Written by Vesna Delic Romero, DDS – Chief Dental Officer, Damage Control Mouthguards
Grinding is one of the few activities where the term carries no upside. In dentistry, grinding and clenching are grouped under a condition called bruxism, and the effects can be destructive. Bruxism places excessive, repeated force on the teeth and jaws, often leading to pain, dysfunction, and permanent damage. This article explains how bruxism affects the jaw joint, teeth, and what can be done to prevent or manage it.
When people think about mouthguards outside of sports, they are usually referring to a night guard. The name can be misleading. Many people grind or clench during the day while fully awake. Regardless of when it occurs, the forces involved are strong, repetitive, and cumulative, which makes the damage irreversible if left untreated.
Interestingly, the earliest signs of bruxism often do not appear on the teeth. They usually show up in the jaw joint, known as the temporomandibular joint (TMJ). Symptoms may include tension, soreness around the ears, jaw pain, or difficulty opening the mouth. When these symptoms become persistent, the condition is known as temporomandibular joint dysfunction (TMJD).
One common contributor to TMJD is an uneven bite. This imbalance often develops over time due to tooth wear, dental restorations, or missing teeth, rather than from the bite someone was born with. When the bite is off, excessive pressure is transferred to the TMJ. Over years, this can wear down the joint cartilage and bone in a way similar to chronic knee damage. Unlike knees, TMJ replacement is uncommon and invasive, which makes prevention especially important.
Several dental conditions can contribute to bite imbalance, including missing teeth, excessive wear from grinding, fractured teeth, or vertical collapse of the bite. These changes can cause uneven jaw movement or overclosure, placing additional strain on the TMJ and increasing the risk of dysfunction.
TMJD can also develop suddenly due to trauma. Sports injuries, physical trauma, or vehicle accidents can damage the jaw joint. These cases often require medical or surgical treatment and may involve medications or injections to manage inflammation and pain.
The good news is that many cases of TMJD are preventable.
After more than 20 years in clinical dentistry, one of the strongest predictors of healthy jaw joints is preserving natural teeth. Patients who prevent cavities and periodontal disease tend to maintain stable bites and report fewer TMJ symptoms. When dental work is necessary, restoring teeth to their correct position and properly balancing the bite significantly reduces TMJ-related problems.
Stress is another major contributor. Modern life creates constant pressure, and many people unconsciously store that tension in their jaw. Over time, stress-related clenching leads to tooth wear, muscle fatigue, and TMJ pain, often without the person realizing it until symptoms appear.
For patients with ongoing pain or severe grinding, a night guard may be the most effective solution. However, not all night guards function the same way. Clinicians typically recommend hard-surface night guards. A hard guard triggers a natural reflex that causes the jaw to relax and open slightly, reducing muscle activity and joint strain.
Soft night guards behave differently. They can encourage chewing-like activity, which increases muscle engagement and may worsen clenching. Regardless of material, a night guard must be properly balanced so the bite contacts evenly. This adjustment is usually performed by a dentist or trained dental lab technician.
Conclusion
TMJ dysfunction can develop for many reasons, including bite imbalance, dental wear, trauma, and stress. In some cases, wearing a properly designed hard night guard is the only way to manage pain and prevent further damage. For many patients, the right night guard restores comfort, function, and long-term oral health.
About the Author Vesna Delic Romero, DDS, is the Chief Dental Officer at Damage Control Mouthguards with over 20 years of clinical experience. Her work focuses on bite balance, protective dental devices, long-term oral health, and dental implants.
