Bruxim

The Cause and Cure of Bruxism and Clenching by Dr. Mike Mew.

Below is a video from Dr. Mike Mew explaining all the information about Bruxism. We do not own any copyright to the information and we just found it very useful for your teeth grinding problem. We have also provided a full transcript of the video. Hope it will be of value for everyone who has Bruxism.

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The Cause and Cure of Bruxism and Clenching. These are issues that cause a lot of concern to quite a lot of people. And I think it’s getting worse. These calls, problems like headaches, jaw joint problems, and even dental wear. And there’s a lot of discussion within dentistry about why these problems are caused and lots of interesting treatments. The treatments seem to be splints. People put splints whether they are hard splints. We have up on the top diagram or soft splints down on the bottom right hand side and the hardest splints are often finally-adjusted as you can see down to the bottom left using basically carbon paper where you bite together that you can then make marks on the splint where the teeth touch the splint and they can be ground so that you can get sort of balances between the jaws, the upper jaw or large or it doesn’t matter which side splint goes can have the teeth adjusted so that they meet the splint in a smooth way so you can move well, some people’s hair smooth way with nonworking side or working contact. There there’s a canine guidance group function. There’s lots of different ideas behind how you can adjust these splints to correct the sort of, or improve the habits or the stimulus that lead to Bruxism.

There is a great deal of disagreement. My concern about a lot of these appliances is a course that they can occupy tongue space. And some of the soft ones they can actually almost encourage chewing, you know, but some think that is chewy between the teeth of the cure and they may well chew on it and that could be counterproductive. So the suggestion is that we’re overworking or chewing muscles and the, our recommendations are often the hold the teeth of pot, whether that relates to a splints or not. There’s some debate on that.

Sometimes you have these reflect liberating splints where you over stimulate one or two of the teeth, usually the lower front small teeth. So they support that load threshold which are mentioned later, so that that sends a reflects back to cause drawer opening or at least a reduction in the jaw closing. But people are asked to avoid holding their teeth in contact and of course avoid holding, chewing, chewing gum or excessive use the jaw muscles. And I guess if you’ve got problems and you’ve got damage in the jaw joints, that I guess is not a bad idea, but that’s not normal state of affairs. So that’s dealing with a pathological situation.

What should we normally do particularly we don’t have problems? Well, when we’re talking about the disuse theories, so we’re saying we are overusing our chewing muscles. It’s interesting to reflect back to see what our ancestors did. It’s important to remember that we’ve been anatomical humans for 220,000 years and there’s no evidence. And also when you look at indigenous populations, there’s no reported symptoms of clenching or Bruxism. It seems to be a modern problem. Now it does interest me. The indigenous and ancient man had a great deal of where they wore their teeth down heavily. Not one or two of them, but they all did that. I mean, here’s an image of a relatively modern aboriginal and some teeth from a preserved skull. Both of them have a great deal of wear on them. That is interesting because there’s a whole science, is formed relating to what we return is attrition. Attrition is tooth on tooth wear. And it’s interesting because of course we know approximately when the teeth should erupt. So your first law of molars coming up soon after six years old, then your 12 rolled molar coming up at 12 year old and your wisdom tooth would come up around 18.

In historical societies it was fairly consistently around 18. I know people don’t tend to, we tend to be very delayed or they don’t come up at all in modern era. But when you had this fairly consistent pattern where the six year old molar arrived at six, the 12 year old molar arrived at 12 and the wisdom tooth arrived at 18, you could use the difference between the wear on these individual teeth to work out roughly how old the individual was. And it seemed fairly consistent. And as mentioned by Brothwell here, we was in fortunate that the rates are where we’re fairly consistent between the Neolithic to the medieval times. So right up to the medieval times, there seems to have been quite a normal pattern and it was used to measure the age of skulls.

And an interesting quote, that I can’t find the exact source of this, but I remember someone saying it’s quite to me it says it was not uncommon for the lower first molar tooth number six or the six year old mode, same tooth to break into its separate in the middle of the fourth decade of life. So that’s where the tooth is worn so far the roots reached the root level. You were through the tooth. We have only got the three routes or two routes in the law present. Now that’s a huge amount of where there’s a vast amount of web. But basically it’s clear to say that our ancestors had a lot of where a real large amount of web and they didn’t get Bruxism or clenching to our knowledge.

So is clinching and Bruxism related to over activity of the muscles? Well, possibly, but I think it’s a little bit more complex. And as with many things, I don’t think anyone out there is completely wrong. It’s just a little bit more complex and sometimes you need to look at a slightly more complex answer. It’s interested me that all skeletal muscles, the cross a joint are arranged in hang tags, autistic pairs or groups. All of them. You don’t have muscles that just work on one side of a joint. It wouldn’t work. You would have no control. Of course the classic example is the biceps and your triceps. And it interests me that of course I can use my biceps and triceps and I can move my arm up because as I do that, I’m clearly using my bicep. But the triceps, there’s also working, it’s not that there’s muscle isn’t being used at all. It’s controlling it. It’s slowing down and regulating the action of my bicep. So both muscles work there in a nice antagonism. And of course they’ll work in an antagonism in this orientation and the work in antagonism in this orientation. And by and large, apart from the physical weight of my forearm, I don’t really perceive any difference. It seems more or less the same to me.

And there’s a lot of this is because I’ve got some neuro control going on. It’s going on in at the level of my spine. And that’s really controlling, you know, not only the regulation, but also the over activity, under activity. You know, it’s controlling the muscles in such a way that I don’t really think about what I’m doing. I’m just saying, move out, move back, move out, move back, move out, move back. And it works it out for me. There’s no point. There’s no point in bothering my higher centers with the sort of thing. It’s a very similar, in a way to when you have a pain reflex, when you burn yourself, so you touch a hot thing. The pain, well, there’s no point in paying going all the way up to your head. You were thinking about it. Oh yeah, it’s burning. I mean, I’ll be spending barbecue by the time that happens. No, you want an instantaneous reflex reaction. So you put your finger or hand or whatever’s being burnt straight away from the source so that you have so you protect yourself. That’d be an you need that. That’s a reflex that goes on.

And now it didn’t trust me. I remember someone hearing telling me that dinosaurs had many brains. Now that’s not entirely true. They only have one place they thinking. But of course a lot of this local regulation can be farmed out. It can be housed further down their body and close. When you’ve got something quite that long, it’s a sensible thing to do because the time lag of coming up to your brain all the way back again would cause you lots of problems. In fact, you could also almost occur sort of levels of resonance going on within the system. It could be quite damaging. So it is interesting that people who have identified the potential of hind brains spaced about by the limbs in the spinal cord area of some dinosaurs.

Now I’ve heard many people say that the masseter has the strongest muscle in the body. Now wait for weight any cubic millimeter of muscle is the same as any other cubic millimeter of muscle. By and large, I mean there are slightly different types of muscles. But if we’re talking about voluntary, straight in muscle, they’re all about the same. Now they’re all different orientations and here I described three of the classical types of leavers. Now most muscles work as a class one lever. So for example, well for example, my elbow, the tricep pulls the bit of my elbow, that’s this side of the joint and the force has produced at some distance on the other side of the joint hindering around in the central the joint, like a classic class one lever working at a disadvantage in the situation.

Now of course the masseter different, the massters working at act, well it was slight disadvantage but not nearly suck to disadvantage. So we look at these different types of muscles. You’ve got the knee where the quadriceps works on about a 25 to one disadvantage, which gives more range but less force. Of course the biggest muscle in your body, the glutes is working there across your hip at about a 10 to one disadvantage which gives it less range, but of course some enormous power. You know, you can wear big rocks. You can carry someone else and you can go from a squat and you can stand up. That’s your glutes, that’s your 10 to one advantage or disadvantage on that lever arm.

Now your masseter, well that’s working. There’s a class three lever and well if you think your joints hair, your muscles here, your food’s here, or even further back when you’re using a back teeth. So you can work at a one to two mechanical disadvantage, which is far more so you can apply for more applicable power using the muscles than in any other part in your body. So as not that the massters does all the temporalis, the jaw closing muscles or any stronger, it’s just that they can apply more force, more power because of the way they’re set up.

Now we’ve got these very large muscles that are able to apply a lot of power, a lot of false. Now what’s their antagonist? So if I’d thought that all of these muscles have antagonists, what is the antagonistic muscle to calm, to regulate, to govern, control these big chewing muscle support, the closing chewing muscles? Well, I don’t think it’s any of these muscles. These are all small muscles. They’re not in the right orientation. They’re not really set up in the right place. It’s important I make the point that we’re not talking about when we’re actually chewing. This is when you’ve got your mouth closed. This is in your sort of homeostatic also of maintenance, your postural position. As soon as you thought chewing, it’s a different situation. But people aren’t clenching in a chewing cycle. People clenching when they’re at rest. And this is Bruxism, this is the problem.

So you got these great big muscles. I mean they, they’re chunky muscles. So what are the antagonists where the antagonist muscle? Well, I can only imagine the antagonistic muscle for the door-closing muscles would be the tongue. I mean it is one of the largest muscles by size, by boat. However, you mentioned a measure it within the cranial facial structure within the skull head, really a tall. And also it’s arranged in a good position. It’s very central. You’ve got the force of the jaw closing muscles either side, you’ve got the tongue in the middle. It’s my likely candidate for the antagonistic muscles for the jaw closing muscles when at rest, the homie staff basis of rest.

And, you know, it’s the right size is right bolt kit’s the right position now. Okay. This is a system. What can go wrong with that system? Well, I have, while my, one of my main thesis is the concept of craniofacial dystrophy and it describes how modern faces literally changing shape and of course something that isn’t the right shape probably doesn’t work as well. But also some of that is not fulfilling its function can lead to a cascade of functional problems. Maher, the concept mainly we’ve kind of major change in diet would have gone from an incredibly tough, hard low calorie diet or very soft high calorie diet just as we need less calories. And also we’ve changed our posture. We’ve gone from a really good posture to a really bad posture, not only using phones and sitting and computers and you know the things that drive poor posture. But of course we’re getting nice obstructions and that’s leading to poor postures and of course we’re having this epidemic of allergies, crooked teeth and crowded teeth.

Now the big element out of that is it cost getting blocked noses. Allergies are going up at an epidemic level and as academic levels I as this occurs, we get transitory blocked noses. Now if you have a blocked nose, you’re faced with two options. Either you separate your lips, you lower your tongue off the roof of your mouth and you open your mouth to breathe or you die. They’re all no alternatives. Now I think one of the big problems here is what starts as necessity can become habit. And I’m surprised how high an open mouth posture, but particular low tongue posture’s because you’re going to be illiterate, close, but still have a low tongue posture. And of course this is in a world where we’ve all got soft food. So the jaw muscles actually all working nearly as much as they should be.

Now when we get this lowering of the tongue, it allows a reduction in the tongue space because the maxilla collapses also because we’re not exerting as much forced through the whole system. And of course we then get a narrow palate. Now that’s when you, one of the angles, which we can look at a reduction tongue space because the maxilla is also dropping down and back. It’s getting narrow, it’s getting shorter, but clearly one of the obvious signs is a narrow maxilla. And it’s estimated that our ancestors had an intermodal wet. So the clear width, when you look at the width, the narrow palate, the bottom line here, that’s the intermodal width. Whereas our ancestors had an intermodal width than the sort of low 50s we now have an intermodal wit in the low 30s and that has happened relatively quickly. So you can go back to those medieval scholars and they tend to have an intermodal width of not far off the low 50s or at least high 40s and we’ve got a gross reduction so that most people now have an intermodal width than the sort of low 30s. And that is a significant change.

And of course if one of the causes of this as the autonomous dropdown, what’s you’ve lost space, it’s very difficult to get the tongue back up there so it can easily become a vicious cycle. Now you then make compensations because you can’t have your tongue pushed down into the airway. So you want to make a compensation for your airway. And more of the compensations you can make is to move some of the bulk of your tongue out between your teeth. I mean this top image here is a relatively mild illustration. I see people who have the tongue right between the teeth. And of course you get this classic marking on the size of the time. And of course usually the teeth should move, touch the opposing teeth because if you have your tongue between your teeth, this is going to happen and the teeth are going to move to fit the time and the sort of pattern of the tongue you’ve got between the teeth. They’re not going to move to fit the other teeth. So it’s easy then.

Well it’s likely that when your bring your teeth together they weren’t fit together perfectly and you get what’s known as premier contacts. Some bits that touch a little bit earlier than other bits. Of course then the tone is not on the roof of your mouth and the tongue is not on the review mouth is not acting as an actual antagonist to the jaw closing muscles. And of course also because your tones, which between the teeth most of the time that becomes your habitual postural position as such being dynamic people, individuals, dynamic organisms, the jaw joint will reform so that it’s balanced with the teeth slightly apart. Yeah, jaw gape, you leave them and then it is not particularly balanced when you bring your teeth together as we’ll come to. But this position, picture of a tongue with scalloping on it, it’s classic is a classic sign that your tongue between your teeth.

I remember when I was young and we didn’t have seat belts in the back of the seat. I’ll lie down on , see I have a snooze you’d wake up, are we there yet? And I’d have loved to written in reverse on the side of my face from where I’d been lying on the seat. Or you know, you have a very heavy night’s, you can wake up the mocks of your sheets on the side of your face. Clearly what we’ve got here is the tongue forming to the position of the teeth for me to the shape of the teeth where it’s wedged in between, we’ll revert with tongue splinting.

Now there is another mechanism for venting you chewing or you biting too hard on your teeth. Clearly the body’s full of mechanisms, usually pain mechanisms to prevent you damaging yet. And this arm I was taught as the buck shot reflex is what we were taught. So the eve get a little better buckshot, eh, as highlighted between knees rather original teeth. The classic example is you’re eating a pheasant or some game that’s been shot by a buckwheat and it has happened to me once. My uncle used to be in a hunt and you’re chewing some meat and all of a sudden you have a bit of buckwheat. It gets in between your teeth and your whole massetory symphony stops like that. It’s actually quite amazing. When you think your teeth are passing across each other with tens, twenties, 30 kilos force, they never touch it. It’s a very small elements of error going on. And all of a sudden this whole system has been working away, stops like that.

Now it stops because as you bite down, you hit the buck shot. That buck shot pushes more on one tooth because clearly other teeth haven’t touched together or touched onto anything yet. That loads to single teeth and that then sends a feedback mechanism down to switch off the chewing mechanism. Now that’s clearly an overload mechanism. Now we’ve got what we should have 32 teeth in the mouth. Most people actually only have 28 teeth in the mouth or less. A lot of people with a 24 teeth in the mouth and heading south. So if the overload mechanism of one individual to, let’s say as a couple of kilos, we would add up all of the overload thresholds for all of the teeth in your mouth, that would add up to be quite a large force, a lot of kilos at say lots of kilos.

So if you’re going to your teeth fit reasonably well, right? You might have a few premature contact, but remembered he’s moved a little bit as you bite them together. As you bring your teeth together and they move around to take the force, you’re going to exert a lot of kilos before you start exceeding the threshold of this whole group together, all of your teeth together. So there’s a lot of force before this mechanism will kick in. This mechanism is not really designed to gain fine control of you bringing your teeth together. So if you don’t have the normal antagonistic mechanism, normal governing system working and you bring your teeth in contact, you will have to exceed a great threshold but for a greater number of kilos before the threshold of overloading surpassed and you could cause a lot of damage with this level of force.

Now of course they, we have systems of feedback. This is the classic feedback system. This is a governor and they were developed when we had steam engines. So the faster this spindle goes round with faster, the rolled in the middle goes round but more these weights move outwards and the more of these weights move out, the more the lower color moves up and that can be attached to something. And that attachment then slows down the steam engine. And this is the way you maintain a constant speed with your early mechanisms. And if you didn’t have this, then the steam engine could go faster and faster and faster and it would bake itself into parts would fall apart. Of course there’s another governor pulling a sort of similar role.

But of course what we’re able to do is without the tongue on the roof, acting as an natural antagonist is light, we’re shoveling coal into our steam engine. We’ve removed the governor, thrown it away and it’s going faster and faster and faster. We’re putting more and more Colin because we’re stressed and our modern lifestyle, this is all the extra cold going in and we’re able to exert huge forces. We can maintain these huge forces for that 10, 20 I doubt a full hour, but you’re talking good periods of time and you’re talking really strong forces and of course you’ve got premature contacts. And these premature contacts, they’re annoying. And of course when you get something annoying, you always want to grind on it because you know, it’s there. You know, in a way possibly you’re trying to push these premature contact down. You would have your teeth were biking together likely for long periods of time. And of course your muscles, these muscles were talking about the joint closing muscles or any of the muscles of mastication and not really set up for having your teeth together. Remember they’re set up for your teeth, things like your part as the jaw joint.

So they’re really well designed for you bring your teeth in contact, bring your teeth together. And also you’re doing this part time. If you your teeth together all of the time, of course the body would reform to this position but you don’t. Max maybe you might have one, two hours in a day or if you’re going to the night through the night. But this isn’t enough to stimulate change, but it’s plenty enough to cause damage way enough to cause damage. And of course this huge force you’re putting across, you’re crushing your skull together it’s going to cause muscle ischemia cause the muscles can’t, they’re not stopping, they’re just switched on. That’s it. Nothing switching them off. It’s a completely pathological situation. They never get switched off or they don’t switch off as Mike Do. You could consciously switch them off or the overloading mechanism, we’ll switch them off, but that’s a very high load.

And so there you get ischemia or you do the blood flow doesn’t move in there so you can get a lot of pain just in the muscles themselves. But of course you’re crushing your whole scar. You’re holding all of the sutures in a position, in a compressed position for long periods of time. There’s their blood flow going in and you could easily close of little veins and archery’s passing through. You could potentially could cause lots of problems. And I’m interested in this concept of the movement of the plates of the skull and the acting as a pump for the Sarah Bro Vascular system. But I don’t know, I don’t know if it’s true, but I had a lot of people saying is low Nordson sort of had a lot of people giving good grounds or suggestion towards it.

However you’re clenching close all the time and the system does work, it’s clear, you’re not going to work very well. And the classic example of this is when people are going to sleep, you try and go to sleep, you’re lying down. And of course a lot of those stresses that come from a modern society are coming in your head. You thought tension a little bit and I think a little bit of clenching is not abnormal. I think the clincher muscles a little bit, it has normal thing to do. But you’d have a regulation, you should have a control, a governor of the system so that when you clench, it’s regulated. There’s not unregulated. This is where the problem starts. And of course we read, didn’t come on to care. What are you gonna do about this?

Well, realistically you need to get your talk tongue on top mouth. And I’m not talking about the tip waste of time. People told me constantly, I’ve got my tongue in the roof mouth, I can feel it. Forget it. You’ve got to get the posterior third of up and fully engaged up as opposed to the tongue gets you good head posture too. That’s got to be fully engaged and that comes up and the soft palate acts as you know, your trampoline up on the back there. You got to get your tongue out from between your teeth. All right? It’s part of getting it on the roof of the mouth so the teeth can come together so the teeth can rest in or near contact. This will lead to reorganization of the jaw joints and of course the muscles around it. And over time, you’ve got to rebuild this governor feedback mechanism. So you’ve got to have a feedback mechanism. You get gain control. Again, you’ve lost control. You’ve got to regain control and also going to gain a butterfly bite.

So the teeth should rest in or near contact. But if they rest in on your contact with the regulatory system working you, you’re not going to get problems. This is how they’re supposed to arrest. And the whole concept we have in a modern society. I mean I even questioned the concept of a freeway space, but that’s another lecture for another day as is jaw joint on issues. But I do think he should be in on your contact. They should be resting in butterfly bite. And that is, we’re a real controversy as one thing. I’m saying, people who are dealing with clenching or Bruxism and it was like, no, no, you’re, you’re, you’re, you’re leading people to do the wrong thing.

Now remember, don’t forget the tropic premise. There’s more just too good or posture than having tongue on the roof of the mouth. You’ve got to gain good, you’ve got to follow the tropic premise preferably with good body posture as well. And we know we can produce conditioned reflex responses. When someone jumps out in front of me, when I’m driving, I don’t run him over. I get to run anyone over. And the reason is I put my foot on the brake and I do that without thinking. So this is a conditioned reflex response. Now I know these are all cranial conditioned reflex response. I mean we’re way above the level of the spine here even with the chewing muscles all the time. But there’s still the same process occurs. The same wiring exists even if it looks different. And I know that when someone jumps in front of me, I hit the brake. I don’t think about it. I frequently do it when I’m sitting in my passenger seat and my brother’s driving, which is a scary enough and my foot hits the floor. Now I’m not even driving. So it must be conditioned reflex response. And I know I’ve built that response over time because I wasn’t born like that.

So we know we can achieve conditioned reflex responses, but of course we need to work on those. Those don’t come easily. You know, David Beckham has constructed, some kitchen should reflex response by continued practice. Any sportsman does the same thing. When you constantly do the same thing, you are building conditioned reflex responses. That’s the whole purpose of practice. My concern really is you need the tongue space to do it because you don’t have tongue space, you’re going to struggle. It’s very home to assume a position that’s uncomfortable. And I believe the primary driver of comfort is your airway. So to maintain an uncomfortable position against your airway for any period of time is going to be difficult. And of course not having tongue spaces, probably the definition of discomfort.

I hope that’s helpful. I haven’t previously, but I’m going to start engaging in some of the discussion below here. I’m concerned with some of the professional people who come on and saying, oh, this isn’t true because I’d say to them, well, come up with an alternative hypothesis. They don’t seem to be any hypothesis. No one seems to be thinking. No one seemed to be putting things together to come up with philosophies or ideas. When one of my hobbies is, which is looking at documentaries, particularly sort of physics and astrophysics I love, you know, looking about, you know, hearing about what they think is going on some of these asteroids and things.

Now, one thing is you have researchers and you’ll have theorists, and I think that makes a good balance science. Where are the theorists in orthodontics and much of medicine? We don’t have them. We just have experimenters who because they’ve done the experiment, are allowed to load it over everyone else and say, this is how it is. Well, I’m being a theorist here. I’m putting forward a hypothesis for discussion and I expect constructive discussion, polite, constructive discussion. We’ve also been a few websites you might find useful if you want to go to some of the all source materials and deeper discussions of this. Thank you very much for watching.

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