In my practice, a variety of oral appliances are used at night as sleep bruxism treatment. These appliances do not stop the grinding or clenching activity but are extremely helpful in preventing or stopping compromise to the teeth, jaw muscles or Temporomandibular Joints (TMJs). These appliances produce the best results when custom fit, monitored, and modified over time.
Over-The-Counter night guards are available, but at best may be able to protect your teeth. The vast majority of them do not fit the teeth well and are too big and bulky and result in even more clenching.
Though the exact mechanisms have not yet been fully understood as to why custom fit oral appliances work for bruxism treatment, patient feedback over the years suggests that oral appliances are indispensable in the management of these problems. These appliances are not designed to move teeth or rearrange the bite but essentially serve as shock absorbers and oral cushions. These devices may be worn on the upper or lower teeth, depending on the nature of your problem, and require adjustment over time.
For most of my patients in NYC and Long Island, the use of a bruxism appliance is not forever, however, many patients state that they can’t go to sleep without their bruxism appliance. The relief that is obtained with these devices is sometimes remarkable and can occur within a short period of time.
Along with appliances, a variety of oral medications can be used prior to bedtime as a sleep bruxism treatment. Prescription drugs that have been commonly used with benefit include muscle relaxants and anti-anxiety medications like Valium or Xanax. These drugs are very helpful over the short term as their calming impact on the mind leads to less aggressive teeth grinding and/or clenching. Supplements advertised as being helpful in promoting restful sleep also seem to reduce night grinding for some patients. Melatonin, Tryptophane, Feverfew, calcium-magnesium preparations and a variety of homeopathic remedies are available over the counter.
In addition, meditation and relaxation techniques prior to going to sleep have proven to be helpful over time as a bruxism treatment.
The use of Botox to partially incapacitate the jaw muscles has also gained popularity as a bruxism treatment and has its place in the management of these problems. Though Botox may not be the first treatment choice, it is effective. In my practice Botox has become the treatment of choice in patients that have used and destroyed night guards, but continue to suffer in the morning with jaw pain, headaches and sore teeth. Though there may be a need for multiple Botox injections to see real relief, it is a treatment that is truly effective.
All of these options can be explored during your consultation in the office. I’m here to help you to stop “The Grind”.