Grinding or clenching the teeth at night is a very common habit, which is known to dentists and doctors as bruxism. Because bruxism happens while you’re sleeping, you have no control over this particular habit, and it can be damaging. Over the course of years, grinding or clenching can wear down the teeth.
In many cases, a dentist may prescribe a nightguard to reduce the damage to your teeth. However, in some cases, this treatment method could actually be dangerous. Why? To understand this issue, it’s helpful to know a bit about night guards for bruxism.
WHAT IS A NIGHT GUARD?
A night guard is a plastic dental appliance that fits over the top teeth. When grinding or clenching, much of the force will be transferred to the night guard instead of to the teeth. Often, deep grooves will eventually form in the night guard from the force of the grinding. The night guard prevents this same force from causing damage to the teeth. Without a nightguard, enamel can be worn down excessively, leading to tooth sensitivity. Teeth may also be chipped or cracked, requiring extensive restorative dental treatments to repair them.
WHY IS A NIGHT GUARD NOT ALWAYS A GOOD IDEA?
The problem with using a nightguard is that it only addresses the symptoms – the damage to the teeth that bruxism can cause. However, a night guard doesn’t get to the root cause of grinding the teeth. A person wearing a nightguard will usually continue to grind and clench the teeth.
There are many potential causes of teeth grinding. Very commonly, the cause is stress, and in many cases, a specific cause is never found. However, there are also many cases in which grinding the teeth at night is actually a symptom of a life-threatening illness – sleep apnea. Prescribing a nightguard to a person with sleep apnea will stop the teeth from becoming damaged, but will not address the much more serious issue of keeping the person breathing at night.
HOW ARE SLEEP APNEA AND TEETH GRINDING RELATED?
At night, when you can’t breathe, the body will automatically attempt to reopen the airway through a reflex mechanism. One of the ways that the body can do this is through grinding or clenching the teeth. This action will tend to bring the lower jaw forward and open up the airway. The grinding motion also moves the jaw from side to side, helping to create airway space.
The scientific evidence that bruxism can be a symptom of sleep apnea has come from studies that were relatively recent, and not all dentists are aware of this information yet. This is why many dentists are still prescribing night guards for bruxism without screening for sleep apnea.
DOES THIS MEAN THAT A NIGHT GUARD IS NEVER THE RIGHT TREATMENT?
Nightguards can protect the teeth from significant damage and maybe a recommended treatment for bruxism. However, those who grind or clench the teeth at night should be screened for sleep apnea before being fitted for a nightguard. Some experts actually recommend a sleep study for every bruxism patient, while others believe that a screening test is sufficient (though it should be followed by a sleep study if the screening test shows possible sleep apnea). If the patient turns out to have sleep apnea, then treatment of this disorder should take priority. If the patient doesn’t have sleep apnea, then a nightguard will most likely be the best treatment for the patient’s bruxism.
HOW IS SLEEP APNEA TREATED?
The treatment for sleep apnea depends on many factors. Many patients prefer oral device treatment because it’s more comfortable and better tolerated than other forms of treatment. This consists of a small device worn in the patient’s mouth at night, to help hold the airway open. Another common treatment is a CPAP machine, which blows air into the face through a mask worn at night in order to push the airway open. When other forms of treatment have not been effective, jaw surgery can help some patients.
CAN I USE A NIGHT GUARD ALONG WITH MY SLEEP APNEA TREATMENT?
Reestablishing an open airway at night will not only improve the patient’s general health and quality of life but often will also stop or greatly reduce the grinding and clenching as well. Once the body no longer needs to push the jaw forward in order to breathe, then there will be no need for the body to activate a grinding response. In many cases, grinding will stop and a nightguard will no longer be necessary once the sleep apnea has been addressed.
In addition, many sleep apnea oral devices also address the problem of grinding. For example, mandibular advancement devices fit over the teeth to hold the lower jaw in a forward position. This also allows them to protect the teeth from the forces of grinding (if grinding still occurs).
LEARN MORE FROM A DENTIST IN MELBOURNE AREA
If you’re interested in learning more about night guards, or if you think that you may have sleep apnea, please visit our office for a consultation. After a screening test, our doctors use a convenient home sleep study for those who show possible signs of sleep apnea. Contact us today to set up your appointment.