Give up bad habits such as lip biting
• Apply compress to jaw area with a hot towel in the mornings
• Avoid stress as much as possible

What is the role of stress in jaw joint disorders?

The muscles around the face have the ability to contract at the slightest reaction. One of the effects of stress on individuals is muscle contraction without relaxation for prolonged amounts of time. Therefore, in stressful situations, the muscles contract, the teeth come into contact with each other by applying intense force against each other, and therefore, the joint is pressured.

What should I be careful about during the treatment of jaw joint disorder?

You should use the joint splint regularly as recommended by your doctor and follow their recommendations.

How long will I use the joint splint?

Jaw joint treatment lasts for an average of 3 months. However, depending on the severity of the disorder, this period may extend.

How should I store the joint splint?

The joint splint is stored in the prosthesis box with a clean damp cloth.

How is the joint splint cleaned?

Upon the removal of the splint in the morning, it is brushed under cold water using an old toothbrush and liquid soap.

How frequently should I visit my dentist for check-ups after the jaw joint treatment?

After the splint is placed, check-ups are carried out in first week, third week, and third month.

How can I tell if I recovered after my jaw joint treatment?

Depending on the severity of the disorder, full recovery may not always be achieved in the treatment of jaw joint disorders. Here, the main criterion for healing is that the patient can perform basic jaw movements in daily life (eating, speaking, swallowing, etc.) without feeling any pain.

Are there any additional physical therapy exercises I should perform?

In some cases, physical therapy exercises are prescribed by your doctor to strengthen the jaw muscles or to reduce the restriction of jaw movement.

How do I know if I have a jaw joint disorder?

There are many possible symptoms of jaw joint disorders. These symptoms include a clicking noise coming from jaw, jaw lock, or jaw pain. If you feel that something is different with your jaw, consult your doctor. The stage of the disorder is important for the treatment.

Author of the Article: Dr. Tuğrul Saygı

 
What is jaw joint and how does it work?

The jaw joint is the joint that is located in the temple area and connects the jawbone to the skull. It enables to chew and speak, operating in harmony with jaw muscles. There is a cartilaginous pad (jaw joint disc) that protects jawbone and skull from friction and erosion, and facilitates the movement of jaw joint.  The ligaments surrounding the joint hold this system together. An individual uses the joint 1500 to 2000 times a day. 

What are jaw joint disorders?

It is the deterioration of harmony between jaw joint and the surrounding structures abruptly or in time. Symptoms that are mild at the beginning may lead to more severe disorders over time, such as severe jaw joint pain, head, neck or shoulder pain, a clicking noise coming from joint, jaw dislocation, jaw sliding, or restriction of jaw movement. The first step of the treatment process is dentist examination, which reveals causes of the disorder.

Who should I contact for jaw joint disorders?

The biggest problem for patients with jaw joint disorders is to be unaware of which specialist to consult and whom to contact with. However, jaw joint problems are treated by Specialist dentists from the Maxillofacial Surgery branch and after the correct diagnosis, the problem can be solved with various treatment methods. In some cases, doctors from the branches of otorhinolaryngology, psychiatry, neurology or physiotherapy contribute to the treatment as well.

When should I contact a doctor?

You should contact a doctor when abnormal changes are noticed around jaw joint. Slight-feeling jaw joint pain may deteriorate the disorder. The earlier the cause is determined, the more likely the treatment to be successful.

What causes jaw joint disorders?

There are many factors that cause jaw joint diseases. The most important of those factors are:

• Teeth grinding and clenching (bruxism) 
• Stress
• Chewing with only one side of the jaw
• Wrong prosthetic procedures that affect jaws' relations with one another
• Missing teeth
• Jaw traumas and injuries
• Sports injuries
• Tumors and systemic diseases affecting the head and neck region
• Difficult treatments that take too long
• Postural disorders
• Neurological, psychological and psychiatric disorders
• Congenital anatomical disorders
• Parafunctional habits such as chewing gum, pencil and nail biting
• What are the symptoms of jaw joint disorders?
• Pain and fatigue around jaw and cheek while chewing
• A feeling of slipping during the engagement of the jaw
• Restriction in opening the mouth
• Difficulty in engaging the jaw in the morning 
• Clicking and crepitation noise coming from the jaw
• Jaw lock
• Ear pain and pressure in ears
• Strong headache around the temple
• Pain in the neck and shoulder area
• Asymmetry in the face due to volume change in masticatory muscles
• Erosion on the surface of the teeth
• Sensitive teeth

Decrease in the quality of life and deterioration of mood due to symptoms

What is the role of stress and clenching in jaw joint disorders?

Daily stress causes us to clench our teeth involuntarily during the day and night, and it is usually noticed later. As a result of continuous teeth clenching, the muscles remain contracted and the jaw joint is subjected to more pressure. Transmitted to the jaw joint area through the teeth, the pressure cause pain and irreversible changes. Therefore, it is very important to consult a dentist early.

What are the diagnosis and treatment methods of teeth clenching?

A detailed examination of teeth, occlusion, masticatory muscles and jaw joint is performed. In some cases, intra-articular imaging methods such as MRI can be used.
In the treatment of jaw joint disorders, full recovery may not always be achieved. The main objective here is to enable the patient to perform basic jaw movements without feeling any pain. For this purpose, methods such as a joint splint, exercises, pain relievers, muscle relaxants, and botox are applied. The treatment method is determined according to the severity of the disorder. The cooperation of the patient is very important in this process.

What is a joint splint? How long should I use it?

Joint splint is a custom-made, transparent dental tray that is used to relax the muscle in the jaw and regulate jaw motion.
It minimizes jaw dysfunction and prevents the damages caused by clenching and grinding.
The treatment period varies between 3-6 months.

How to care for joint splints?

After the joint splint is removed from the mouth, it should be washed with cold water using liquid soap and a brush. Toothpaste should not be used and splint should not be contacted with hot water. Otherwise, the splint may be deformed. It should be stored in a dry environment and in its box until the next use.
What to be careful about in jaw joint disorder

• Following a soft diet
• Not chewing gum
• Front teeth should not be used for biting and chewing and food pieces should be smaller.
• The jaw should be supported from below while yawning
• Parafunctional habits such as pencil biting and nail-biting should be abandoned.

The Author of the Article: Dt. Alara Naz Kenir