Anyone had problems with clenching their teeth?

[grumpygirl]

Hello everyone!! I saw my dentist today because I have been having a problem with clenching my teeth at night. It has created some problems with my teeth including making my gum recede on two different teeth. Don't ask me why it does that but my dentist explained it to me. Anyway he wanted to make me a mouth guard (for $250) to keep my teeth apart during the night. Well, I explained to him my situation with apnea and my mouth taping. He looked at me like I had two heads and said that I needed to do something to keep my teeth from being ruined by nightly clenching.
I admit that I have been waking up in the mornings with a feeling that I had been clenching or grinding my teeth at night(going through some anxiety with unemployment and other $$ issues etc, etc.). I tried one of the OTC kits that you can fit to your mouth to keep from clenching but I have some issues with my bite being off and these OTC kits would not mold to my teeth. Wasted $27 on that one!!
I know you guys are probably saying I should use a FFM but I have tried many of them and just cannot find one that fits and feels the least bit comfy. I also have a recessed chin that makes fitting a FFM kinda difficult-they leak horribly and I have to make the straps so tight that I wake up with neck pain and a headache.
My question is this- has anyone else ever had problems with clenching, and what did you do to solve the problem? Any thoughts on how to solve this problem other than the $250 appliance and a FFM?? With being unemployed I just cannot spend the money for the appliance AND a FFM.
It seems there is always some problem with my body lately, one problem that creates another problem and then I end up with TWO problems that I can't afford to fix or that just cannot be solved with some easy solution!! Any thoughts here??
THANKS-GG

[lbw]

Sorry to hear of one more problem. I hear you and understand. A couple of yrs ago I developed severe ear pain (or what I thought was ear pain) turns out that I clench to the point I now have jaw pain. I have gone thru 3 dental appliances. Bit thru them to the surprise of my dentist.

Google TMJ (trans madibular joint)

You can find some exercises and massage that can help. I actually went to see a physiotherapist who specialises in the jaw and they did no different than the exercises I found on the web. Stress is also a big factor in clenthing teeth. Try relaxation or meditatation. (I have tried them all).

Good luck

[robysue]

I've suffered from TMJ for something like 25 years (at least)---far longer than apnea. I've worn custom made night guards since the mid-80s and braces retainers that were made similar to my night guards for several years in the late 70s and early 80s. If I forget to put my night guard in at night, boy do I feel it the next morning---sometimes with a nasty headache, often with a very sore jaw joint, and often with sore teeth.

So I believe the mouth guard your dentist is talking about really will help your teeth clenching and grinding at night. The custom made ones are usually made out of a soft plastic. They take a mold of your teeth and it will fit very snuggly and not want to fall off the top teeth at all, and yet be easy to pull off the teeth in the morning. Unlike the OTC ones, the custom ones will both fit your teeth and be comfortable to wear. I know you're under a lot of stress, but it's important to realize that stress and anxiety are not the only causes of night-time teeth grinding. Many people who grind their teeth are grinding because their teeth fit together poorly (a bad bite) and the grinding starts because of the bad bite. Some dentists will do a series of "bite adjustments" before taking the mold. The bite adjustments are painless---they consist of the dentist having you bite down on a dye-infused flim so that he can see where the teeth are hitting in an abnormal fashion and then gently grinding off very small amounts of enamel.

Since you say that your grinding is beginning to cause gum problems, you may very well have bite problems as well as stress that are leading you to grind your teeth at night. And in that case, your teeth really need treatment. Think of it this way: You're grinding your own teeth with a force that is at least as great as you need to use to properly chew hard food without any cushioning between them. Without protecting your teeth from the grinding, you're likely to have much more serious and expensive dental problems in the future: In addition to gum problems, grinding can also lead to cracked teeth and molars with little or no enamel in spots. Worse case, not treating the grinding could eventually lead to you losing some of the teeth.

A custom-made night guard will only separate your teeth ever so slightly----it's real purpose is to provide a cushion so that the grinding you're doing doesn't continue to harm your teeth. I've never actually put an OTC guard in my mouth, but judging from their appearances, I think the OTC ones may be quite a bit thicker than the custom made ones. For most people a quality custom made night guard will last many, many years. I know people who've used the same night guard for ten years or more. Alas, I'm not one of them: I grind my teeth so hard that I chew through a soft night guard in about 18 months and even though my dental insurance would not pay for a new guard any where near this often, I always found it well worth the money to get a new one. But please keep in mind that my situation is MOST unusual no matter how much tension you have and no matter how bad your bite is. About two years ago my dentist ordered a hard night guard for me. It's not quite as comfortable, but I haven't bitten through it yet. [Although, with the stress of being diagnosed with sleep apnea, getting used to CPAP, my son's leaving for college, and hosting two exchange students last year and this year, I've noticed some cracks in it.]

And wearing a night guard with a CPAP mask is NOT a problem. And if you don't need a full face mask now, you won't need a full face mask with the properly fitted night guard. I took my night guard to both my sleep study and the titration study and use it every single night. Wearing a night guard with CPAP doesn't create problems with mouth breathing or mouth opening at night if you don't normally mouth breath or open your mouth at night. I'm still new to CPAP, but I wear my night guard with my nasal pillows mask every night and so far there's no evidence that I've suddenly started opening my mouth just because of the CPAP & night guard combination.

Relaxation techniques will help relax your jaw joint (the TMJ joint), but likely you'll still grind---I know I do even when I'm doing 30 or 40 minutes of yoga and deep breathing exercises a day. Some of us are just more high strung I guess. But since you seem to have real dental problems being caused by the grinding, my advice is that a quality custom-made night guard is likely to give you years and years of relief from the clenching and teeth grinding. So I'd say find the money to get it if at all possible.

Good luck!

[robysue]

lbw,

I notice you bite through your guards too. I have to ask: How long does each guard last you? In 25 years, I'm easily been through close to a dozen under two dentists in two states. Both were shocked at how quickly my teeth shred a soft guard into pieces. Have you asked about getting a hard guard instead of a soft one? They're not as comfortable, but they do last much, much longer.

[cflame1]

I'm on my second hard guard... I don't bite through mine... I lost the first one in a move.

I do have TMJ, it was dx'd about 20 years ago.

[physicsbob]

Before six years before I got my Cpap I ground my teeth down to the point of now having eight caps, my Dentist made me a guard. Very expensive, but insurance covered it. I used it religously for several years until my dog got a hold of it and chewed it up pretty good. But by then, several caps more my bite has changed so I don't seem to grind them. several things that has helped me were cutting out caffeine out completely, and brushing and flossing before going to bed. Some complete pharmacies carry a do it yourself guard, that you form and harden at home for about 70-80 dollars. I haven't tried one but I have talked to several people that have and they say they work pretty good.

[Eeyore_1]

I've worn a TMJ splint for about 20 years now. Mine is the harder one that needs to be softened in hot water before inserting. I do a pretty good job of chewing them up and grinding them down. Each one lasts me about 4-5 years. By then I REALLY need a new one. I don't have a problem with using a nasal mask at all.

[BrianR4743]

Grab your Ipod and download the jaw clenching meditation podcast from Inner Health Studios (free download) from Itunes. Lasts about 25 minutes, and really helps you doze at night too. I didn't believe it until I tried it. Now, like my CPAP, I don't go to bed without it.

Ditch the caffiene.... it helps as well.

Good luck!

[grumpygirl]

THANKS EVERYONE!! The suggestions and helpful hints were great. I am a mouth breather and still wonder if the guard will make that worse- I DO tape my mouth every night to keep my mouth closed. I do not have an ipod so I can't download the info someone suggested-but it sounds very interesting and helpful. I am going to have to wait til finances improve a little to see my dentist again about the mouth guard but I am thinking now(thanks to all your info.) that it is probably going to be something that I will HAVE to do soon.
I still hesitate to pay for the guard wondering if I will be able to close my mouth properly in order to continue taping it shut before using my cpap. THANKS for all the info-GG

[robysue]

I still hesitate to pay for the guard wondering if I will be able to close my mouth properly in order to continue taping it shut before using my cpap. THANKS for all the info-GG

Unlike the dental appliances that are used as a treatment of mild sleep apnea, a properly made custom night guard for treating TMJ and tooth grinding will not change how your mouth closes. In other words, a TMJ night guard does not move your lower jaw forward the way an oral sleep apnea appliance does. A TMJ night guard is designed prevent you from destructively clenching and grinding your teeth by providing a cushion between your teeth that absorbs the grinding force. Hence, a TMJ night guard fits entirely inside your mouth and is thin enough where you should not notice any difference in opening and closing your mouth. If the TMJ night guard is properly made, you won't be able to visibly tell if the guard is in or not just by looking at your face with your mouth closed and you should be able to talk normally with the guard in your mouth as well. So if the TMJ guard is properly made, it shouldn't interfere with your taping your mouth shut for the CPAP mask.

Did you ever wear braces? If so, you may recall having to wear a retainer of some sort after your braces came off. A TMJ night guard is usually as small and as (or more) comfortable than a standard braces retainer, and it doesn't interfere with anything any more than a braces retainer does.

[Eeyore_1]

robysue is right. A properly made TMJ mouth appliance won't change the set of your jaw. It also won't make you more prone to opening your mouth during sleep. In fact I've found the opposite. Your dentist will make sure it fits properly and make fine adjustments so that your teeth fit snuggly. Also, the grinding and clenching that you do will also adjust the splint. Ask for a bottom splint. It's easier to wear in the daytime if you need to and doesn't interfere as much with your speech. It's also less visible and will prevent huge dental bills later on. Ask your destist if you can pay it off in installments that will suit your present income. $20 a month will have it paid off in a year.

[nanwilson]

Hi
I clenched my teeth when I first started CPAP too...broke two fillings within 6 weeks. I no longer clench or grind, I guess I just learned to relax with this therapy and it has done the trick.
Good luck
N

[Moby]

I've been wearing a mouth guard at night for many years to prevent teeth clenching at night that wore my front teeth down and cracked the molars.
It is custom made (the dentist took casts of my teeth and sent them away). I soften it in warm water before use and it is very snug and comfortable. It took about three nights for me to get used to it. I sleep much better with it, and it doesn't interfere with my Cpap at all.
It is expensive and needs renewing if I get major dental work done but I believe it is money well spent.

[J-Mac]

Teeth clenching! Makes me clech them just reading and writing about it!!

IH ave been on CPAP for just shy of 11 years now, and on full face masks for a little over 9 years. And I have clenched my teeth ever since starting with the full face masks. I haven't broken any teeth nor caused any undue ear pain, but man oh man do my jaws ache upon waking. In all this time I have not found a solution for this that has worked for me. I check around every year or so to see if anything new and improved is on the market but thus far, no help for me!

Thanks!

Jim

[robysue]

J-Mac,

You say, "And I have clenched my teeth ever since starting with the full face masks. I haven't broken any teeth nor caused any undue ear pain, but man oh man do my jaws ache upon waking. In all this time I have not found a solution for this that has worked for me. I check around every year or so to see if anything new and improved is on the market but thus far, no help for me!"

Call your dentist and tell him/her that you think you're grinding your teeth at night because you're waking up with severe jaw pain. Jaw pain is one of the main symptoms of TMJ. Ask your dentist to evaluate you for TMJ and see if he/she will make you a custom-made night guard. Sleeping with the night guard is really easy to get used to and for most people, relief from jaw pain is almost immediate---the first morning you sleep with the guard. And as others have said, the night guard won't interfere with wearing your CPAP mask at all.

If you've got decent dental insurance, it should pay for some of the cost of a night guard. There probably will be restrictions on how often you can get a new one; for most people that's not an issue since most people don't chew through them like rabbits.