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GRINDING GRINDING TO A HALT Breaking the habit can spare teeth from damage R

December 3, 2006 12:50 am

By KATHRYN MOLINARO

OGER SUTHERLAND didn't know what was wrong. He woke up every morning with a headache, sore jaw muscles and a constant earache that threw off his balance.

Thinking he had an ear infection, Sutherland, the assistant fire chief for Stafford County, visited a doctor who told him to see a dentist. Skeptical, Sutherland followed the order and found out he had been grinding and clenching his teeth so much that he had developed temporomandibular joint disorder.

The disorder, known as TMJ, is named for the joints in front of the ears that connect the jaw to the skull.

"I would grind almost 24 hours a day," Sutherland said. "It's not the normal, average grinding your teeth when you go to sleep. It's chronic pain every single day."

An estimated 20 percent of American adults grind or clench their teeth, though it's hard to know for sure because most people grind in their sleep.

According to the Mayo Clinic Web site, 30 percent of children grind their teeth. Many children outgrow the habit once they get their permanent teeth, so it is rarely a cause for concern.

But for adults, it can lead to all sorts of problems--headaches, neck and shoulder pain, teeth sensitivity and the erosion of tooth enamel. Without treatment, it can become a serious and expensive problem to fix.

The earlier grinding and clenching is detected, the easier it is to prevent complications.

Long before the spasms in his jaw and neck began, Sutherland said, his doctor told him he was grinding his teeth at night.

"But of course I wasn't symptomatic, so I just thought he was kind of nutty," Sutherland said.

Also called bruxism, grinding and clenching are often caused by stress. Other causes of grinding include a misaligned top and bottom bite.

Sutherland thinks it was a combination of factors for him.

He said that although he had braces when he was younger, his jaws were misaligned. He was also under a lot of job stress when his jaw problems got bad about 12 years ago.

"I would grind a lot at work because at the time I was doing a lot of work behind the computer," Sutherland said.

Dr. Cathie Butterworth, of Fredericksburg Smile Center, estimates that 50 percent of her patients grind their teeth.

"I think our life is getting more and more stressful," she said. "It just wasn't like that 10 years ago."

Butterworth said she looks for "wear facets," shiny spots on the tops of teeth, to see if a patient is grinding.

She said some of her commuter patients have started wearing their night guards, which prevent grinding, during their drives to work. Though the guards generally are worn at bedtime, the commuters realized traffic makes them prone to grinding their teeth.

Butterworth typically prescribes night guards when she discovers her patients are grinding. The guards are similar to mouthpieces used in sports, but they're soft against the teeth and hard on the outside. They click into place so that they won't fall out at night, and they keep the mouth open just enough to prevent grinding or clenching.

Because they must be custom-made and fitted by a dentist, the guards usually cost about $300. Similar devices for more serious bruxism problems can cost up to $1,500. Butterworth said a night guard lasts 5 to 10 years.

There are less-expensive, over-the- counter night guards, but Butterworth said they are less reliable.

"They'll work for some people for a short amount of time," she said.

Night guards seem expensive, but Dr. Lloyd F. Moss Jr. said they are better than the alternative--root canals and other procedures to repair or replace damaged teeth.

The normal burden put on teeth while eating is 45 to 60 pounds of pressure per square inch, Moss said. Grinding exerts 450 to 500 pounds of pressure per square inch.

"People should really be aware of the damage they can do," Moss said.

He said some people grind their teeth to less than 25 percent of normal size.

"They have just ground them down so there's nothing left," Moss said about some patients. "It's easier to just prevent it."

Spotsylvania County resident Sarah Lagasse, 32, has had a night guard since 1997 and said the over-the-counter ones don't come close to the one her dentist prescribed.

"I've tried everything out there," she said.

She said she forgot her night guard on a trip and bought a temporary one at CVS for $50. That night she woke up with it in her hand.

"I've got to have the dentist's one," Lagasse said. "I've been wearing that thing religiously."

The night guard prevents the headaches Lagasse had when she was clenching her teeth. When she doesn't wear it, even for a night, she can tell.

"It's the right-next-to-my-jaw headache," she said. "There's no chance of sleeping without that thing in my mouth because I wouldn't have any teeth left."

By the time she found out she was grinding, her teeth were already damaged. But the night guard has kept her from harming them more.

Not everybody who grinds ends up with significant dental problems, Moss said. Some, though, like Sutherland, end up paying a hefty price.

After about $20,000 in treatment, which included braces for the second time in his life, Sutherland is no longer in pain.

"It's manageable now," he said. "Then, it was not."

To reach KATHRYN MOLINARO:540/374-5400
Email: kmolinaro@freelancestar.com