Bruxism refers to an oral
parafunctional activity which occurs in most humans
at some point in their lives. The grinding of the
teeth and the clenching of the jaw are the two main
characteristics of this condition, which can occur
either during the day or at night.
Bruxism is one of the most common
known sleep disorders and causes most of its damage
during sleeping hours. The clenching and grinding
which accompanies bruxism is symptomatic of a
malfunctioning chewing reflex, which is turned off
in non-sufferers when sleeping. For sufferers, deep
sleep or even naps, cause the reflex nerve control
center in the brain to turn off, and the reflex
pathways to become active.
Typically, the incisors and
canines (front 6 upper and lower teeth) of opposing
arches grind against each other laterally. This
side to side action puts undue strain on the medial
pterygoid muscles and the temporomandibular joints.
Earache, depression, headaches, eating disorders and
anxiety are amongst the most common symptoms of
bruxism; which often accompanies chronic stress,
Alzheimer’s disease and alcohol abuse.
Bruxism is frequently
misdiagnosed or not diagnosed at all, because it is
only one of several potential causes of tooth wear.
Only a trained professional can tell the difference
between bruxing wear and wear caused by overly
aggressive brushing, acidic soft drinks and abrasive
foods.
A BiteStrip® is an
economical device used to diagnose bruxism at home.
The device itself is a small electromyography which
senses and monitors any activity in the jaw muscles
during sleep. The frequency and severity of the
condition can then be assessed and the best
treatment plan can be formulated.
Reasons for the
treatment of bruxism
Here are some of the main reasons
why bruxism should be promptly treated:
-
Gum recession and tooth loss
– Bruxism is one of the leading causes of
gum recession and tooth loss; firstly
because it damages the soft tissue directly,
and secondly because it leads to loose teeth
and deep pockets where bacteria can colonize
and destroy the supporting bone.
-
Occlusal trauma – The
abnormal wear patterns on the occlusal
(chewing) surfaces can lead to fractures in
the teeth, which may require restorative
treatment.
-
Arthritis – In severe and
chronic cases, bruxing can eventually lead
to painful arthritis in the
temporomandibular (TMJ) joints (the joints
that allow the jaw to open smoothly).
-
Myofascial pain – The
grinding associated with bruxism can
eventually shorten and blunt the teeth.
This can lead to muscle pain in the
myofascial region and debilitating
headaches.
Treatment options for
bruxism
There is no single cure for
bruxism, though a variety of helpful devices and
tools are available. Here are some common ways in
which bruxism is treated:
-
Mouthguards – An acrylic
mouthguard can be designed from tooth
impressions to minimize the abrasive action
of tooth surfaces during normal sleep.
Mouthguards should be worn on a long-term
basis to help prevent tooth damage, damage
to the temporomandibular joint and help to
stabilize the occlusion.
-
NTI-tss device – This
device is fitted by a health professional
and only covers the front teeth. The goal
of the NTI-tss is to prevent the grinding of
the rear molars by limiting the contraction
of the temporalis muscle.
-
Botox® – Botox®
can be injected into the muscles to relax
and weaken them. Botox® is an
excellent treatment for bruxism because it
weakens the muscles enough to prevent the
grinding, but not enough to interfere with
everyday functions like chewing and
speaking.
Other methods of treatment
include relaxation exercises, stress management
education and biofeedback mechanisms. When the
bruxing is under control, there are a variety of
dental procedures such as crowns, gum grafts and
crown lengthening that can restore a pleasant
aesthetic appearance to the smile.
If you have questions or
concerns about bruxism, please ask your dentist.
