Both adults and kids can benefit from mouth guards when playing sport. Many kids begin contact sports and it especially important to protect newly erupting teeth to ensure a lifetime of smiles. A mouthguard can still be fitted when teeth are changing (losing baby teeth and growing new adult teeth). The best mouthguard you can get is a custom-made mouthguard from your dentist. Chemist and sport-shops may stock “boil-and-bite” mouthguards. These are not properly fitted to protect against all impact types and intensities.
Bruxism is a “parafunctional activity” which refers to the grinding and clenching of teeth that usually occurs while asleep (although it can also happen while people are awake). It is called “parafunctional” because it is a function for which the mouth and jaw were not originally intended (like speaking, chewing and breathing). The grinding and clenching of teeth can cause wear, cracks and chipping of teeth, as well as damage to the muscles and jaw joints.
For many years the cause of bruxism has been poorly known. Below are the most common suspected causes of bruxism:
Psychological stress: Anxiety and tension may cause subconscious clenching.
Physical stress: Illness, nutritional deficiency and dehydration causes the body to be under stress which can lead to parafunctional activity.
Sleep Disordered Breathing: Night time bruxism is strongly linked to difficulty breathing at night – be this snoring or even sleep apnoea. If the body isn’t getting enough oxygen, it is stressed.
Management of Bruxism
Addressing the underlying cause of bruxism is usually most beneficial. Otherwise the focus turns to protection of the teeth from further damage, while repairing any teeth already damaged.
Occlusal splint (night guard) is an acrylic guard which fits over the teeth on either the upper or lower arch to protect them from further wear. These are custom fitted, light weight and comfortable but extremely strong and resistant to wear and grinding.
Stress management and/or counselling to relax and de-stress.
Sleep disordered breathing treatment.
Medication such as pain killers and muscle relaxants.
Dental treatment to damaged teeth.
TMJ/TMD Assessment and treatment
The jaw joint is known as the TMJ (Temporomandibular Joint). Problems with the jaw joint are known as TMD (Temporomandibular Dysfunction), not “TMJ” as it is often referred to. Discomfort can be either acute, lasting only a few days or weeks and then subsiding, or chronic, lasting for years.
The TMJ is located just in front of the ears. As we open and close during speech, eating, swallowing and yawning, an articular disc moves forward and back, acting as a buffer between the condyle and the skull. Clicking and pain often occurs when the disc is out of position.
The causes are often difficult to pinpoint which can be frustrating for many patients. Some of the known and suspected causes include;
Grinding/clenching of teeth (bruxism) - particularly at night time. This can be linked to sleep and breathing problems.
Emotional stress or physical exertion can lead to tension in the muscles.
Direct injuries to the jaw.
Changes in the bite from extensive dental work (extensive crown and bridge, denture or implant work).
Rheumatoid arthritis, osteoarthritis, and even autoimmune conditions such as lupus can lead to symptoms in the TMJ.
Management of TMD
Treatment will depend upon the duration and severity of the symptoms.
Occlusal appliance therapy: Also known as“occlusal splints” are aimed at opening the bite slightly to take the load off the jaw joints and simultaneously protecting the teeth. They are most commonly worn at night, although there are daytime appliances, which can be used in more severe cases. If there is any suspicion of a sleep breathing disorder (such as sleep apnoea) this should be discussed with your dentist as the design of the appliance may change.
Exercises and physiotherapy
Cold and heat packs
Behaviour modification and stress management