What is ‘bruxism’?
The term "bruxism" describes an oral parafunctional behavior that most people experience at some point in their lives. This condition, which can happen during the day or at night, is characterized mostly by teeth grinding and jaw clenching. One of the most prevalent sleep disorders, bruxism primarily harms people while they are asleep. The chewing reflex, which is switched off in non-sufferers when they sleep, is the cause of the clenching and grinding that accompany bruxism. For those who experience it, naps or even deep sleep makes the reflex nerve control center in the brain shut off and the reflex pathways active.
The front six upper and lower teeth, or the canines, of opposing arches typically grind against one another laterally. The temporomandibular joints and medial pterygoid muscles are overworked by this side-to-side movement. The most typical bruxism symptoms include earaches, depression, headaches, eating disorders, and anxiety; these symptoms also coexist with conditions like chronic stress, Alzheimer's disease, and alcohol addiction.
As one of many possible reasons of tooth wear, it is frequently misdiagnosed or not detected at all. Only a qualified expert can distinguish between bruxing wear and wear brought on by excessively vigorous brushing, acidic soft beverages, and abrasive foods. An inexpensive tool used to diagnose bruxism at home is the BiteStrip®.
The actual equipment is a tiny electromyography that detects and keeps track of any jaw muscle activation as you sleep. The optimal treatment strategy can then be developed after determining the condition's frequency and severity.
Types of Bruxism
There are two types of bruxism, and their symptoms and causes can differ:
Awake or Diurnal Bruxism
Awake Bruxism occurs (AB) during daytime and it is a semi voluntary ‘clenching’ activity. It is also known as Diurnal Bruxism (DB). It consists of clenching and grinding as well as other oral habits such as cheek and tongue biting, finger and thumb sucking, and many occupational habits such as biting on pins or pencils etc. performed throughout the day.
It is predominant in females and is usually associated with a stressful lifestyle. This disorder is more common in younger population.
Sleep Bruxism or Nocturnal Bruxism
Grinding teeth while sleeping either during daytime or during night is termed as ‘Sleep Bruxism’ (SB). It is also known as Nocturnal Bruxism. SB is an oro-mandibular behavior and it consists entirely of clenching and/ or grinding of teeth, and often occurs in association with certain stages of sleep. It was recently grouped as sleep related movement disorder according to recent classification of sleep disorders.
Risk factors
These factors increase your risk of bruxism:
Stress: Increased anxiety or stress can lead to teeth grinding. So can anger and frustration.
Age: It is common in young children, but it usually goes away by adulthood.
Personality type: Having a personality type that’s aggressive, competitive or hyperactive can increase your risk of bruxism.
Medications and other substances: Bruxism may be an uncommon side effect of some psychiatric medications, such as certain antidepressants. Smoking tobacco, drinking caffeinated beverages or alcohol, or using recreational drugs may increase the risk of bruxism.
Family members with bruxism: Sleep bruxism tends to occur in families. If you have bruxism, other members of your family also may have bruxism or a history of it.
Other disorders: Bruxism can be associated with some mental health and medical disorders, such as Parkinson’s disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, night terrors, sleep-related disorders such as sleep apnea, and attention-deficit/hyperactivity disorder (ADHD).
Bruxism causes
The exact cause of teeth grinding is not totally understood and there are numerous different theories. However, there is a link to breathing airway issues, such as
Sleep apnea,
Jaw posture positions
Tooth position
Dental work that has changed jaw position or tooth positions
Abnormal bite
Trauma
Repetitive strain
Lifestyle activities, as well as emotional and developmental issues.
Symptoms of Bruxism
Many patients are unaware that they clench or grind particularly if they have sleep bruxism. The following symptoms may be indicative of bruxism.
Sleep partner’s complaint of tooth grinding.
Waking with teeth clenched.
Indentations in the inside of the cheeks or the edges of the tongue.
Waking with tenderness and restriction in the muscles of mastication.
Hypertrophy of the masseter muscles.
Waking with tooth or gum sensitivity.
Excessive dental wear, including loosening or fracturing of the teeth.
TMJ clicking or locking, TMJ pain, headache.
Snoring can be an indicator of sleep bruxism.
Complications
In most cases, it doesn’t cause serious complications. But severe bruxism may lead to:
Damage to your teeth, restorations, crowns or jaw
Tension-type headaches
Severe facial or jaw pain
Disorders that occur in the temporomandibular joints (TMJs), located just in front of your ears, which may sound like clicking when you open and close your mouth.
Diagnosis and test
During regular dental exams, your dentist likely will check for signs of bruxism.
Evaluation
If you have any signs, your dentist looks for changes in your teeth and mouth over the next several visits to see if the process is progressive and to determine whether you need treatment.
Determining the cause
If your dentist suspects that you have bruxism, he or she tries to determine its cause by asking questions about your general dental health, medications, daily routines and sleep habits.
To evaluate the extent of bruxism, your dentist may check for:
Tenderness in your jaw muscles
Obvious dental abnormalities, such as broken or missing teeth
Other damage to your teeth, the underlying bone and the inside of your cheeks, usually with the help of X-rays
A dental exam may detect other disorders that can cause similar jaw or ear pain, such as temporomandibular joint (TMJ) disorders, other dental problems or health conditions.
Treatment and medications
Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.
In most cases, it can be successfully treated. Treatment may include:
Behavior changes: You may be taught how to rest your tongue, teeth, and lips correctly. You may also learn how to rest the tongue upward to ease mild pain on the jaw while keeping the teeth apart and lips closed.
Mouth guard: You may be fitted for a plastic mouth guard that you can wear at night to absorb the force of biting. It can be worn during the day if you grind your teeth while awake. This mouth guard may help prevent future damage to the teeth and help in changing behavior.
Biofeedback: Biofeedback uses an electronic tool that measures the amount of muscle activity in the mouth and jaw. It then signals you when there is too much muscle activity so you can take steps to change that behavior. This is especially helpful for daytime bruxism. More research is needed to create a treatment program for those who clench during the night.
Medicine: Some medicines may be helpful in controlling the neurotransmitters. Changing medicines may be needed if antidepressant medicines are found to be the cause of bruxism.
Botulinum toxin shots (injections): This may be offered to some people with severe bruxism who don’t respond to other treatments.
Combating bruxism
Bruxism is frequently a child's innate response to growth and development. These incidents cannot be avoided. However, it is possible to prevent stress-related teeth grinding in both kids and adults. The first step you may take to stop grinding your teeth is to establish a relaxing bedtime routine. Assisting your kid to unwind at night:
Limit your use of devices and television several hours before night.
Give them some soothing music to listen to.
Give them a warm bath or shower.
While you read, let them listen or read.
Stress management is critical. Regularly discuss your child's feelings with them. Aid them in stress management. Take action to lessen stress in your life if you have bruxism. Tell a friend, member of your family, or a counselor what is stressing you out. If you can, try to get rid of stress sources.
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