Three levels grinding/clenching

1. Mild
2. Moderate
3. Destructive

Symptoms destructive clench-grind

1. Tooth movement after ortho
2. Recession/bone loss
3. Cracks-Broken fillings, teeth, crowns, bridges
4. Loose implants
5. Broken, cracked, chipped appliances
6. Worn out dentition
7. Failed implants
8. Broken retainers, brackets, spacers
9. Atypical toothace
10. Atypical earache
11. Cervical erosion
12. Enlarging tori, bone buttressing
13. Loose crown or bridges
14. Build-ups broken off inside crown
15. Tooth pain after cementation crowns
16. Worn out night guards-biteguards in short time

Grinding/Clenching:

1. Daytime: clenching, posturing, bracing, gnashing, nail biting, tongue biting, cheek biting, lip biting
2. Nighttime grinding is more destructive due power at night exceeds the chewing power by 6 times.
3. Need to measure power, frequency, and duration to determine damage potential
4. Sleep studies measure breathing, sleep architecture, and grinding activity (only source data)
5. Clenching & grinding damage all structures of chewing system: TEETH, BONE, MUSCLE, JOINT

Tension in Muscles

Three processes occur from anxiety/stress:

1. CORTISOL
2. ADRENALIN
3. TENSION MUSCLES

Levels of tension in muscles:

1. STRESS
2. ANXIETY
3. EMOTIONAL HYJACKING
4. PTSD

Muscle Joint Pain is #2 pain world:

1. BACK
2. NECK
3. HEAD
4. JAW

Tension in Muscle Pathway:

Stress---Sympathetic---Gamma Efferent--Muscle spindle-- Tr Pt --Muscle Inflammation--PAIN

Ligament Tear:

Stress- Sympathetic-Lat Pterygoid-Pulls Lateral Ligament-Stretch-Tear Lat Lig- Disc Disp--PAIN

Progression Tearing:

Displace Disc Pathway: starts at lateral pole and proceeds to medial pole unless dentists intervenes

Lateral pole -- middle disc -- medial pole