How Night Guards Protect Your Teeth from Bruxism

Dr. Diamandis was recently interviewed on CBC radio, about how stress and the unknowns about the pandemic are causing many people to suffer from bruxism (grinding teeth either during the day or at night). Listen in or read the transcript below.

Radio Host
This next part is going to apply I think to a lot of people out there who are listening and who are just waking up right now. If you grind your teeth when you sleep, you might know this feeling having that achy, tight jaw in the morning, maybe even cracked teeth if you’re really unlucky. And some dentists say they’re seeing more and more of this during the pandemic. And here with what you can do about it is Athena Diamandis, she is an associate dentist at Montreal West Dentistry, and she joins us on the line this morning. Good morning.

Dr. Diamandis
Good morning.

Radio Host
What have you been seeing in your practice lately?

Dr. Diamandis
Well, in the last about, what is it 22 months now, we’ve been getting a lot of calls for emergency treatment for broken teeth. And sometimes these are teeth that we had an eye on, and that we had plans to be treating further with a crown or something like that. And because of whatever circumstances due to the pandemic, the patient never got around to it. But other times, we’re seeing teeth that were in really good condition that now come up as fractured or chipped. So that’s definitely a shift in what we’re seeing. And a lot of times people are reporting that this is coming up because they find that they’re way more stressed. And that manifests itself with them clenching or grinding their teeth. So the official term for that is bruxism. And it is a combination between clenching, which is clamping down your teeth really hard. And or grinding the teeth, which is really sliding side to side. And, you know, some people will do it throughout their day, because they are that much more stressed out. And if you’re doing it during the day, then there’s a pretty good chance that you’re also doing it at night when you’re not really conscious of what’s happening.

Radio Host
And so that was my next question, which is how, how aware are most people that they are actually doing this?

Dr. Diamandis
Well, some people are quite aware of it. Others it’s when they come in, and we start investigating a little bit because of what we’re seeing in the mouth or because of what they’re reporting. Classic symptoms are, as you mentioned, soreness or aching in the jaw, especially in the morning. Some people will actually report headaches. And then when we’re looking into the mouth, we’re noticing that there’s significant wear on the teeth that might not necessarily jive with the person’s age. And sometimes we’ll see little micro fractures on the teeth or chipping of the teeth. One thing I would like to mention, though, that’s very important is that bruxism or clenching, and grinding can really be a sign of sleep apnea. So if people have any doubts about whether or not they’re doing this, they should definitely bring it up when they’re seeing the dentist and their physician as well.

Radio Host
Maybe it’s a bit technical to get into, but what is the connection there? Why is bruxism associated with sleep apnea?

Dr. Diamandis
Well, they’ve noticed that this is something that comes up a whole lot in patients with sleep apnea. And in doing all the testing that goes with diagnosing that, it is a symptom that comes up quite often.

Radio Host
You mentioned stress, what do you think it is that is causing the stress? I mean, maybe, maybe that’s an obvious question, given that we’re living through a global pandemic, but why do you think you are seeing so many people who are feeling that much more stress?

Dr. Diamandis
I think it’s the circumstances, there’s so much uncertainty. Are things going to be open, or closed? I think remote working is a big component. With regards to that, what I’m hearing from patients some people love working from home, it gives them flexibility. Others just feel like the workday never ends. It starts in the morning and it carries on throughout their entire day. And there they have to be constantly available so it seems like it never ends. Then there’s the stress of child care and and there’s all these factors, little things that at the end of the day, little and big things that at the end of the day accumulate and ends up showing signs and symptoms in someone’s body.

Radio Host
And who does this tend to affect? Do you see any commonalities in the patients that you’re seeing?

Dr. Diamandis
It actually carries throughout the entire spectrum. We’re seeing it in younger kids. We’re seeing it in young adults concerned about what’s going to happen with Cegep or university? Is it on? Is it off? Will I get to see my friends or not? And then obviously everyone that’s in the workforce, but it doesn’t stop there. There are also the people that are retired. Then there’s the whole social aspect of will I get to see my family. So it’s not just one kind of specific patient profile.

Radio Host
Some one might say, okay, I’m grinding my teeth, I’ve been stressed out, I’ll try to be less stressed out. How urgent is it have this problem get fixed?

Dr. Diamandis
I think most people will realize it on their own. And the more we talk about it, the more they realize that oh, wow. Okay, yes, this is definitely something that’s affecting me. So, some of the easiest things that people can try to implement is good sleep hygiene. And that means try to limit your caffeine intake throughout the day, and especially in the afternoon, so that when it’s time to go to bed, you’re not wired, because of all the caffeine. Sometimes I’ll suggest that people try to relax before going to bed, maybe using some hot compresses on the muscles of their face, to help relax those muscles. And if it gets to the point where it can be quite debilitating for some people, that’s when the discussion for a night guard may come up.

Radio Host
And as you were talking, I was just sort of massaging the jaw muscles. Thinking about this is making me think about it. But you know, I do have this problem. I do grind my teeth, I did end up getting a mouth guard. Is that something that you that you recommend?

Dr. Diamandis
Yes, definitely. So just to make everyone aware of what we’re talking about. A night guard is basically a custom made acrylic appliance that’s worn at night, either on the top or bottom teeth. The idea is to help protect the entire dentition by allowing the patient to wear this at night and to wear away at the appliance rather than their teeth. And it helps to elongate the muscles of the face. So that provides some relaxation. And it also makes for the jaw to be able to generate a little bit less force when grinding teeth.

Radio Host
And how much does a device like that cost?

Dr. Diamandis
Well, the pricing can definitely fluctuate. There is a range there. But what I can tell you for a fact is that getting a night guard will definitely cost you much less than having to need a crown or root canal because of a fractured tooth. So getting a night guard is definitely a good investment.

Radio Host
So this is in a few $100 range, but less than major dental work.

Dr. Diamandis
Absolutely.

Radio Host
It is possible to buy these mouthguard kits that you can mold yourself at home? If you look online, what do you make of those options?

Dr. Diamandis
I think what’s available, let’s say at the pharmacy is it’s, you know, an okay idea. What we often see is that some patients will try it before actually getting the real night guard, or the one that we make at the office. And what they’ll notice is that it can be something that’s quite bulky, because it’s not custom made for them. So it’s an alternative, especially if someone’s in the midst of getting extensive dental work. But often times people will shift to getting something custom made.

Radio Host
You mentioned that some people may have missed dental appointments or been putting things off during the pandemic, what are some of the other things that you’re seeing that we should be keeping in mind and watching out for in terms of our dental health?

Dr. Diamandis
As mentioned before, remote working has really shifted how people function in general. So we’re seeing that fluidity, we are seeing some of the habits getting lost, since you’re not actually physically leaving home to go to the office, for example. So oral hygiene, sometimes can fall into that. So a lot of patients will be maybe brushing less, flossing less and that can obviously carry over and end up causing you major or more significant issues in the mouth. The other thing that I’m noticing is people’s dietary habits are changing. You’re sitting in front of a computer for a greater part of your day, you may be much more frequently sipping on something as it’s more readily available, you may be snacking more frequently. And it’s that increase in frequency, that can actually increase the rate of cavities in some individuals or even the rate of cavity progression. So it’s those things that we’re noticing. And going hand in hand with the stress factor that we mentioned earlier. You know, more people are dealing with anxiety and depression, whether it’s been triggered by the pandemic, or just exacerbated. And that means that more people are taking anti-anxiety medications and antidepressants. And unfortunately, some of these medications have as a side effect – dry mouth. Now we don’t give saliva all the credit it needs. But saliva is actually very, very important in the protection of the teeth against cavity. So if you have if you have less of it, then you’re much more at risk for cavities.

Radio Host
So what should you do about that, drink more water or what is the solution?

Dr. Diamandis
Yes, you know what? Flat water without any additives in it. No lemons, not limes. No herbs. Oh, herbs, they’re not a bad thing. But no lemons and limes for sure. Plain flat water is probably the best thing you can do for your teeth.

Radio Host
Alright, so drink water and try to wind down before bed, less caffeine. Lots of good things to keep in mind. Thank you so much, Dr. Diamandis, for joining us this morning.

Dr. Diamandis
Thank you very much.

Radio Host
That is Dr. Athena Diamandis who is an associate dentist at Montreal West dentistry.

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