Temporomandibular joint disorder, called TMJ or TMD, is a complicated group of problems related to the temporomandibular joint, the joint that attaches your jaw to your skull. This is the busiest joint in the body and is the only one with two joints working in unison. TMJ and tooth destruction as a result of decay, tooth loss, or grinding, go hand in hand and may be both a cause and an effect of TMJ.
Causes of Bruxism
When analyzing the risk of tooth destruction from bruxism, we have to isolate the cause of your clenching and grinding behavior. Some common causes of bruxism include:
- TMJ
- Anxiety
- Depression
- Lifestyle
- Medications
There are several forms of TMJ. The one most associated with destructive bruxism occurs when your jaw is out of balance. When this happens, your muscles cannot get into a good resting position, but they try. The jaw muscles strain against the teeth to achieve a resting position, creating a destructive clenching.
Psychological factors contribute to many clenching and grinding behaviors. While we associate clenching with stress and anxiety, it’s also common among people with depression.
Some lifestyle factors can increase a person’s risk of bruxism. Caffeine, alcohol, and tobacco use can all make it more likely that you will clench and grind your teeth.
Bruxism is a common medication side effect. If you recently started a new medication, ask your doctor if bruxism is a possible side effect.
Types of Tooth Damage from Bruxism
Bruxism can destroy your teeth in many ways. With bruxism, you might experience:
- Grinding
- Chips
- Cracks
- Abfraction
- Receding gums
Grinding damage is when your tooth enamel wears away in small particles. In some cases, you might perceive this as grit in your mouth, but often people don’t notice damage of this type until their teeth are smaller or sensitive.
Chipped teeth occur when larger fragments of tooth enamel break off. These enamel pieces are sometimes noticeable as chunks in your mouth, or you might notice the sharp tooth edges they leave behind.
Cracks in your enamel occur when the force of clenching and grinding causes a tooth to split. The split might penetrate deep into the tooth pulp or the tooth root.
When you clench your teeth, you compress them. You might think your teeth are inflexible, but they can actually squish. Your teeth are structured a little like a Tootsie Pop–hard enamel on the outside, with a softer, more flexible interior. When a tooth squishes, sometimes the enamel flakes off where it’s thinnest: at the neck of the tooth, near your gums, we call this abfraction.
Abfraction and the excessive force of clenching and grinding aren’t good for your gums, either. They can lead to receding gums, making your teeth vulnerable to root cavities, which can lead to tooth loss.
Factors That Accelerate Tooth Damage from Bruxism
The strength of your teeth helps them resist damage from bruxism. Anything that weakens your teeth will speed the pace of tooth damage. In particular, acid weakens your tooth enamel. So you might experience faster tooth destruction because of:
- Tooth decay
- Consuming acidic foods and drinks
- Dehydration or dry mouth
- GERD
Tooth decay is when bacteria in your mouth attack your teeth with acid. This leads to cavities, but it can also weaken your teeth against bruxism. Weakened enamel wears away faster, and a minor cavity can serve as the starting point for a chip or crack.
Acidic drinks like soda, fruit juice, wine, and more can significantly weaken your teeth. Eating acidic foods like citrus, hot sauce, pickles, and more weakens your teeth. People who rinse daily with vinegar or lemon water might see more damage from bruxism.
Saliva neutralizes acid in the mouth, so if you’re dehydrated or have dry mouth (xerostomia), your mouth might be more acidic, weakening your teeth.
Gastroesophageal reflux disease (GERD) causes stomach acids to bubble into the mouth. This weakens your teeth and accelerates the pace of tooth destruction.
TMJ Symptoms Related to Bruxism
Whether you experience TMJ because of bruxism or if bruxism caused your TMJ, the effect can be the same. You might experience numerous symptoms that interfere with your daily life, such as:
- Jaw pain
- Headaches
- Facial pain
- Tinnitus
- Locked jaw
- Popping or clicking noises
As the pain worsens, the damage to the teeth may increase and cause a downward spiral of tooth destruction and aggravating TMJ. The neuromuscular dentist is specially trained to determine the underlying cause of your pain and establish a treatment plan to get your jaw back into alignment.
Repairing Tooth Damage from Bruxism
If you are a bruxer, we must first identify the cause of your bruxism and treat it before we start repairing the damage it’s caused.
Once your bruxism is controlled, we can restore your damaged teeth with appropriate restorations. Porcelain veneers work well for chipped or worn teeth. Cracked teeth and abfractions might require dental crowns to treat. For serious cracks, root canal therapy heads off or treats tooth pulp infection. If a tooth is badly cracked, we might need to extract it and replace it–usually with a dental implant.
We will recommend the ongoing use of a bite guard to protect your restored teeth against further damage.
To find out more about TMD and tooth destruction or grinding problems, please call (248) 656-2020 to schedule a consultation with the TMD specialists at Rochester Advanced Dentistry to schedule an appointment.
