Braces can help with teeth grinding (bruxism), but their effectiveness depends on the cause. When bruxism is caused by a bite misalignment, orthodontic treatment corrects the underlying structural issue. If the habit is driven by factors like stress or certain medications, braces alone will not stop the grinding, though they will protect the teeth from damage.
Understanding Bruxism and Its Causes
Bruxism is the involuntary clenching, gnashing, or grinding of teeth, subjecting the teeth and jaw muscles to excessive force. The condition is divided into two categories based on when it occurs. Sleep bruxism happens unconsciously during the night and involves rhythmic grinding movements that wear down tooth structure.
Awake bruxism involves more clenching, often in response to emotional states like stress or anxiety. Consequences of both types include jaw pain, headaches, and tooth wear. Structural issues, such as a poor bite (malocclusion), contribute to grinding because jaw muscles work harder when teeth do not align correctly. Behavioral factors, including stress and certain stimulants, are also recognized as triggers, especially for awake bruxism.
How Orthodontic Correction Affects Grinding
Braces address the structural factors contributing to bruxism by correcting malocclusion. A misaligned bite creates uneven pressure points, which the jaw muscles attempt to neutralize by clenching or grinding. Orthodontic treatment gradually moves the teeth into ideal positions, establishing a balanced bite where forces are distributed evenly.
By creating proper occlusion, braces reduce the muscular tension and strain that trigger the grinding reflex. This realignment can eliminate bruxism when the primary trigger was physical misalignment. Braces treat the underlying structural cause, but they do not treat non-structural or behavioral causes, such as habits driven by psychological stress. Supplemental therapies are necessary for these patients, even after the bite is corrected.
Managing Bruxism During Braces Treatment
Bruxism can intensify temporarily after braces are placed or adjusted, as the changing bite causes jaw muscles to seek a new resting position. This temporary increase poses a risk because grinding forces can damage the orthodontic hardware, leading to loose or broken brackets and wires. Damage to appliances can delay treatment and require extra appointments for repairs.
Orthodontists use several methods to manage this habit while teeth are moving. A common solution is a custom night guard, which acts as a protective barrier and can be fabricated to fit over the brackets. Temporary appliances like bite turbos or bite ramps may also be bonded to the chewing surfaces of the front or back teeth. These devices prevent the upper and lower teeth from fully meeting, protecting the brackets from impact and helping to correct deep overbites. Patients experiencing irritation from the brackets or wires may also use orthodontic wax to reduce friction and protect the soft tissues of the mouth.
Long-Term Outcomes After Braces
For bruxism rooted in malocclusion, the long-term outcome after braces can be a sustained reduction or complete elimination of the grinding habit once the bite is stable. However, maintaining the corrected bite is essential, which is the role of the retention phase following treatment. Retainers ensure the teeth do not shift back toward their original, misaligned positions, preventing relapse.
For patients whose grinding persists due to non-structural factors, the retention phase includes specialized, protective appliances. While an orthodontic retainer offers some barrier protection, patients with strong, persistent grinding may be prescribed a custom-fitted nightguard, also called an occlusal splint. These devices are specifically designed to absorb the heavy forces of clenching and grinding, protecting the newly aligned teeth and the jaw joint from damage.