Grinding & bite raising

Teeth grinding | Bruxism

Grinding or clenching occurs during the day and at night and gradually wears away valuable tooth substance.

Bruxism is a common dysfunction of the masticatory apparatus affecting people of all ages. It occurs by day as waking bruxism and at night as sleep bruxism, which cannot be controlled. Many show no symptoms while tooth substance is lost, often leading to a loss of bite height and jaw joint pain.

Common causes include everyday stress and malocclusion, for example from crowns or fillings that are too high, as well as sleep disorders, reflux, alcohol, caffeine and certain medications.

We diagnose bruxism by taking a history and examining the teeth, muscles and bite. The most effective treatment is an occlusal splint; finding the cause is just as important.

Bite elevation

A bite elevation restores optimal jaw and tooth spacing in worn teeth, and with it function and aesthetics.

Decay, periodontitis, accidents or abrasion, for example from grinding, cost tooth substance and bite height; the front teeth in particular become shorter. The treatment is primarily functional, and we also address the causes so that they do not recur.

We begin with a clinical functional analysis and impressions. For teeth not yet badly worn, a Michigan splint is the therapy of choice; advanced wear requires ceramic crowns or tabletops.

With temporary dentures, we determine the optimal bite height in a test phase of 3–12 months before the definitive ceramic restoration follows. Dr. Nina van Sprundel has written numerous publications on bite elevation after erosion damage.

Splint against teeth grinding

A custom-made occlusal splint protects the teeth from abrasion and relieves the muscles and jaw joints.

Teeth grinding itself cannot be cured, but it can be reduced. The most effective treatment for craniomandibular dysfunction (TMD) is the occlusal splint. It should be worn consistently every night; if the discomfort subsides quickly, the therapy may end after a few weeks.

We often use a Michigan splint made of hard plastic, which covers all the teeth of the upper jaw and which we make especially for you. It distributes pressure evenly when you clench, relaxes the jaw muscles and relieves the temporomandibular joints. In the long term, it can correct the malocclusion and prepare for rebuilding worn tooth substance.

Botox against teeth grinding

Botulinum toxin, injected into the large jaw muscle, can counteract teeth grinding.

Botulinum toxin, known as «Botox», is injected into the large jaw muscle on both sides. Chewing is not affected. The full effect occurs after around 14 days and lasts for up to six months; because of the reduced effect, a repeat treatment is recommended after 4 months.

In contrast to splint therapy, the treatment stops the grinding: the muscle relaxes over time and the enlarged jaw muscle recedes. Possible side effects include small bruises at the injection sites and, in rare cases, dry mouth.

In principle, it is suitable for all patients with bruxism. Pregnant women, breastfeeding mothers and people with neuromuscular diseases should avoid Botox.