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Bruxism

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.

While a bruxer sleeps, the jaw focuses on interferences in the way the teeth come together.  The body tries to wear down these interferences by grinding the teeth.  This grinding 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.

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).
  • Myofacial 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:

  • Palliative treatment – Anti-inflammatory medications, hot and cold treatments to the facial muscles and TMJs, and reducing caffeine intake can improve the symptoms caused by bruxing.
  • Centric relation splint – This device eliminates the bite interferences that stimulate the grinding action.  When worn during the sleeping hours it decreases the stress  on the teeth, muscles and the jaw joint.
  • Splint therapy and full mouth reconstruction – Inflammation in the TMJs can be resolved through wearing a splint during the day and night.  The splint is adjusted regularly as the joints heal.  Once the TMJs are healthy, the teeth are restored in a way that eliminates the  interferences that origonally stimulated the grinding

Other methods of treatment include relaxation exercises, stress management education and biofeedback mechanisms.  If you have questions or concerns about bruxism, please ask Dr. Fracolli.