There are a number of reasons that nightguards and braces could provide great benefits to your dental health, and at Bitterroot Dental, we want you to preserve your natural smile as long as possible. However, one thing that causes immense dental problems is something most people are not even aware they are doing: teeth grinding. Many people grind their teeth at night, and the results are quite devastating and can be painful, especially when it manifests in a condition such as TMJ. As the Top Rated Local® family dentist in Missoula, Dr. David B. Duke can help.

Put An End To Jaw Pain

Whether your jaw pain is the result of TMJ caused by teeth grinding or your bite is out of alignment, Bitterroot Dental can help put an end to your jaw pain. From custom mouthguards used to combat teeth grinding to an occlusal adjustment, Dr. Duke’s modern dentistry techniques all him to analyze your jaw’s joints and muscles as well as your bite to determine the best solution.

Continue reading below for thorough explanations of how nightguards and braces can help, or schedule an appointment today!

Night Guards

Many people are afflicted with bruxism, or teeth grinding. Some people may do this consciously during the day, but it is a larger problem at night while you are asleep. Grinding your teeth can damage enamel, wear down teeth, cause jaw pain, increse tooth sensitivity or irritate your gums. The noise from teeth grinding can also disturb your spouse’s sleep if loud enough.

If you grind your teeth you should consider a night guard. The night guard, which is very similar to a mouth guard worn by athletes, provides a barrier between your top and bottom teeth while you sleep. All night guards are custom fitted for comfort and to allow for proper breathing. We will take an impression of your teeth and have the night guard created in our dental lab. Night guards are very durable and can be used for up to 10 years.

There are also some things that you can do to try to stop teeth grinding. You can train your jaw to be free and easy rather than clenched. Refrain from chewing gum or on other objects like pens. You should also avoid alcoholic drinks and drinks with caffeine, as these can increase the likelihood you will grind your teeth. If you suspect you might be grinding your teeth at night set up an appointment with us today.


TMJ is the initialism for temporomandibular joint, which connects your lower jaw (the mandible) to your skull at the temporal bone. This joint controls many jaw functions, like chewing. If the chewing muscles or the joint itself are causing you pain you may have temporamandibular disorder, or TMD. TMD can be caused by stress, continual clenching of the jaw muscles, teeth grinding, misaligned or missing teeth, uneven bites, skeletal growth abnormalities, medications, or trauma.

Some of the symptoms of TMD are:

  • Pain when opening or closing mouth
  • Inability to hold the mouth open for more than a few seconds without pain
  • Trouble chewing
  • Jaw won’t open very wide
  • Jaw becoming stuck open or shut
  • Headaches or ear pain
  • Clicking or popping sounds when opening or closing your mouth
  • Teeth grinding or clenching

tmj_problemsMany of these symptoms can often be associated with other health problems, so only a medical professional can tell you if it is due to TMD. Teeth grinding is an especially problematic symptom because it can lead to further problems. Prolonged teeth grinding, or bruxism, can cause enamel to wear off teeth and expose dentin. This material is softer than enamel and more susceptible to decay. Sensitivity to hot and cold food or drink may also develop from excessive teeth grinding.

If you suspect you may have TMD come in for a consultation. We can help diagnose you and provide relief for your symptoms. Pain relievers and hot/cold compresses are short term methods to provide relief for pain symptoms. A night guard or therapeutic appliance can be used to help prevent or lessen the effects of TMD. This can lead to a more permanent solution. Often, balancing the bite can alleviate your problems. In our office, we use the T-Scan computer bite analysis technology to evaluate if balancing your bite will resolve your symptoms. In very severe cases of TMD surgery may be required, but behavioral treatments to change the way you use your jaw muscles or balancing the bite are usually enough to provide relief.

Occlusal Adjustment (or Equilibration)

Do you wake up in the morning with a sore jaw or headache? When you bite, do you feel like your jaw is lopsided? If so, then you may need an occlusal adjustment.
An occlusal adjustment, or equilibration, corrects the alignment of the bite, that is a result of loose, shifting, crowded, or missing teeth. The result is an evenly distributed bite that eliminates irregular pressure on one side of the mouth. Once your bite is adjusted, your teeth will meet properly. Occlusal adjustment are generally painless, and in fact, most often they relieve pain from sore muscles. Dr. Duke will use the T-Scan computerized bite analysis system to determine if an equilibration is necessary and to pinpoint the exact locations to equilibrate. The adjustment is made by using a fine polishin stone and using selective recontouring of necesssary in teeth in specific places. Equilibration does not permanently damage the teeth and usually does not require numbing. In addition to the actual adjustment, removable mouthpieces (therapeutic appliances) are also utilized, to protect the tooth surface, and relax the jaw muscles once the adjustment is completed.

Who is a good candidate for an occlusal adjustment?

  • Patients with joint sounds (clicking or grinding noises)
  • Patients with sore chewing muscles, frequent headaches or neck pain
  • Patients with loose or shifting teeth that do not meet correctly.
  • Patients who grind or clench their teeth, have an uneven bite
  • Patients with tooth sensitivity from wear areas at the base of the teeth (cervical notches) and the accompanying recession and root exposure

If you suspect that you may need an occlusal adjustment, schedule an appointment with Dr. Duke for an occlusal analysis of your jaw joint, muscles, and bite relationships.