What Your Dentist Doesn't Know Can Hurt You

By Andrew Trenton Weil

Over one million Americans wake up each morning in significant pain from nighttime teeth grinding and clenching (bruxism). Does the fact that these people remain in pain every day mean they all don't have dentists? No, actually most of these people have dentists. Unfortunately, while most dentists are expert at preventing tooth damage and repairing damaged teeth, they are taught little or nothing in dental school about the psychology of habits, and most long-term tooth grinding and clenching is a habit most people would very much like to kick.

So what does it take to kick the habit of tooth grinding and clenching? As you might suspect from thinking about other habits (such as smoking, over-eating, drinking, or nail biting), the answer is different for different people. The "solution" that most dentists currently recommend is a custom-made mouth guard.

There are many variations of the custom mouth guards that dentists recommend, most costing between $500 and $800. Different dentists disagree strongly on which is the "best" type of mouth guard to use. Some are thin plastic, made by vacuum-molding a hot thin sheet of plastic over a plaster replica of your upper teeth. Some are hard plastic cast in a mold made from an impression of both your upper and lower teeth.

It's not unusual for people to follow their dentist's advice and plunk down between $500 and $800 for a custom-made mouth guard. Once you put out the big bucks, you get to find out if you are someone whose nighttime clenching gets worse or better when you wear your custom mouth guard.

"Wait a minute" you might say, "did you say my clenching could get worse?" It certainly could. You see, the problem is that while mouth guards obviously protect your teeth, they don't necessarily make you bite less. The nature of the tooth grinding and clenching habit for some people is that a mouth guard is more of an annoyance to be chewed through than a signal to relax.

Most mouth guards are made to sit between your upper and lower molars, and spread the load if you clench your teeth, the idea being that even if you keep clenching, the mouth guard will help you do less damage. Sometimes this may work. Sometimes the damage done becomes much worse with a mouth guard.

Some mouth guards (notably the "NTI") are made to snap on to your front teeth and prevent your molars from touching, even if you bite down. The theory here is that the NTI will feel so different than a normal bite that your mind will know (even subconsciously) that something is wrong, and it is not safe to bite down. Sometimes that works. In the cases when it does not work, biting down on a front-tooth-only guard such as the NTI can misalign your jaw and do serious damage.

Fortunately, there are many other ways to interrupt a habit besides using a mouth guard. Some methods are free to try, some are moderately expensive, and some can be quite expensive to try. Some offer money-back guarantees, and some don't. The methods that people have successfully used to rid themselves of the teeth grinding and clenching habit include: hypnosis, biofeedback, using a comfort-improving mattress pad, soothing sound machines, changing to a new pillow, chiropractic work, diet changes, massage, meditation, and other positive psychology practices.

Interestingly, the mouth guards sold by dentists are not only among the most expensive possible solutions you can try for teeth grinding and clenching, they are also among the options with no free trial, and no guarantee whatsoever. This is a great deal for your dentist, but not a great deal for you. Trying an over-the-counter mouth guard from a pharmacy that you can mold yourself may be a better first step. - 29879

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