or Grinding

Some prefer to split these concepts into separate behaviors while others group them together. Grinding or bruxism involves moving the jaw with the teeth held together. This results in substantial visible wear and flattening of the teeth which is usually obvious both to dentist and patient. Clenching is simply holding the teeth together and tightening the jaw muscles. Clenching generally results in less obvious wear to the teeth but can still result in substantial muscular soreness, pain, and damage to the jaw joint.


Clenching or grinding while awake is especially common during periods of concentration, anger, or stress, and often occurs without a person being aware of it. Once a person is made aware of the habit, it can potentially be stopped or reduced by behavior modification, in some instances assisted by various forms of splint therapy. 

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Bruxism during sleep is very different from bruxism while awake. Sleep bruxism is not under a person’s conscious control and usually occurs throughout the night during periods of arousal as a person goes from a deeper stage of sleep to a lighter stage of sleep. This pattern may be repeated many times during the night. Extreme forces can be generated by the jaws during clenching or grinding during sleep which can result in overuse of the jaw muscles – resulting in morning jaw pain or fatigue and jaw dysfunction. Sleep bruxism is not effectively treated by behavior modification or awareness and requires a different therapeutic approach. It also may be associated with a sleep disorder, such as obstructive sleep apnea.


What causes sleep clenching or bruxism?

The exact cause of sleep bruxism is not known, however, it has been found to be associated with several factors such as daytime stress, anxiety, obstructive sleep apnea, loud snoring, heavy alcohol use, caffeine, smoking, and certain antidepressant drugs.. Recently, studies have shown that bruxing episodes during sleep are preceded by an increase of brain activity and heart rate. This suggests that central nervous system factors may play a important role in the initiation of bruxing. In the past, it was felt that a bad bite or a malocclusion was the cause of bruxism, however, numerous scientific studies have failed to show a relationship.

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How is clenching or bruxism treated?

Daytime bruxism can usually be effectively treated by behavioral modification and habit reversal. This may be as simple as making the person aware of the habit and then placing visual cues around the home and work area to alert the person to check and be sure that their teeth are apart. For difficult cases, psychological counseling may be necessary. For sleep bruxism, a splint or bite guard worn at night is usually a cornerstone of treatment (see Right). In addition, medications may be used for short term control of the activity and may include muscle relaxants, tricyclic antidepressants, or antianxiety drugs such as the the benzodiazepines. Some other drugs are currently being investigated for treatment of the problem. Since a relationship between occlusion (or bite) and sleep bruxism has not been conclusively proven, adjustment of the bite by grinding the teeth or placement of crowns is not recommended.


4 reasons you are clenching and how to stop.


It’s no surprise that when you’re stressed or anxious, you may clench your jaw and grind your teeth during sleep. In fact, research shows that 70 percent of people grind their teeth as a result of their stress, with certain anxiety-elevating medications or a highly stressful work environment increasing the effect. Meditation, relaxation techniques and psychoanalysis can all help to alleviate teeth grinding caused by stress and anxiety.


There also seems to be a connection between nighttime caffeine consumption and teeth clenching during sleep. It makes sense — the caffeine elevates your energy and heart rate, and poor sleep and teeth grinding can occur as a result. To prevent the destructive habit, try switching to decaf or water after 3 pm.


Adults who heavily use tobacco and alcohol, especially at night, are also more prone to bruxism. Both substances affect the sleep cycle (especially when combined) and can lead to frequent REM interruptions or sleeplessness. Teeth grinding commonly accompanies these symptoms. Try cutting back on, or quitting both altogether — for the good of your teeth as well as your overall health.


The most common cause of bruxism is actually the presence of another sleep disorder, like chronic snoring or obstructive sleep apnea (OSA). Both of these conditions cause frequent interruptions in the sleep — someone suffering from sleep apnea can actually have their sleep interrupted more than 100 times in one night. If you think you or a loved one are suffering from chronic snoring or OSA, you shouldn’t hesitate to schedule an appointment with the Williamsburg dental team. Seeking a correct diagnosis is the first step to finding much-needed relief in a full night’s sleep.


Symptoms of clenching can range from jaw pain, head and neck aches, tmj popping, grating or clicking. At Eternal Smiles we use treatments that can range from night guards.

Dr Singh has been trained to analyse the problem in Florida, America.  A thorough joint examination reveals the problem.

Ann had problems with a dentist not understanding her bite.  After placing many crowns and fillings he did not understand her bite was not in the proper place. Then after 3 visits with Dr Singh she recovered and now able to enjoy her foods.



“I had headaches and sore shoulders for years. The night guard has helped wonders and for the first time in years. I no longer wake up with a headache or discomfort in my front teeth. I am really impressed with the time and attention Dr Singh took to make it comfortable and the after care given to ensure it remains correct and comfortable.”                                                                                               Sally Holgate

Jaw joint conditon

Dr Singh has extensive training in treating problems associated with the jaw joint and bite, or what we call ‘Temporo-mandibular joint (TMJ) disorders’. These come in many forms and the symptoms can include:

  • Painful clicking, popping or grating in the jaw joint when opening or closing the mouth.
  • Pain in the chewing muscles or jaw joint, especially first thing in the morning or in the evening after a stressful day.
  • Soreness in the jaw.
  • Difficulty opening or closing the mouth or locking of the jaw.
  • Jaw muscle stiffness.
  • Headaches or radiating pain in the face, shoulders and neck.
  • Ringing in the ears.
  • A change in the way the upper and lower teeth fit together.
  • Can be mistaken for chronic toothache.

What causes it?

These problems have many contributing factors such as stress and grinding of teeth. Trauma to the jaw plays a role in some TMJ disorders. But for most jaw joint and muscle problems, scientists don’t know the cause. For many people, symptoms seem to start without an obvious reason. Research disputes the popular belief that a bad bite can trigger TMJ disorders. Because the condition is more common in women than in men, scientists are now exploring a possible link between female hormones and TMJ disorders.


In summary, careful planning and analysis will allow the treatment to be designed around your individual needs.


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The facial muscles and jaw joints are all part of a system that is controlled by the brain. Because Dr Singh has a detailed understanding of this system, he can detect specific reasons that cause harmful bite pattern and head and neck pain.

When muscles and joints do not work properly, the muscles will often tire. The tiredness can become part of a cycle that results in tissue damage, pain, muscle tenderness and spasm.

Although accidents involving injuries to the jaw, head, or neck, or diseases such as arthritis may result in some bite problems, Using detailed bite evaluation we can diagnose any discrepancies with your bite. We also use it to get the accuracy of newly fitted restorations 100% correct to make your restorations last longer.

How is it treated?

Dr Singh is fully trained to diagnose these problems and treat them –He uses ‘TMJ therapy’ and bite adjustment. The therapy involves wearing a specialised (Hard Night guard) stabilisation splint. This is carefully fabricated and adjusted to relax the chewing muscles and place the jaw joint in a comfortable position to allow it to heal properly.

Once the pain has been resolved over a period of 3-6 months, certain restorative treatment may be required to correct the bite.


“My jaw joints were sore and the side of my face were painful the last few  months.  Dr Singh advised that I wear a night guard to protect my teeth from wearing down due to my grinding and help my jaw joints recover. The treatment and care was great. Thank you for helping sore jaw   better.”

                                                    Gary Dickenson

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