People handle stress in different ways and today's economy is adding more. Those in the field of dentistry may be seeing the results of this stress in their patients' teeth.

Clenching or grinding teeth is on the rise as people are enduring more and more stress, says Dr. Ron Reinmiller of Lancaster Oral Appliances Therapy, located in Landisville.

"There is not a day that goes by that I don't see someone who is suffering from one of these problems," Reinmiller said. "I am seeing it in epidemic proportions."

Clenching or grinding one's teeth is a common problem and many do not realize they do it, especially in stressful situations.

"Your teeth should not touch, the mouth was not designed that way," Reinmiller said. "The only time they should touch is when there is food in between them and then it is for only a fraction of a second."

Unnatural grinding or clenching can cause wearing and cracking of the teeth, as well as serious jaw impairment. It can cause headaches, body aches, earaches and a plethora of other ailments without the patient really knowing what is causing them.

Grinding on a regular basis is a condition called bruxism.

If bruxing persists — as it does in an estimated 20 percent of the population during waking hours and 8 percent during sleep, according to a report on www.goodmorningamerica.com — it can have a negative effect on tooth enamel, bone, gums and the jaw.

"These can lead to much more serious dental problems," Reinmiller said.

The thought that bruxing is caused by a misaligned bite has taken a back seat to the belief that anxiety and stress are the primary causes.

Bruxism can start early in life while the teeth are still developing. Although the condition eventually wanes, damage can be extensive.

Tooth enamel that is subject to normal stress wears down at the rate of .3 millimeters every 10 years. It's not uncommon for bruxers to experience two millimeters of enamel erosion by their mid-20s, Reinmiller said. Furthermore, nighttime bruxing can occur as often as 40 minutes for every hour of sleep, producing up to 250 pounds of force per square inch. That's enough pressure to crack a walnut, he said.

Bruxing can lead to sleep problems. Sleep is the time when the brain goes into a semi-resting state but stays alert to notice disturbances. When these disturbances happen, the brain decides whether they are routine or not and it either wakes the person or allows him to remain asleep, Reinmiller said. The bruxing can trigger nerves in the back of the jaw, which then signals the brain of the disturbance. This can interrupt sleep many times over the course of a night.

Clenching is more likely to occur during the daytime, and is more likely to occur in women. One theory is that women are more predisposed to be vigilant. For example, they are more alert to the sound of a baby crying. This type of conscious attentiveness translates into more frequent closings of the jaw rather than sideways grinding motions.

Unfortunately there is no cure for teeth grinding or clenching, but there are ways to treat them.

Consult a dentist, Dr. Matthew Freedman of Lancaster said. If you suspect that you clench or grind your teeth, undergo a bruxism evaluation, Freedman said.

"Your dentist is in the best position to evaluate the extent of wear and tear on your teeth, gums and jaw, and to provide a practical remedy to offset further damage," Freedman said.

One such practical remedy is the use of a bite plate that has been custom-fitted by your dentist. Wearable day or night, it acts as a bumper guard, absorbing the force of the clenching or grinding, Freedman said.

While horseshoe-shaped, over-the-counter night guards are also available, they tend to be uncomfortable and are so soft that they may get chewed away, Reinmiller said.

In addition, over-the-counter night guards do not account for discrepancies that may be the source of your bruxing problems and will still allow the teeth to touch where they shouldn't, he added.

Reinmiller and Freedman prefer to use a custom-fitted plate, made of hard acrylic, on their patients. This device, called the NTI, is worn in the mouth to prevent the teeth from touching.

"This is made of a hard acrylic that prevents the teeth from touching," Freedman said.

"There are nerves in your back teeth and when those are triggered they slam shut," Reinmiller said. "You can end up clenching all night long because these nerves were triggered."

There are also other things that can be done in conjunction with the dental treatments for clenching and bruxing, Freedman said. These include looking into orthodontics, in case misaligned teeth are part of the problem; stress reduction (psychotherapy, biofeedback, yoga, meditation); or an adjustment to your medications, arranged by your physician in consultation with your dentist.

Bruxism signs
Signs of bruxism or clenching include:

• Vertical lines, cracks or chips in the teeth.

• Front teeth worn down so they are flat and even in length.

• Micro-cracks and broken fillings, eventually leading to nerve damage.

• Gum recession, due to pressure on the gum line.

• Loose teeth, caused by the rocking effect of bruxing.

• Headache and aching jaws due to overuse of muscles.
Source: Dr. Ron Reinmiller of Lancaster Oral Appliances Therapy, Landisville

Cesbenshade@Lnpnews.com