Paul Isaacs' Blog

Autism from the inside

Autism – Bruxism, Pain Agnosia & Brushing Teeth

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Note – This is from personal experience of Bruxism 


Bruxism is the habit of clenching and grinding the teeth. It most often occurs at night during sleep, but it may also occur during the day. It is an unconscious behavior, perhaps performed to release anxiety, aggression, or anger.


Bruxism is one of the oldest disorders known, and approximately one in four adults experiences it. Most people are not aware of it before their teeth have been damaged.


While bruxism is typically associated with stress, it may also be triggered by abnormal occlusion (the way the upper and lower teeth fit together), or crooked or missing teeth.

Symptoms of bruxism include: dull headaches; sore and tired facial muscles; earaches; sensitive teeth; and locking, popping, and clicking of the jaw.

During a dental examination , a dentist may recognize damage resulting from bruxism, including: enamel loss from the chewing surfaces of teeth; flattened tooth surfaces; loosened teeth; and fractured teeth and fillings. Left untreated, bruxism may lead to tooth loss and jaw dysfunction.


Medical and dental histories and examinations are necessary to differentiate bruxism from other conditions that may cause similar pain, such as ear infections, dental infections, and temporomandibular joint (TMJ) dysfunction. However, uncommonly worn-down teeth strongly suggest a diagnosis of bruxism.


To prevent further damage to the teeth, bruxism is treated by placing a removable, custom-fitted plastic appliance called a night guard between the upper and lower teeth. Although the clenching and grinding behavior may continue, the teeth wear away the plastic instead of each other.

In some cases, abnormal occlusion may be adjusted and high spots removed so that the teeth fit together in a more comfortable position .Missing teeth may be replaced and crooked teeth may be straightened with orthodontic treatment to eliminate possible underlying causes of bruxism. In cases where jaw muscles are very tight, a dentist may prescribe muscle relaxants.


Yes this is true for all my teeth are worn and 5 are noticeably worn down specifically by grinding or gnashing which commonly occurs during night time – Teeth have “points” and can be “sharp” (this is due to them pushing up through the gums) many of my teeth have lost those “points” due to bruxism they feel rough and “jagged” where the enamel (which covers the tooth and the soft dentin) has grinded and worn down, this makes their appearance slight irregular to my other teeth as as they look slightly stumped as a result, anxiety I have no doubt is the the underlying cause for this as I also get “jaw-popping” to and tension.

Thankfully only 5 of my top back teeth are worn and 2 of my lower back teeth are worn (I have 4 wisdom teeth and had three extractions due to overcrowding and needing a fixed brace)


Yes there are more reasons for this as apart of my Autism “Fruit Salad” I have Pain Agnosia an under processing/perception of pain this meant that on night I decided to “clean” my teeth with a hard/jagged surface appliance (this was to scale off tea stains) I “went to town” on these teeth not knowing or “connecting” that I was shredding away my enamel with every movement (I have problems with pressure too) it was many years later that my new dentist pointed out this enamel wear.
My bottom two teeth are slightly chipped due to damage with grinding luckily I didn’t decide to clean them in the same fashion as the 5 teeth above.  😉 Also these a very minor chips which would need to be checked but not capped/filled.

I still have any issue with over brushing due to pressure, knowing when to stop, “forgetting” the pattern, once the pattern is remembered repeating the cycle this has lead about 6 of my teeth having their gum lines receded (exposing the dentin) this means I have very sensitive teeth due to this, bruxism and enamel wear.



Yes I do believe it or not! I like the dentist in many ways the positive to being under sensitive/under processed to pain means I like having my teeth checked, scrapped, picked, cleaned polished etc. I have a friendly dentist and tooth hygienist.


  • Pro-Enamel Sensitive Toothpaste (builds up strengthens enamel)
  • Pro-Enamel Mouthwash (non-alcoholic)
  • Electric Toothbrush (modify brush settings)
  • Mouth Guard (to be used at night time it is made out of a soft plastic so teeth aren’t worn)
  • Regular check-ups with a dentist who has experience of bruxism


Author: Paul Isaacs

Paul was branded as a “naughty & difficult child” at school. He was classically autistic and non-verbal due to speech articulation difficulties. He had complex sensory issues and appeared both deaf and blind. He gained functional speech around the age of 7 or 8 years old. He went through the mainstream school system with no additional help or recognition of his autism. Consequently, he did not achieve his academic or his social potential and had very low self-esteem. At age 11, Paul was referred to the children’s mental health service with childhood depression where he was regarded as “developmentally underage” and having speech problems. As an adult, Paul had a string of unsuccessful jobs, and his mental health suffered. He developed both Borderline and Schizotypal Personality Disorders in early 2007. He was referred to mental health services and misdiagnosed with “Asperger traits with a complex personality”, which did not satisfy Paul or his family. A local autism organisation put Paul in touch with an experienced psychiatrist, who diagnosed him with Autism at 24 years old. In 2012 Paul was also diagnosed with Scotopic Sensitivity Syndrome by an Irlen Consultant who confirmed that he also had face, object and meaning blindness – conditions which Paul describes eloquently in his speeches and training sessions. He also has dyslexia, dyscalculia and also a dissociative disorder. Having started working as an local autism organisation as a public speaker in 2010, Paul joined their mission to promote autism awareness. His hope is that others will not have to suffer as he did. Now also a core member of our Training Team, Paul continues to enhance true understanding of autism at every opportunity. Paul has released and published 5 books on the subject of autism published by Chipmunka publishing and has contributed to other books too. Having overcome many challenges to achieve the success that he now enjoys, Paul’s message is that Autism is a complex mix of ability and disability. He firmly believes that every Autistic person should have the opportunity to reach their potential and be regarded as a valued member of society. Apart from autism related blogs Paul also write about movies, fashion, art and anything that is of interest. As of August 2015 Paul now works as a freelance speaker, training and consultant in and around the Oxfordshire & Buckinghamshire area. If you are interested please contact him via email at

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