In my 31 years of dental practice, I have seen all kinds of wear and damage to the teeth from a variety of accidents and oral habits. But the most common – and the most damaging – activities seem to be the ones that people are the least aware of. I'm talking about clenching and grinding your teeth, and many people clench and grind far more often than they think they do.
The exact causes for these habits are not known, but we do know that stress is often a contributing factor, and there is some evidence that airway problems and severely misaligned bites may also play a role. But many people who have none of these problems still clench and grind regularly either out of habit or some other cause we don't yet understand.
The muscles that control your bite can generate huge amounts of force – more force, in fact, than any other muscle system in the body. Certainly, teeth can crack and break under that kind of pressure, and the muscles will often go into spasm and cause all kinds of facial pain. But these immediate symptoms can also be compounded by the slow wearing of the teeth caused by years of unconscious grinding. As the teeth are ground shorter and flatter, the bite collapses. The space that those teeth once held open for the joints and muscles to function properly closes, and chronic pain can set in for many people.
It is always sad for me when I see a new patient who has obviously worn away several millimeters of tooth structure through some kind of long-term grinding habit and seems to be completely unaware of it. "Why didn't anyone ever tell me this was happening?" is such a common question from new patients in this situation, that I find myself asking the same question: Why aren't we communicating the importance of this information to our patients more clearly?
Protecting your teeth, muscles, and joints from the wear and tear of an unconscious clenching or grinding habit can be as simple as wearing a nightguard appliance during sleep and becoming more aware of whether or not your teeth are pressed together during the day. Stretching during the day – especially when you notice yourself clenching or grinding – can alleviate muscle spasms, headaches, and help break daytime habits.
If you suspect that you may have a habit of clenching or grinding during the day, or at night – and certainly if you suddenly notice in recent photographs that your teeth just don't seem to be as tall as they used to be – I encourage you to speak with your dentist about what you can do to protect your teeth from further damage.
There is no question that the best teeth you can have for the rest of your life are the ones you were born with. Anything you can do to protect them from damage and avoid the need to replace them with implants, partials, or dentures will always be worth it for the long-term health of your mouth and your body.