The Whole Tooth

Gnashing Of Teeth Can Hurt You More Than Your Source Of Stress

By John R. Lake, Jr., DDS, MAGD

We all deal with stressful situations every day. The effect of stress is well documented to be harmful to most of us. It is often reflected in numerous ways in the mouth.

One of the most common complaints is pain and limitation of function of the joints that allow the lower jaw to function. These are thetemporomandibular joints, TMJ for short.

Dysfunction of the TMJ is a very individual situation. The many symptoms can vary from patient to patient. Stress seems to play a role in making things worse.

Of the many TMJ cases I have treated over 30 years, the vast majority of complainants are female. Could it be that living with men is what causes so much gnashing of teeth?

Correcting TMJ dysfunction is a challenging task. There is an ideal orientation of one’s teeth that allows the TMJ and all the muscles, ligaments and tendons affiliated with them to function in a smooth and healthy manner. Few of us have the ideal.

Malposition of teeth can be the result of many factors. These can include orthodontic treatment (or lack of it), broken teeth, worn teeth, and teeth restored too high or too low. All are part of what we describe as occlusion.

When a patient presents with TMJ pain and dysfunction it is difficult to immediately assess the causes as the swelling and malposition of the TMJ needs to be addressed first.

In a conservative manner, we provide the following home care instructions:

• Soft diet & no caffeine;
• Place tongue up to roof of mouth & keep teeth apart;
• Chew on both sides of your mouth;
• No oral habits such as chewing gum or pencils;
• No excessive or prolonged opening of the mouth;
• Moist heat for 10 minutes;
• Ice & gentle massage for 5 minutes;
• Alternate heat & ice for thermal contrast therapy;
• Massage;
• Gentle range of motion exercises

We also recommend nutritional supplements including specific dosages of Glucosamine, Chrondroitin Sulfate, Calcium, Magnesium, Vitamin C, Vitamin E, Beta Carotene and an over-the-counter analgesic (such as Advil).

If these are not enough, we often provide an occlusal or night guard that usually is quite successful.

After the patient wears this for a period of time and describes a comfort level, we’ll evaluate the occlusion.

Treatment may progress with simple adjustment of tooth surfaces or it may require reconstruction that can require orthodontia. This is up to the patient. Often continued use of the night guard with periodic maintenance is the end of treatment.

Insurance companies generally do not cover this treatment. One would think that care that protects the teeth and prevents future problems would be covered by the insurance companies. But they disagree. Ergo: more stress.

 (Dr. Lake practices at Lightship Dental in Marstons Mills, 508-428-4929 or lightshipdental@verizon.net.)