How can I make the pain due to bruxism stop?
February 17, 2011 5:36 PM   Subscribe

I've been grinding my teeth for a while now. I have a fancy mouth guard, yet I still have constant jaw pain and headaches. Anyone have any advice on how I can make this stop?

This past summer I found out that I grind my teeth at night, and I suspect that I've been doing it for about a year now. I wore a cheap mouth guard for a few months and then got a proper one done through my dentist.

I catch myself clenching my teeth during the day all the time. I don't know how to stop it. I also grind my teeth at night but the mouth guard takes care of that. I can no longer rest my head on the palm of my hand because the pain on my jaw is unbearable. I also suspect that some of the headaches I've been getting are due to this. I wear my guard every night, without exception. I can no longer fall asleep without it, so it's not a matter of not wearing it at night. I sometimes clench/grind my teeth so hard at night that even with the mouth guard I wake up with jaw pain. My lower back gums (where my wisdom teeth used to be) are swollen every single morning - I suspect due to pressure from the clenching and grinding.

I've seen people complain about jaw pain due to teeth grinding, but for most people the pain disappears after they get a mouth guard. I've already lost half a tooth due to this teeth grinding business. Now I want the pain to stop! What do I do?
posted by carmel to Health & Fitness (19 answers total) 18 users marked this as a favorite
Best answer: IANAD. You need to see your dentist and your physician and get them in touch with one another. I am not a dentist, but swollen gums plus tooth loss plus intense pain may mean you have more than bruxism going on. Basically you need to get the two aforementioned knowledgable people together to discuss a course of treatment for you, which could involve seeing other specialists, medications, etc. It's a pain to organize but it's nothing compared to what you're dealing with now. Good luck.
posted by Inspector.Gadget at 5:40 PM on February 17, 2011

Your mouth guard may not be fitted right. I've had two and it took a few visits back to my dentist for adjustment (meaning, shaving down places where it didn't fit my teeth correctly) each time for mine to start working properly.
posted by amro at 5:41 PM on February 17, 2011 [1 favorite]

Best answer: Go see your dentist again. There are different kinds of guards you can get. A friend of mine had one that fit over his front teeth so that the rest of his teeth didn't touch. Kind of like the one at the bottom of this page. (Except his was on his top teeth.)

The dentist can also adjust the guard. I was having some pain with mine and the dentist just had to shave down some of the pressure points and it's been much better.
posted by sadtomato at 5:44 PM on February 17, 2011

You don't have the right mouth guard, or as amro suggests, yours just isn't fitted properly. Go back to your dentist and explain the problem. Rather than a guard that only prevents grinding, it sounds like you need one that positions your jaw in a way that precents you from clenching.

Also, when I had really bad TMJ, my dentist sat me down in front of a video about how TMJ is the only dental problem that is frequently treated by mental health professionals, or exercise. Grinding your teeth is almost always related in some way to stress - so try and reduce your stress, if you can.
posted by Kololo at 5:46 PM on February 17, 2011 [1 favorite]

This past weekend a 30 year old woman called into Dr. Zorba Paster's show on NPR about grinding her teeth. She too wore a mouth guard but still ground her teeth.

This was the 2/12/11 show. MP3 direct download here. The relevant call starts at the 13:36 mark.

Zorba recommended she see if her doctor would give her a prescription for gabapentin (trade name Neurontin), a seizure drug also used for neuropathic pain. It is sedating but not habit-forming, he said. He suggested she ask for a 300mg dose and said it might lead to a better night's sleep, which might lead to less nocturnal grinding. You can google around to see a number of instances in which it is used to combat bruxism.

I read that bruxism is sometimes caused by medications. One example is certain kinds of anti-depressant - the medicine caused the bruxism and they used gabapentin to treat that. So if you started taking a particular medication around the time this started, it's possible there's a link.
posted by Askr at 6:11 PM on February 17, 2011 [2 favorites]

My dentist and I suspect I grind my teeth at night, and he prescribed me a low dose of a muscle relaxer (specifically Flexeril). I never ended up filling it for the same reason I've never gotten a night guard, because my bruxism hasn't really been causing me any serious problems. I can't provide any anecdotal evidence about it one way or another, but it might be something to bring up with your dentist/doctor since the night guard isn't working.
posted by MadamM at 6:34 PM on February 17, 2011

Seconding sadtomato's suggestion of a different type of nightguard. I had the type of guard you describe and still had crushing headaches and jaw pain almost 24/7 - the full-size guard protects your teeth, but you can still clench, just against that material. The NTI clips over just a few teeth and basically redirects the pressure so that you cannot clench at all. My dentist switched me to an NTI and I cannot recommend it highly enough.
posted by Ink-stained wretch at 7:06 PM on February 17, 2011

I had the same experience as Ink-stained wretch. The NTI is much better for me, too.
posted by Ery at 7:23 PM on February 17, 2011

Response by poster: Thanks everyone. The answers are very helpful and I will be seeing my dentist to talk about this. In the mean time, does anyone have any advice regarding clenching/grinding during the day? I catch myself doing this usually when I'm concentrating or working on something.
posted by carmel at 7:30 PM on February 17, 2011

I'd try chewing gum.
posted by Taurid at 9:16 PM on February 17, 2011

I stopped grinding my teeth when I started taking a multi-B vitamin. Eventually I stop taking them, and eventually I catch myself clenching my jaw again. Starting up with the vitamin again always solves the problem.
posted by oneirodynia at 10:22 PM on February 17, 2011

I am a fellow grinder who recently ground through her night guard. While I'm waiting for the replacement, I've found massaging the area around the jaw to be fairly helpful to loosen the area. Here's a youtube video showing how to do it.
posted by statsgirl at 4:33 AM on February 18, 2011 [1 favorite]

I also grind my teeth. Sometimes I wake up sort of sore, but even when I'm not grinding, like in the middle of the day when I can tell what I'm doing, I get a very sore jaw. For whatever reason, my jaw is where I store my stress. In fact, I can tell when I'm getting stressed out because my jaw starts to hurt even though I'm not grinding it. I mention all this because it may not all be a mechanical problem amenable to mechanical solutions.
posted by OmieWise at 5:20 AM on February 18, 2011

Chewing gum is supposed to be bad for people with bruxism.

I read that loosely holding a pencil in your mouth (cross ways) can help, and it can definitely keep you more aware of it so you can consciously relax, but for obvious reasons it's not an all the time solution!
posted by Salamandrous at 6:15 AM on February 18, 2011

I have TMJ - and also grind. My denist hooked me up with a soft guard, similar to an athletic mouth guard. It didn't help much.

Then I went to a doctor at a head and neck pain clinic. He told me that soft guards weren't good for people like me because we chew on the soft guard. He fitted me for a hard/solid guard. Worked like a charm.

He also told me, during the day, to try to focus on my mouth position. Specifically, the best jaw relaxing position is when I say the letter "N."
posted by thatguyjeff at 6:56 AM on February 18, 2011

Similar to Salandrous' suggestion, I sometimes keep my tongue loosely between my front teeth. It looks a little funny and obviously doesn't work when you're out or talking with people, but when I'm at my desk concentrating very hard or doing other tasks that usually lead me to grind my teeth, it keeps me from doing so.
posted by hefeweizen at 8:15 AM on February 18, 2011

I have similar issues. What's working for me is a combination of a hard resin over-my-top-teeth night guard, daily exercise, jaw massage, and using an electric heating pad on each side of my face for ten minutes before bed. The heating pad is meant to warm and soothe the jaw muscles to discourage clenching and grinding, and overall I think it helps more than the other methods do; the next most helpful element is the exercise.

A year ago when I was in a much worse state, Salamandrous' suggestion of biting on a pencil held horizontally (at roughly my incisors) during the daytime was very helpful.
posted by cinco at 8:28 AM on February 18, 2011

I'd try chewing gum.

This is a really bad idea. Which you probably already know, because chewing gum probably makes your jaw hurt more.
posted by amro at 11:17 AM on February 18, 2011

Best answer: Just like sadtomato and others, the tiny night guard over a few teeth helped me so much more than wearing a full night guard. The full sized didn't do anything for me. As I've said before in AskMe, I used to get terrible migraines on a frequent basis, and getting my little night guard has made my life much better. I used to get headaches bi-monthly and now I get them two or three times a year. I had to pay full price because my insurance did not cover it, and I would do it again. Totally worth it.

As for not clenching during the day - this may be way out there - are you trying not to think about something and grinding your teeth instead of dealing with a feeling? If so, figuring out what you're stressed about will be highly uncomfortable (because you're dealing with the feeling by clenching, so now you have to deal with it directly), but helpful. I force myself to relax my jaw, holding my teeth slightly apart (with my lips closed) pretty much all the time.
posted by santaslittlehelper at 12:15 PM on February 18, 2011

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