Clenching and grinding of teeth, mostly during sleep, is known as Bruxism. We believe this to
be a major factor leading to headaches, damage to teeth and fillings, and implant failure
and even neck pain. Most people are unaware that they clench their jaws while they are sleeping or during the day. Your teeth are only meant to be contacting with force whilst you are chewing.

Find out more about Bruxism

How do I know that I have a problem?
You may find that you clench or grind your teeth, although most people who do aren’t aware of it. Sometimes can be caused by anxiety, but generally most people clench their teeth when they are concentrating on a task - housework, gardening, car mechanics, typing and so on.

You may wake up in the morning with a stiff jaw or tenderness when you bite together. This could be due to clenching or grinding your teeth in your sleep. Most people who grind their teeth do it while they are asleep and may not know they are doing it.

If you suffer from severe headaches, or neck and shoulder pain, you may not have linked this with possible jaw problems. Or you may keep having pain or discomfort on the side of your face around your ears or jaw joints or difficulty in moving your jaw. These are all symptoms of TMJ problems.

If you are missing some teeth at the back of your mouth, this may lead to an unbalanced bite, which can cause uneven pressure on your teeth

Together, all these symptoms are called ‘TMJ syndrome’

How are occlusal problem treated?
Depending on the problems you are having, it can be possible to spot the signs of an occlusal problem. Various muscles may be sore when tested, or the broken and worn areas of your teeth will show you are grinding your teeth - a common sign of an incorrect bite.

If your dentist suspects that your problems are due to an incorrect bite, he or she may help to diagnose the problem by supplying a temporary soft nightguard or hard plastic appliance that fits over your upper or lower teeth. This appliance needs to be measured and fitted very accurately so that when you bite on it, all your teeth meet at exactly the same time in a position where your muscles are relaxed. You may have to wear this all the time or, just at night. If the appliance relieves your symptoms then your bite may need to be corrected permanently.

Tooth Adjustment (equilibration)
Your teeth may need to be carefully adjusted to meet evenly. Changing the direction and position of the slopes that guide your teeth together can often help to reposition the jaw.

Replacement of teeth
The temporo-mandibular joint needs equal support from both sides of both jaws. The chewing action is designed to work properly only when all your teeth are present and in the correct position. Missing teeth may need to be replaced either with a partial denture or bridgework.

Replacement is not usually done until a diagnosis has been confirmed by using an appliance and this has fully relieved the symptoms. Relief in some patients is instant: in others it can take a long time.

Medication
Some drugs can help in certain cases, but this is usually only temporary. Hormone replacement therapy may also help some women.

Diet and Exercise
As with any joint pain, it can help to put less stress on the joint. So a soft diet can be helpful, as can Corrective exercises and external heat. Physiotherapy exercises can often help, and your dentist may be able to show some of these to you.

Relaxation
Counselling and relaxation therapy may help in some cases. These techniques help the patient to become more aware of stressful situations and to control tension.

How many people suffer from this problem?
Up to 1 in 4 people may have some symptoms. Both men and women are affected equally, although women tend to seek treatment more often than men. The symptoms can often start with the menopause or other hormonal changes.

Many people have imperfect occlusion and missing teeth, yet never have symptoms because they adjust to their problems. Occasionally, in times of increased stress and tension, the symptoms may appear and then go away immediately. Or, your teeth and gums may be affected straight away and instead of headaches, you may suffer:

• flattened, worn teeth
• broken teeth, fillings and crowns
• loose teeth
• continual sensitivity of your teeth to temperature change
• toothache with no apparent cause.

If you think you have any of these problems, ask your dentist