The goals of treatment are to reduce pain, prevent permanent damage to the teeth, and reduce clenching as much as possible.
The following self-care steps may help relieve pain:
- Apply ice or wet heat to sore jaw muscles. Either option can help.
- Avoid eating hard foods like nuts, candies, and steak.
- Avoid chewing gum.
- Drink plenty of water every day.
- Get plenty of sleep.
- Learn physical therapy stretching exercises to help restore the action of the muscles and joints on each side of the head to get back to normal.
- Massage the muscles of the neck, shoulders, and face. Look for small, painful nodules called trigger points that can cause pain throughout the head and face
- Relax your face and jaw muscles throughout the day. The goal is to make facial relaxation a habit.
- Try to reduce your daily stress and learn relaxation techniques.
To prevent damage to the teeth, mouth guards or appliances (splints) are often used to treat teeth grinding, clenching, and TMJ disorders. A splint may help protect the teeth from the pressure of clenching.
A well-fitting splint should help reduce clenching. However, some people find that the symptoms go away as long as they use the splint, but pain returns when they stop. The splint may also not work as well over time.
There are many types of splints. Some fit over the top teeth, some on the bottom. They may be designed to keep your jaw in a more relaxed position or provide some other function. If one type doesn't work, another may.
A splint called the NTI-tss fits over just the front teeth. The idea is to keep all of your back teeth (molars) completely separated, under the theory that most clenching is done on these back teeth. With the NTI, the only contact is between the splint and a bottom front tooth.
After splint therapy, orthodontic adjustment of the bite pattern may help some people. Surgery should be considered a last resort.
Finally, there have been many approaches to try to help people unlearn their clenching behaviors. These are more successful for daytime clenching.
In some people, just relaxing and modifying daytime behavior is enough to reduce nighttime bruxism. Methods to directly modify nighttime clenching have not been well studied. They include biofeedback devices, self-hypnosis, and other alternative therapies.