Co-morbid bruxism

I like my teeth. Even throughout the period where my top teeth were being straightened, I liked them.

Although, I hated the mottling, I hated the facings that the dentist installed to cover that, and I dislike the yellowing now that my teeth have no facings (take the surface off the teeth and the mottling became more even), and I dislike that my bottom teeth are still overcrowded.

Other than that, they are good teeth.

Even if I’d like my teeth to be a little bit whiter, they are hard and strong, something that is uncommon in my family. Until recent years, the only fillings in my teeth are preventative.

But my teeth are disappearing, showing signs of extreme wear. Subconsciously, as a reaction to chronic pain, I grind my teeth.

Bruxism wears teeth down

My molars look like I am 10 years older than I actually am, and a recent trip to the dentist, stress fractures - currently only a cosmetic problem - on the surface of my front teeth were discovered (although this is fairly normal with age), my canines are no longer pointy, and the night guard (which has done a wonderful job of protecting my teeth during the night), shows signs of increased wear at the front.

I often catch myself grinding throughout the day, or gritting my teeth, but for me, the bruxism is much. much worse at night.

Bruxism from inflammed tendons

The muscles and tendons around my jaw are regularly inflamed, and more regularly lock the jaw. Of course, the spondyloarthritis (psoriatic arthritis) is likely the main cause of this.

Bruxism, SSc and PsA interact badly

Additionally, spondyloarthritis can directly cause inflammation in the gums, which leads to periodontitus, loose teeth and other problems. The gum inflammation has resulted in quite some additional fillings though, compounded when my older fillings wore out. Four years ago, I had to visit the dentist 13 times! But touch wood, everything has been stable for the past few years.

The more recently diagnosed systemic sclerosis also affects mucous membranes and skin around the mouth - I can’t close my mouth now at night as the skin has tightened and my lips have shrunk in recent years. Thankfully, the nightguard acts as an extra ‘lip’, locking the moisture in my mouth in and protecting the teeth.

Treating bruxism

The tension around the jaw affects the muscles in the neck and shoulders, and causes headaches to worsen. It also seems to worsen sinus problems, possibly through the nearby inflammation.

Physiotherapy: Those tight muscles and tendons can be massaged to loosen them, but it’s not a pleasant therapy session. There are also jaw and neck stretches, which I try to do regularly.

Conscious relaxation: When I recognise that I am gritting my teeth, I consciously force the muscles to relax as much as possible. But I am forgetful, and a lot of what I do is on autopilot, subconscious actions. Progressive relaxation exercises do help, when I remember to do them. I probably should do them several times a day, but I forget, or become distracted.

Meditation: Meditation also helps to reduce the tension, and helps when there is chronic pain that is causing the bruxism.

Heat: helps, but I can’t walk around all day with heat packs pressed to my face.

Mouthguards: At my next dentist visit I will inquire what options exist for ‘day’ guards, perhaps something like the plate I wore for many years to straighten the top teeth. I like my teeth, and I’d like to keep them for as long as possible.

Update 2026: I never ended up getting a dayguard, but did purchase a replacement night-guard. I had to have it made in America though, using the material my original nightgoard was made of. The German system only offered me two options - acrylic, which damaged my lips enough that I needed two mini-operations to block the damaged blood vessels because it was too hard. Or silicone, which used a plasticiser that I was allergic to.