Continuing with the subject of tooth conditions we encounter daily, bruxism is very common. Estimates of prevalence of this damaging behavior based on studies range from 50 to 75% of the general population. It wears the teeth down, and accelerates once the tooth wear has progressed past the enamel layer. It also makes chewing muscles sore (such as the masseter and temporalis) which can then affect hyperactivity of other connected muscles in the neck and upper back.
There is a lot that is not understood about bruxism. Currently, theory states that it results from one (or more) of three causes: neurologic (central nervous system-based behavior, and this includes effects of meds such as SSRI anti-depressants), airway impingement (whereby the lower jaw thrusts forward in the sleep, thus opening the airway if it is not wide enough for adequate oxygen), and stress. Traditionally it was believed to occur at night, although recently there is some thought that perhaps it occurs more during the day for some people.
It can be difficult to treat bruxism, but some things that can help are a splint made by a dentist, which is an acrylic appliance worn on the upper or lower teeth. Botox injections can help temporarily. Having an airway evaluation if there are any signs or symptoms of sleep apnea is always a good idea. Even changing sleeping posture from the side or stomach to the back can keep the jaw better aligned and eliminate bruxing episodes for some.
Someday I hope we can more predictably avoid the tooth destruction that bruxism causes for so many patients. We will keep searching and learning.