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Illustration by Paola Saliby

80,000 Reasons to Stop Grinding Your Teeth

8% of adults grind their teeth—a condition known as bruxism—but most have no idea about the long-term consequences.

By Tend

We’re often simply told we do it, recommended an expensive mouthguard, and sent on our way with little to no more information. But why do we grind our teeth in the first place? Do I have to wear my night guard? And is grinding really such a big deal? Tend’s Head of Clinical Development, Dr. Marc Schlenoff, has these answers and more. (Spoiler: when it comes to your oral health, yes, grinding is, in fact, a very big deal.)

Teeth grinding can be caused by stress, but it’s also genetic

While a lot of us grind due to stress, “some people who are seemingly under no stress grind because that’s just the way they’re hardwired,” says Dr. Schlenoff.

Smoking, drinking alcohol, and certain recreational drugs are all risk factors that increase the likelihood of bruxism. Bruxism can also be a side effect of certain medications, like antidepressants.

Another unexpected cause of bruxism? Missing or crooked teeth. It’s also associated with some medical conditions like Parkinson’s disease, gastroesophageal reflux disorder (GERD), and dementia.

Grinding produces a huge amount of force

“Grinding can generate up to 1,100 pounds per square inch of pressure on your teeth.” To put that in perspective, that’s 3-6 times the pressure you use to eat. No wonder grinding can lead to loose teeth, tooth pain, sore jaw muscles, jaw pain, and can worsen, or even cause, TMD/TMJ disorders—compromised movement of the temporomandibular joint.

Evidence of grinding is easy to spot

When people grind, the cusps of their teeth gradually become flatter, and shinier, then shorter. “I always show my patients a picture of the wear to show them exactly what’s happening,” says Dr. Schlenoff.

Grinders typically grind for an hour or so per night

“We grind and clench and then we stop and then we do it again...all night long,” says Dr. Schlenoff, adding up to about 60 minutes total.

You’re more likely to grind if you snore

Some snorers assume they couldn’t possibly grind their teeth while snoring, but sadly they’re wrong. In reality, “grinding is just momentary, and there’s almost a 100% correlation between snoring and grinding.” Sleep apnea, a sleep disorder that causes pauses in breathing, is also linked to sleep bruxism.

Grinding wears away at tooth enamel, then at dentin

Now for some dental anatomy: a tooth has layers that grinding destroys bit by bit. The first layer is the enamel, which coats the outside of the tooth and is “the hardest substance in the body.” One of the first signs your enamel is going? Tooth sensitivity.

Once you grind through your enamel, you’re in trouble. Underneath the enamel is “dentin,” a yellowish substance that’s 11 times weaker than enamel. As a result, it will erode 11 times more quickly.

Grinding affects multiple teeth at a time

Grinding doesn’t just happen to one tooth: it occurs in a sliding motion that wears down many of your teeth simultaneously in a fairly symmetrical way. (And if you’ve got fillings, grinding can wear away at those, too.)

There’s a point of no return when it comes to tooth damage

Because the tooth gets softer the deeper you go, over time the damage grinding causes begins to accelerate. At a certain point, the damage is beyond repair and your teeth will require crowns. Dr. Schlenoff recalls, “I’ve had cases where I had to do crowns on every tooth in the mouth to rebuild them to their original height because people have worn them down so dramatically.”

Repairing this damage can be incredibly expensive

A single crown can cost up to $2500, depending on where you live. If your case is really extreme and you need crowns on every single tooth like Dr. Schlenoff’s patient, that could result in a whopping cost of $80,000.

There’s a way, way cheaper alternative

If you’re grinding due to stress or anxiety, your healthcare provider might recommend stress management techniques like mindfulness. For the vast majority of sufferers, though, that might not be enough—especially if your bruxism is genetic or occurs overnight, like most people’s.

Since there’s no way to consciously stop grinding (especially in our dreams), the best mode of defense is a night guard, or a simple piece of plastic custom-molded to your mouth that you wear just when you sleep. A night guard typically costs less than a thousand dollars. We charge $599 if you don't have dental insurance, and if you do, it could cost significantly less than that. That’s a savings of $79,401 or more if things were to really go awry.

Here’s to strong enamel, and grind-free teeth!

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