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Cosmetic Dentistry: Restoring a Smile Worn Down by Bruxism


Bruxism, or teeth grinding, impacts anywhere from 8% to 31% of the general population. Mild bruxism does not always require treatment, but it can cause teeth to become chipped, broken, or worn. Severe bruxism can also affect the jaw and gums.


Some patients gnash, grind, and clench their teeth while they're awake, but others do it while they're sleeping ‒ conditions known as awake bruxism and sleep bruxism, respectively. Sleep bruxism is considered a sleep-related movement disorder, and people with it are more likely to have other sleep disorders such as snoring or sleep apnea. Patients might not even be aware of it.


After the damage has been done, a dentist can restore eroded teeth and treat them to stop further damage. Treatment options for worn down teeth include composite bonding, cosmetic veneers, crowns, and (in severe cases) orthognathic surgery.


This article explores two of the most common treatments for bruxism: veneers and bonding.


Bruxism and Dental Veneers


Veneers are thin porcelain or composite resin shells attached to the front part of the teeth. Porcelain veneers are generally viewed as the superior option, since they’re stronger and less likely to colour or stain. Porcelain veneers require at least two dental visits to apply, whereas composite resin only requires one appointment.


Composite resin veneers require a mild chemical to be applied to the front surface of the tooth. This will establish some roughness, allowing the composite resin to adhere to the tooth's enamel. You want a resin that matches the color of your patient's teeth, so it can blend in. When the resin's final layer hardens, the tooth is shaped and polished so it looks smooth.


Local anesthesia is usually required for porcelain veneers because a thin layer of enamel is removed from the patient's teeth to make room for the veneers. Temporary veneers are often necessary to replace the part of the tooth that was removed, and they are used until the permanent ones are ready. Temporary veneers need to be handled with care while eating and cleaning because they come loose easily.


When the patient returns for their next visit, the temporary veneers are removed, and a mild chemical is applied to the teeth to give them a rough texture. This allows the veneers to adhere better to the teeth. The veneers are then glued to the individual teeth with composite resin cement.


Caring for Dental Veneers


Patients should brush (with soft bristles) twice per day and floss once daily. They should avoid toothpastes that contain abrasive chemicals. Regular dental checkups are also a must. Coffee, tea, tobacco, and other things that will stain teeth should also be avoided.


For patients with sleep bruxism, a mouthguard can protect the veneers from the wear that damaged their natural teeth.


Bruxism and Composite Bonding


Bonding, also called bonded restoration, fixes minor breaks in teeth using a tooth-coloured composite resin. The procedure is painless, and multiple teeth can be bonded during a single visit to your practice.


The bonding resin can be matched to the teeth, shaped to fill in a gap or chip, build up teeth, or fill space between them. On top of that, it can be used to fix a broken tooth.


A protective film is first positioned between the damaged tooth and neighboring tooth. Then, a mild chemical is placed on the tooth to roughen it up and ensure the composite resin sticks. The composite resin is then layered onto the tooth, to be shaped and polished after the last application hardens so the finished tooth is smooth.


In a recent article for DentalTown called Reversing the Grind, Dr. Terry Shaw demonstrates this technique, restoring a patient’s maxillary teeth and lower incisors worn by bruxism.


Caring for Bonded Restorations


Patients should brush twice a day and floss once daily. Avoiding hard food, coffee, tobacco, and nail-biting will help. As with veneers, a mouthguard may be necessary to protect the newly bonded teeth from sleep bruxism.

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