Bruxism, the medical term for teeth grinding or jaw clenching, is a common habit that often occurs subconsciously, particularly during sleep. This repetitive, forceful action subjects the teeth to intense pressure, making it a significant contributor to dental damage. Over time, this constant mechanical stress can weaken the tooth structure, leading to issues including severe wear, painful jaw symptoms, and cracked teeth. Addressing this damage requires both expert dental repair and a long-term strategy to manage the underlying grinding habit.
How Grinding Damages Teeth
The excessive, non-functional force exerted during bruxism creates concentrated stress points on the teeth, resulting in structural failure. Dentists classify the resulting cracks into distinct categories based on their depth and location, which determines the necessary treatment.
The mildest form of damage is craze lines, superficial cracks confined to the outer enamel layer that typically cause no pain. These hairline fractures are often visible only with specialized dental lighting.
A fractured cusp occurs when a piece of the tooth’s chewing surface breaks off, usually around an existing filling, but typically does not extend into the pulp (nerve). A more concerning issue is a cracked tooth, where the fracture extends from the chewing surface toward the root, potentially reaching the inner pulp tissue.
If left untreated, this crack can progress into a split tooth, a severe condition where the tooth is divided into two separate segments. Only a dentist can accurately diagnose the type and extent of the crack using visual aids, dyes, or specialized imaging techniques.
Repairing Cracked Teeth: Treatment Options
Treatment for a cracked tooth depends entirely on the fracture classification, ranging from simple reinforcement for minor damage to complex procedures for severe breaks. For minor craze lines, often no treatment is required, but small chips or surface irregularities can be addressed with dental bonding.
This procedure involves applying a tooth-colored composite resin directly to the tooth’s surface, which is then shaped and polished to restore the tooth’s appearance and protect the underlying structure. Bonding is a conservative and cost-effective option best suited for minimal damage.
When the crack is deeper, such as a fractured cusp or a crack that has extended past the enamel but not yet reached the pulp, a full-coverage restoration is necessary. A dental crown acts like a cap that fits over the remaining tooth structure, binding weakened parts together and preventing the crack from spreading. Crowns are the primary solution for cracked tooth syndrome, providing the structural integrity required to withstand the heavy forces of grinding.
The material (e.g., ceramic or porcelain fused to metal) is customized to restore both the function and appearance of the damaged tooth. If infected, the tooth requires root canal treatment to remove the infected tissue from the pulp chamber and root canals.
After the nerve tissue is removed and the space is cleaned and sealed, a dental crown is almost always placed over the treated tooth to protect it from fracturing, since the procedure weakens the tooth structure. In the most severe cases, such as a vertical root fracture or a fully split tooth, the damage is often irreparable, and the tooth must be removed. Following extraction, options like a dental implant or bridge can replace the missing tooth.
Strategies for Managing Bruxism
Once the dental damage is repaired, the focus must shift to managing the underlying bruxism habit to prevent future cracks and protect the restorations. The most common and effective strategy for sleep bruxism is the use of a custom-fitted nightguard, also known as an occlusal splint.
This device is fabricated by a dentist to fit precisely over the teeth, creating a physical barrier that absorbs the grinding forces and prevents tooth-on-tooth contact. While over-the-counter guards are available, custom-made appliances offer superior comfort, fit, and protection, making them the preferred choice for long-term management.
Since stress and anxiety are frequently linked to bruxism, incorporating stress reduction techniques can help lessen the severity and frequency of grinding episodes. Practices such as meditation, regular exercise, and mindfulness training reduce the muscle tension that contributes to the habit.
For individuals with awake bruxism (clenching during the day), conscious awareness training is beneficial. This involves periodically checking and correcting jaw posture to keep the teeth slightly apart, which can be reinforced through biofeedback devices that monitor muscle activity.
Lifestyle modifications also play a supportive role in reducing bruxism activity. Avoiding stimulants like caffeine and alcohol, especially before bedtime, can help decrease muscle activity during sleep. Improving sleep hygiene, by maintaining a consistent sleep schedule and creating a relaxing bedtime routine, can promote deeper, less disrupted sleep, which may reduce nighttime grinding. In some cases, a dentist may perform an occlusal adjustment, which involves slightly reshaping the biting surfaces of one or more teeth to ensure they meet correctly, thereby reducing concentrated forces that could trigger grinding.