“Biting the bullet” is a slang phrase that dates back to the Civil War, and there’s no doubt that humans can bite strong enough to dent Civil War-era lead bullets. Healthy teeth can withstand heavy biting forces during normal function such as chewing food and swallowing.
However, when these forces are exerted beyond function, such as during grinding or clenching teeth, considerable irreversible damage can happen to teeth, gums and jaw bone. Other components of the chewing system — the jaw joint and facial muscles — also could be affected, especially when the magnitude of these forces exceeds their adaptive capacity.
Although grinding and clenching teeth is a frequent sleep habit with approximately 8 percent of the general population, it has not been adequately recognized by the public as a cause of tooth loss when compared to cavities and gum disease. Grinding and clenching wear off and crack enamel, making teeth susceptible to fracture. Enamel, the strongest part of the human body, will not break while eating soft food unless teeth have been considerably weakened by such trauma.
If you wake up tired with headaches, muscle and jaw soreness, your chewing muscles may have had quite a workout during sleep. A grinding and clenching habit is considered a sleep-related disorder that affects quality of life. Most people are not even aware of that habit and it is not necessarily recognized by bed partners. However, wear patterns in teeth can show that grinding has occurred and is easily recognized by dentists.
Traditionally, it was believed that the way teeth bite together was the main cause of sleep grinding and clenching. Currently, other factors such as genetics, recreational drugs, medications, emotional stress and anxiety have been added to the mix. Grinding also has been associated with other sleep disorders. Nearly one in four patients with obstructive sleep apnea suffers from sleep teeth grinding; that is thought to be an inherent defense mechanism of the brain to decrease the obstruction of the upper airway during sleep.
A grinding and clenching habit is difficult to control and has no permanent cure so far. The most common approach is to protect teeth against damage by wearing a mouthguard during sleep. All types of over-the-counter soft mouthguards are helpful. However, if used for long periods, they can put the jaw joint out of alignment and the muscles under additional stress.
Professionally custom-made hard sleep mouthguards are designed to simulate ideal bite relationships without disrupting the harmony between all the components of the chewing system.
— Samer Alassaad has a private dental practice in Davis. Contact him at [email protected]