07/16/2021
How do you stop grinding/clenching your teeth? Will a biteplane/plate help you?
The short answer is that biteplanes usually do not STOP you from grinding or clenching but they can help mitigate TMD symptoms and protect your pearly whites from damage.
I get asked questions about biteplanes every day and there is a lot of misinformation about how to treat bruxism (teeth grinding, clenching, gnashing, tapping, jaw posturing, etc.).
Sadly, I also see many people struggling to use them. Why does person A absolutely LOVE their biteplane and can’t go to sleep without it and patient B take it out and throw it across the room in the middle of the night?
First off, bruxism is primarily a movement disorder and is quite common in the healthy adult population. You may already know that you do this while sleeping or even while awake. It may be that you experience jaw pain, headaches or fatigue from it, or maybe you never have pain (lucky you! 😜)
We know that for some people, the act of temporarily moving the jaw around between sleep stages actually helps stimulate salivary production and lubricate the airway. A lot of the time though, it becomes a destructive and painful habit that is difficult to manage let alone control.
Perhaps you have heard your dentist express concern over seeing worn down teeth in your mouth, fractured enamel and loose fillings. Maybe you have even had to deal with a cracked molar or two. Do you get a poke in the ribs from your bed partner in the middle of the night because your grinding sounds are freaking them out or keeping them up?
Research has found that there are certain risk factors for bruxism. It is often associated with sleep problems although the relationship is still not understood well. For instance, people who have a sleep related breathing disorder like sleep apnea or insomnia may have increased chances of bruxism. Certain medications like anti anxiety and anti depressants can up-regulate it; caffeine and stimulants like amphetamines, medications to treat attention deficit disorder and co***ne use can be huge problems; night terrors, stress, anxiety, PTSD, alcohol consumption.... basically anything that can disturb your sleep can increase your risk for bruxing.
Are you someone who hits the snooze button 10 times before getting up? Or perhaps sleeps in on the weekends and wakes with a sore jaw or headache?
What about during the day? Well, that’s a different animal altogether and best left to discuss in another post but to be honest, my sleep bruxers are much easier to manage than my daytime clenchers both in the way of treating the pain from sleep bruxism (SB) and managing jaw dysfunction.
So what happens if your dentist recommends a biteplane? Well, first, make sure you ask WHY it is being recommended. I don’t like to prescribe appliances unless I have a good reason to because biteplanes actually can cause problems for some people, particularly if they cause airway restriction or impinge on the tongue. Not everyone needs one and they are not always appropriate. They ARE absolutely the best treatment for protecting your teeth from clenching and grinding BUT they do not stop you from doing it (in most cases). In fact, for some people they can actually stimulate your bruxing and make your pain and TMJ dysfunction worse. This sounds like I am condemning biteplanes and let me be clear, I am not. Biteplane therapy is a huge part of my practice and the majority of my patients need to wear them. However, patients need to be aware of the potential problems before they invest in one.
Biteplanes come in different shapes, designs, materials and sizes. Your teeth, how they occlude (how your teeth touch), your tongue size, your airway, when you need to use it, why you need to use it are all factors when I consider what type of biteplane may serve you best. And guess what? I am not always right!! That is one of the reasons as to why you need to commit to returning to your dentist to have your biteplane adjusted and modified depending on how you are doing with it.
As you start to use your biteplane, your jaw muscles and jaw joints will change somewhat to accommodate it and that will result in your ‘bite’ on the appliance shifting. Incidentally, this often is one of the pathways to improving the jaw pain that often is associated with SB. The biteplane needs to be carved, ground down and modified to account for these changes. It is somewhat similar to having foot orthotics made except that the jaw can be much more complex than feet.
There are multiple theories as to why and how biteplanes work to relieve symptoms but it is safe to say that they work in different ways for different people. Sometimes they help to stabilize an unstable bite, sometimes by opening the airway, sometimes by changing our sensory input to our trigeminal nerve (the nerve that relays sensations from our teeth and jaw to our brain) and sometimes it is just the placebo effect. Much more research needs to be done in this area.
But, biteplanes can and do help many patients and can be an effective, non-invasive and efficient way of managing bruxism. If it looks like it might be beneficial for a patient to use a biteplane, I will almost always recommend a biteplane be tried before orthodontics, surgery, prolonged medication use or injections. The trick however, is the DIAGNOSIS.
If your bruxism is surging because you drink 3 large Timmies in a day.... guess what? You need to slow down on that coffee. If your jaw pain is actually a facial migraine or a cluster headache, a biteplane won’t solve the problem. If you clench your teeth during the day but not at night, don’t expect use of your biteplane while sleeping is going to suddenly stop the daytime habit.
In summary, managing tooth grinding and the dental damage caused from it as well as controlling pain and dysfunction associated with both sleep and awake bruxism takes the proper diagnosis, lifestyle changes, the right appliance, the right attitude towards getting better and sometimes, good old experimentation to see what works for your body. Many people benefit greatly from biteplanes. Some do not. It might be you need a different style of appliance, improved sleep, a different opinion or even health care provider. Maybe it just takes being a little more aware of the reasons why you grind/clench your teeth. And maybe it will take some other measures like taking reflux medication, giving up daily alcohol consumption, reducing stress, Botox injections or sleep apnea treatment.
What I can say for certain is that it takes being your own advocate. Your dentist can alert you to problems with your teeth but if you aren’t getting the help you need, ask questions, seek answers, work with your dental team to find the best solution that works for you.
Have a wonderful weekend everybody!!
