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When we eat, our teeth generally crush food and rather surprisingly we do not wear our teeth away much.
If this was the only wear going on, our teeth would last well beyond our lifespan.
Unfortunately some of us grind our teeth directly against the opposing set for no "good" reason and because it has no function we call it a "parafunctional activity" , in this particular case, also known as bruxism.
There are different patterns of grinding which includes clenchers, grinders and rockers, the latter rocking backwards and forth against a single tooth. Some people do it during the day, some at night. Some damage front teeth, some damage back teeth. Some loosen teeth, some wear teeth away and some split or crack teeth.
It is common in many of us in late teenage years but many of us leave it behind, a few show recurrence in stressful times and some retain the problem for life.
Its not known why people brux. It can occur in someone with a perfect occlusion (how they bite together) or in someone with a massive discrepancy.
I have seen cases where teeth have been ground to stumps at gum level by sixty years of age and where the tooth nerve has been killed before forty.
Bruxing destroys teeth and it also destroys dentistry. If we place a near" indestructible" restoration in opposition to this destructive force, the patient may either wreck the opposing tooth or damage the tissue that supports our strong restoration.
Treatments are oriented towards preventing damage by four methods:
If there is a daytime trigger such as sitting at a work station or driving we can try to train against it.
Soft night guards help some people although experts in occlusion are dismissive of these.
Bite appliances are rigid plastic appliances that can help diagnostically and also protect.
Deprogrammers of various designs that can switch off grinding for short periods.
In some patients the destructive forces are not visible on their teeth but they will complain of headaches, sometimes specifically associated with a time of day or on waking and sometimes with a consistent location.
This group exhibit Myofacial Pain Dysfunction syndrome or pain referred from a muscle that is regularly in spasm, therefore generating lactic acid and remaining tender and inflamed. In other words a muscle cramp. Because our brains are not fully aware of the source of the pain in terms of "body mapping" (because of our complex nerve pathways in this area) a "guessed area" is associated with it. (known as pain referral)