Dr Margaret answers e-mailers' embarrassing problems in this biweekly problem page.

Tooth grinding

Dear Dr Margaret
My partner says I grind my teeth in the night. How can I stop when I don’t even know that I’m doing it?

Like you, most people are unaware that they are grinding their teeth during sleep, and they find out only because their partner complains. When they wake up they may feel discomfort or pain in the jaw, shoulders, or neck, or have a headache, but they will not know the cause.

Tooth grinding is sometimes caused by the upper and lower teeth not fitting together properly – dentists call this ‘malocclusion’. The grinding may be a subconscious attempt to grind them down until they fit. Some people who grind their teeth have a problem with the joint of their jaw (where the jaw hinges onto the skull). Clicking or grating of the joint, or occasional locking of the jaw, suggests a joint problem.

Another possibility is stress. Dentists say that tooth grinding is becoming increasingly common, which may be a sign that we live in a stressful society. Apparently tooth grinding usually occurs during the dreaming phases of sleep.

Your dentist should be your first port of call. The dentist will tell you if there is abnormal wear and tear of your teeth, and whether the grinding has damaged the enamel. Serious damage to the enamel is fairly unlikely. Unfortunately, enamel does not repair itself (a design fault of the human body) so, if the enamel has been damaged, the teeth might need to be crowned.

To help you break the grinding habit, your dentist may make a night-guard for you to wear, This is a plastic appliance that keeps the teeth apart, and allows your muscles to relax into a normal position. Sometimes a dentist can relieve the problem by slightly grinding down some of your teeth, so they meet correctly – doing the job you were trying to do in your sleep.

If you think stress is a factor, work out ways of reducing it or coping. Look in your local library for self-help books on stress. Anything that helps to relax you – such as massage, yoga or exercise – would be worth trying.

If you want to know more, there is a nice little website about teeth grinding on www.teethgrinding.org/html/understanding_bruxism.html. From it I learned that may be over 40 million people grind their teeth destructively, so you are not alone.

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