Patients ask me Doctor, my teeth are getting shorter!! I used to be be able to see my teeth when I smiled but now I cant see them! Whats happening?
On examination of the patient I find that the teeth are indeed short and the cause of this is the patients muscles working against their own teeth and wearing them down! This is called bruxism or tooth grinding. Tooth wear can be due to an external abrasive agent wearing them down such as a diet that is gritty in texture (abrasion) or by acids either from the diet (extrinsic acids ) or coming up from the stomach (intrinsic acids). So we have 3 types of loss of tooth tissue that is not as a result of tooth decay. These are abrasion, attrition and erosion! We are concerned with attrition (tooth/tooth contact) in you folks out there that are grinding their teeth.
Tooth grinding affects around 40% of the population and the majority of you guys out their will do it when your sleeping. So often you are not aware that you are doing, because your sleeping!
Okay now teeth are the hardest tissue in the whole entire body, in fact tooth enamel (that’s the white material that you see on your teeth) is so strong that us dentists have to use specially designed turbine (drills) with diamond tips to remove tooth tissue.
If I was to ask you to clench as hard as you can and if we could measure the forces that you would exert on your teeth we would get a reading of 30-40 pounds per squre inch. Okay this values will mean nothing in isolation its not until we compare it to the forces that you exert on your teeth when you are grinding whilst sleeping (Bruxing). The force rise from 30-40 all the way up to a huge 300-400 pounds per square inch! That my dear friends is a 10 fold increase in force that your jaw muscles can exert on your teeth. This force coupled with the side to side movement of the lower jaw causes enormous damage to your teeth.
Now folks lets take a step back and think about the time that teeth are normally in contact when you are awake. When you tally up (that’s add up!) the total contact time for tooth to tooth contact its around 12 minutes per day! The only time your teeth come together is when you swallow (try it) and when of course we are eating. Now when we are sleeping and you are grinding your teeth, the teeth can be in contact for 4-5 hours a night and as already stated sliding from side to side at forces that are much larger than when you are awake. This will do lots of damage to your own teeth.
Now here’s the next bit, studies have shown that folks that grind don’t fall into a deep sleep and in fact they have a very restless sleep, waking up in the morning feeling tired, not well rested and sometimes with pain in their jaws, face,neck or back! Not surprising because your jaw muscles been working out all night! Like going to gym afterward your muscles will feel sore!
During the consultation I will ask the patient about therir sleeping pattern and whether they are awre of grinding their teeth. Often the answer is that I don’t sleep well but I am not aware of grinding my teeth. I ask the patient to put the question to their partner, I have had aptients that have said that they don’t but I have still requested that they ask their partner. When they come back to see me the answer to the question much to the surprise of the patient is yes! I grind my teeth and it’s been driving my partner crazy for a number of years!
Tooth grinding left untreated can lead to multiple problems such as headaches, neck pain , back pain, shortening of teeth, breaking of teeth and fillings, nerve damage to teeth, damage to the jaw joint and a lack of restful sleep!
So, why am I doing it? I can hear you asking. It seems to be stress related and the theory is that it’s a build up of mental stress during the day and the releasing of this stress when your sleeping through the night resulting in the contraction (tightening) of your jaw muscles leading to the closure of your jaws and tooth to tooth contact, sliding from side to side.
The solution is simple pick up on the problem early and put things in place that will either stop you from grinding or stop you from wearing out your own teeth. That folks is for next time!
Dr Atif Bashir
Falkirk’s Life Transformational Dentist