During sleep we all do strange things, such as snore, kick our legs and even talk. But one of the most common things we do at some time during our lives is grind our teeth. For lots of people, this goes unrecognised. Some people may notice their teeth are wearing down or breaking, but for the unlucky ones, they suffer with headaches and migraines.
Did you ever wonder what these symptoms have in common which all make your life miserable ?
They all are controlled and/or moderated by the Trigeminal Nerve System. When the muscles start making your jaw clench and grind your teeth, the Trigenminal Nerve System gets bombarded with signals. If the system is compromised, then it is unable to handle the signals and is misinterpreted. This results in a stimulus to the fluid surrounding the brain, resulting in a pounding headache or migraine.
We now know that many symptoms can be related to this noxious input and our understanding of the Trigeminal nerve, and how the symptoms relate to a migraine sufferer.
The Trigeminal Nerve has to two divisions:
- Motor Root, which sends nerve impulses to the jaw muscles to make them contract; the far more massive Sensory Division (made up of the nerves that bring in information from the periphery).
- Sensory Division is divided into three distinct segments of sensory reception (thus the term Trigeminal):
- First Division: Opthalmic: receives sensory input from arteries that surround the brain to around and behind the eyes
- Second Division: Maxillary: receives sensory input from below the eyes to the upper jaw.
- Third Division: Mandibular: receives sensory input for the entire lower jaw. All three divisions feed into the Trigeminal Sensory Nucleus.
The current understanding of the nature of the migraine is that it results from a disorder of “sensory modulation”, meaning that information received by the Sensory Nucleus is misinterpreted, thereby resulting in either a disproportionate response, or an inappropriate response altogether. For example, during a migraine attack, the simple pressure changes of the fluid that surrounds the brain (resulting from the beating of the heart), is perceived as “pounding”.
The therapeutic goal in migraine prevention is to limit the amount of noxious sensory input (that is, to limit your migraine “triggers”) to the Trigeminal Sensory Nucleus. The way in which we can do this is by reducing the intensity of tooth grinding and clenching, thereby reducing the amount of signals being sent back to the Trigeminal nerve system. The most clinically effective device that can do this is SCi.
Tooth wear and broken teeth
Your teeth should last you a lifetime and not wear down. However, bruxism is a destructive condition. Normal chewing and eating does not cause wear or damage to your teeth. If you suffer from bruxism, you are putting your teeth and gums under massive amounts of pres- sure. During sleep, there is no feedback mechanism to tell your brain that your teeth are hurting because of too much pressure, hence we can put up to 40 times the amount of pressure on our teeth whilst we sleep – it is no surprise to see a lot of damage.
The most common sign of bruxism is shortened front teeth (incisal wear). However, in more severe cases, we see signs of cracks in enamel, abfractions (enamel loss at gum level), gum recession, bone overgrowths (bony exostosis), broken cusps of molar teeth, and damage to restorations (crowns & bridges). Poor diagnosis often sees patients suffering from bruxism having multiple root canal treatments, which are unnecessary, as the condition has been mis-diagnosed.