Dr. Enrico DiVito is a general and cosmetic dentist who specializes in laser dentistry at the Arizona Center for Laser Dentistry in North Scottsdale. A graduate of Arizona State University and the University of the Pacific Arthur A. Dugoni School of Dentistry in San Francisco, Dr. DiVito returned to Arizona and established a private practice in 1980. He founded the Arizona Center for Laser Dentistry in 2007. Here, he tells us what options are available for people suffering from nighttime grinding.
One of the first thing that patients who are nighttime grinders should do after determining what is going on while they sleep is to seek a dentist who has a strong familiarity and background in treating TMJ and teeth grinding. This should be the patient’s first line of defense—not visiting an ENT (ear nose and throat) doctor or a general physician. I say this because many of these doctors are not qualified to identify and treat TMJ, which is usually what is leading to the clenching and grinding in the first place.
Just to give everyone some background, TMJ—which an acronym that stands for temporomandibular joint disorder—is essentially a term that we use to describe when patients’ jaw joints are not in line. So people who are suffering from clenching or grinding of the teeth, jaw pain, or neck pain might very well be suffering from TMJ. When a jaw is misaligned, it can cause a myriad of problems including headaches and pain. So TMJ can cause a patient to grind or clench his teeth at night, which can in turn lead to excessive amounts of wear and tear on the teeth themselves. And of course, this wear and tear isn’t just bad for the health of the teeth—it can also lead to a lot of pain for people.
Does everyone who is clenching their teeth on a nightly basis have TMJ? No. But I will tell you that after my years of experience, I have learned that in the majority of cases when a patient is grinding his or her teeth for a period of weeks, it is usually an indication of an underlying TMJ problem.
We treat TMJ in a number of therapeutic ways. In fact, we have a number of options available since so many specificities are involved in issues like this. When a patient says that he or she is experiencing clicking of the jaw, that could easily be a sign that his jaw is out of alignment. So in situations like that, we will work to line the jaw up correctly to hopefully alleviate that clicking along with the grinding at night. Lining the jaw back up can be a great way to alleviate neck pain and headaches that patients might not even realize are connected to the original issue, as well.
Another treatment option that we use is to fit patients for a mouth guard that they will wear while they sleep at night. In many cases, a mouthpiece can be helpful for people. However it must be one that is custom fit in order for it to work. We do not approve of those generic mouth guards that people can buy at a sports shop or a drug store that will supposedly stop their clenching at night. In fact, those mouth guards can actually hurt a patient over time, since they are not fitted properly and might cause the teeth in the mouth to shift. So, while mouth guards are typically the best-known treatment option for nighttime grinders, it is important that people do not try to take the matter into their own hands and handle it themselves.
Overall, I think it is important that people visit their dentist first when determining the cause of their nighttime grinding. Rather than visiting an ENT specialist or a general physician—who probably do not have nearly as much experiencing treating patients with these issues—or trying to handle it yourself by buying a mouth guard at the drug store, people should simply make an appointment with their dentist to find out about what options might be the best fit and solution for their individual grinding problem.
The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.
