Teeth grinders! Mind over Matter doesn’t work!

By: Belle DuCharme, CDPMA, Editor, Director of PACE/CE

Ever told yourself that weight loss is mind over matter or that correcting any bad habit is simply saying “I am not going to do that anymore?” So, how is that working for you?

For years I have been a bruxer or night time tooth grinder.  A plunger cusp on the upper left second molar didn’t help and eventually both #18 and 19 were so badly cracked that both needed crowns and #18 eventually went south to need endodontic therapy.  Neither were decayed.

The tragedy here is it was preventable but I would not wear my nightguard.  I had convinced myself that I didn’t need a piece of plastic in my mouth at night to save my teeth—that I could control my mind not to grind.   Not so.

When you are sleeping there are forces within your subconscious that you cannot control.   Recently after putting another 1,000.00 into my mouth for chipped and fractured anterior teeth due to bruxism, I made a pledge to wear my nightguard or orthotic splint (correct term) every night.  That was 5 months ago and I have worn it every night.   No more chipped or broken teeth for me.  I told myself there were no other options–I had to wear it.

Dentists routinely recommend or say diagnose and prescribe orthotic splints or occlusal guards (night guards) for patients that by evidence show signs of wear by grinding on their natural teeth and on restorations.  This grinding which is powerful and destructive not only on the teeth and the restorations but also on the ligaments and bone that support the teeth in the jaw.   Most people are not aware of the damage being done and don’t face the fact until the bite has collapsed into itself and now will cost thousands to correct.

It is important to note that not all patients have pain in the jaw or headaches when they grind at night.  I never did yet the damage was profound.

With every occlusal guard or orthotic splint that is recommended maybe 1 in 4 will agree to it because of the expense or the insurance coverage.  Don’t let that stop you from educating patients.  Every time that patient is examined for signs of more wear, chipping, craze line fractures etc. will be an opportunity to demonstrate the need.  Eventually most patients will agree to get one and now the next step is getting them to wear it.  

Many people exercise at home to get in shape and try weight loss plans that don’t work because the intention is to follow the plan but the results are poor.  People need to be monitored and counseled for best results.  That is why medical systems to monitor weight loss works and having a trainer at the gym has better results.

Be your patient’s trainer to better teeth.  When delivering the orthotic or occlusal guard, instruct the patient to come in for an evaluation every month to help support the new habit of wearing the mouthpiece every night.  Offer to clean and adjust the occlusal guard at the visit.  Discuss ways to remember to put the occlusal guard in at night, how to clean it and where to store it for better compliance.   For instance, keep the orthotic in a plastic case next to the bed (out of reach of pets).  Out of sight is out of mind—so keep it in sight.  If the patient travels for work suggest having two made for a special fee so that one can be kept in the travel case.

The dental teams are healthcare providers but also advocates and a necessary support resource for patients who must develop healthier habits to keep their teeth.

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