Bruxism or clenching effects 80-90% of patients in my practice. Whether stress or pharmaceutic induced, clenching is a difficult habit to control. Nightguards are recommended for most patients and required for those who have dental implants.
Common signs of bruxism or clenching are the usual wear and wear faucets on teeth including pits and abfraction lesions.
Another less conspicuous sign is buccal extosis or overgrowth of bone.
The body will compensate for the additional biting force and help protect the dentition (teeth) by applying more bone as a protective mechanism.
Those patients who have wide ridges with extosis should receive nightguards.