Tooth Wear: Genetics, Stress, or Sleep Apnea?

Last month’s blog dealt with things I learned while at a dental convention in Las Vegas.  Half of the seminars I took overlapped considerably.  In essence they all dealt with bite, grinding and jaw joint positioning. While this topic is vast and complicated, there are some simple concepts that we count on to guide us in treating our patients.

During our exams we will palpate your jaw joint and have you open and close.  We feel for deviation in movement. We also listen and feel for grinding or popping.  Any of these indicate a dysfunction in the joint that may need to be addressed.  Next we look at the teeth and look for wear.   Wear on the back teeth can mean different things than wear on the front teeth.  We also look for gum recession and loss of tooth structure (grooving) along the gum line.  This is called abfracture and can be an indication of several problems.  Tooth mobility can also be due to bite or grinding problems.  Finally, we look for extra bone growth in the jaw or roof of your mouth.  These growths, called tori, can be an indication of poor jaw positioning or inadequate breathing airways.

The majority of issues that we encounter are bite problems.  The upper jaw and the lower jaw come from different genetic areas and each one can come from a different parent.  When the jaw sizes don’t correspond the bite doesn’t line up like it should.  When the bite doesn’t line up something must give.  You may end up with crooked teeth.  Commonly the lower jaw is pushed back so the teeth can fit together better.  This causes pressure on the jaw joint and we get deviations, clicking or popping.  Often you just grind away on the teeth until they fit together better.

Luckily the majority of these genetic issues are now correctable through early orthodontic treatment (retainers and braces).  However, not everyone had the benefit of that early type of treatment.  In fact, before the 1980’s, it was not routinely available.  Some adults can still get benefits from orthodontics, but others may need night guards, bite splints, occlusal (bite) adjustments or multiple crowns to restore worn teeth or defective bites.

There are other reasons besides genetic issues that may cause you to grind your teeth.  Stress is a big contributor to grinding.  While we can’t control your stress levels for you, we can help you protect your teeth and jaw joint during your periods of high stress.
Another issue that causes people to grind is a poor airway.  There is a high correlation between people who snore and people who grind.  If your airway is small, the tissues in your throat can collapse while you sleep causing air to be forced through and the resulting vibration of tissue is what causes snoring.  Studies have shown that people will grind their lower jaw forward trying to make a bigger airway.  This is why we see wear on the teeth of people who snore.  Some people can actually get bone growths in their jaws (called tori) as they continually work their jaws forward trying to open the airway.

I hope this gives you a better understanding of why we do all the things we do during a routine dental exam.  If you have noises when your jaw moves, wear on your teeth, boney growths on your jaw, or if you snore, ask us to take a look.  Your bite may be the issue and we may be able to help.

Thanks for reading,

Dr Bruce

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