Botox, collagen, retinol. We’re constantly told what to add to our skincare routines to slow down aging. But there’s one area you might be overlooking, and that’s your teeth.
Years of clenching and grinding, clinically known as bruxism, can wear teeth down millimeter by millimeter. As teeth become shorter, flatter and more jagged, they lose the structural support that helps hold up your lower face, creating a more collapsed or sunken appearance.
“Our teeth provide scaffolding or support to the vertical dimension of our face,” says Dentist Rebecca Kisling of Leawood’s Kisling Family Dentistry, who has completed extensive training in full-mouth rehabilitation, TMJ disorders and sleep-disordered breathing. “As the teeth shrink and get shorter or more worn, that collapses our face,” she says.
The transformation usually happens slowly, and because gradual enamel loss often doesn’t hurt, many people have no idea they’re grinding until a dentist points out the damage or worse: a tooth cracks.
Kisling emphasizes that there’s rarely a single cause to why someone clenches their teeth, which is why each patient requires a closer look. Some arrive in pain, but many first learn about their clenching during a routine exam after 3D scans reveal divots, chips or the layer of tooth tissue under the enamel called dentin.
“Tooth wear happens slowly, and it doesn’t usually hurt,” Kisling says. “Most people wouldn’t realize unless they looked at snapshots of their smile over time.”
A worn smile can make someone appear older because the teeth no longer have the length and shape they once did. Wear can also reduce the vertical distance between the upper and lower jaws, and with less structural height supporting lips and cheeks, the lower third of the face may look compressed.
In advanced cases, dentists may recommend a full-mouth rehabilitation, which rebuilds the teeth with crowns to restore their original height. Kisling says that after these procedures, patients often notice a change not only in their smile, but also in their facial proportions.
“If you restore the teeth back to the correct vertical height, then their face essentially looks younger,” she says. “Teeth are a huge component of the vertical support of our lower face.”
Bruxism doesn’t have a single cause. Stress is a common contributor, but dentists also say posture, medications, inflammation, nasal obstruction and sleep-disordered breathing are also factors. Certain antidepressants and ADHD medications can increase clenching, and nighttime grinding may be your body’s attempt to open a restricted airway.
Because there isn’t a one-size-fits-all cause of teeth grinding, there isn’t a one-size-fits-all solution, either. Kisling starts by looking for cues that can point to what’s driving the problem, like frequent morning headaches, facial muscle tension, chronically inflamed gums and a scalloped tongue, which are small indentations created when the tongue presses against the teeth.
The evaluation helps determine the course of treatment. Instead of buying the first bite guard you see on Amazon, Kisling recommends seeing your dentist for a custom one, which creates a precise barrier between your upper and lower teeth to protect enamel from grinding while fitting your unique bite. An over-the-counter guard can be bulky or position your jaw in a way that aggravates TMJ pain rather than relieving.
During the day, Kisling encourages keeping your jaw relaxed, which we know is easier said than done. “Our teeth should only be touching when we’re chewing,” she says. Noticing when your teeth are pressed together—and consciously separating them—can help. Maintaining clear nasal passages, limiting excess caffeine and addressing posture or medication side effects may also help, depending on the cause.
The most important step, Kisling says, is to act early, before the damage is done. A custom night guard may feel pricey upfront, but it is far less expensive than rebuilding multiple damaged teeth.
“A $500 night guard is a lot cheaper than a $2,000 crown,” she says. “The more preventative care and the better you take care of your teeth, the less you’re going to spend on them throughout your lifetime.”
