Last week, a new patient arrived in the office. Her chief complaint was of sharp pain in her right cheek. Pressing in that spot only brought more pain. She thought that she needed a root canal. In a few minutes, the dentist was able to determine that her teeth are fine, but she clenches and grinds her teeth. The dentist calls grinding teeth bruxing or bruxism.
Some people grind their teeth due to physical stress; witness people at the gym who grit their teeth as they do weight training. Others will grind their teeth while driving in traffic. Many grind their teeth while they sleep.
There are some simple ways to tell if someone bruxes or grinds their teeth. Pain is one of the more obvious symptoms. Bruxing can make teeth sensitive to cold air and liquid. Another common symptom is soreness in the muscles of the jaw and up to the temples. Some patients refer to jaw pain as a tension headache. Occasionally, patients do not notice that they are in pain. Even so, the dentist may notice other signs of grinding. Those patients can ask a friend or family member to listen to determine if they grind their teeth at night.
Often, patients do not realize that they grind their teeth. The dentist makes the diagnosis based on seeing a pattern of severe wear on the biting surfaces of the teeth. Sometimes, the teeth are worn short and smooth by grinding. Firm pressure on healthy facial muscles does not cause pain. Pressure on tense, overused muscles does result in sharp pain. Expect dentists to check muscles around the sides of the head, cheeks, lower jaw and neck for soreness.
Stress and tension will increase grinding intensity and frequency. Treatment should include identifying causes of stress and attempting to diminish them. The dentist will recommend a mouth guard for the patient. Mouth guards made by a dentist are very different from sports mouth guards sold with sports equipment. Dentist-fabricated mouth guards are made to fit closely and adjusted to provide the teeth with an even bite.
If there is a recent increase in pain or muscle tightness, try the following recommendations for one week:
1. Maintain a soft diet. Do not eat anything firm or crunchy.
2. Limit mouth opening to the width of two fingers.
3. Those who are able to take ibuprofen or aspirin should take a therapeutic dose for one week. That amounts to 1,000 milligrams of aspirin or 600 to 800 milligrams of ibuprofen.
The pain should subside within a few days, but continue following these recommendations for the full week. See a dentist if the pain does not subside within a week or if the pain returns.
The information in the article is not intended to substitute for the medical expertise and advice of your health care provider. We encourage you to discuss any decisions about treatment or care with an appropriate medical professional.
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