Bruxism and dentistry
Bruxism (a Greek term), is the medical term for the grinding of teeth or the clenching of jaws. It is a condition in which the closing of the upper and lower jaw is powerfully strong and is accompanied by rubbing between the upper and lower teeth. Bruxism is an unconscious activity and most people who grind their teeth are unaware of it.
Almost everyone grinds their teeth, but the important question is the intensity of the grinding. Mild bruxism requires no treatment. Bruxism is usually a nocturnal activity, especially during the early hours of sleep. During sleep, pressure on the temporomandibular joint (the joint that connects the upper and lower jaws and allow chewing and talking) is six times greater than the pressure exerted during mastication and speech.
What causes bruxism?
It is difficult to answer this question. There is still no consensus on the causes of bruxism. There are physiological reasons, such as incorrect bite of the teeth, central nervous system disorder and crooked teeth, as well as psychological reasons such as stress and anxiety, depression, aggressive or hyperactive personality. But we do know that there are a few causes which are risk factors: temporary emotional stress, drug abuse, large amounts of alcohol and nicotine, use of psychiatric drugs and age (bruxism decreases with advanced age).
What are the symptoms of bruxism?
As mentioned, most people are unaware that they are grinding their teeth. Usually spouses report that they hear the sound of teeth gnashing, in some cases to such an extent that it bothers them to sleep. These reports are accompanied by other symptoms:
Cosmetic damage to the teeth – dental erosion and a shortening of tooth length affect appearance.
Breaking of dental restorations such as fillings, crowns and implants. In rare cases a failed implant can cause bruxism.
High tooth sensitivity resulting from the erosion of tooth enamel that protects the tooth.
Receding gums –years of teeth grinding lead to the erosion of teeth and enamel which affects the gums, causing them to recede.
Irritable cheeks - teeth grinding sometimes causes people to bite the inside of their cheeks which irritates the cheeks and causes ulcers.
Headaches, facial and neck pain – resulting from activity of the facial and neck muscles during the night.
How is bruxism treated?
When one or more of the above symptoms begin to appear, the dentist can examine the state of your mouth and the symtoms of bruxism. Sometimes the dentist will decide to refer you to a specialist. To diagnosis the problem, the dentist will inquire if you take medication, and consume alcohol and nicotine. These questions will help him find the cause of the problem.
In most cases bruxism does not cause complications, but the complications that may develop are serious damage of the teeth or jaws, persistant headaches, intense facial pain that can disrupt the function of the face and cause dysfunction of the temporomandibular joint (the joint that connects the upper and lower jaws).
When treating bruxism, it is important to treat the cause of the problem so there may be several types of treatment:
of stress or anxiety
modification: the dentist can instruct the patient how to close his mouth
without exerting pressure on the teeth and joints, and relax the muscles.
C. Medication: In a small number of cases, muscle relaxant medication will help. Another method used in the U.S. and more recently in Israel, is Botox injection in the joints which can help people in those areas where alternative treatments failed.
D. Reduction in the quantity of alcohol and nicotine consumption.
E. When the
cause of bruxism stems from dental problems, these problems must be addressed.
F. A night splint (brace): a night splint is not a solution but a means to reducing the damage caused by bruxism. A splint will maintain a space between the jaws of two millimeters, the optimal space necessary to relax the chewing muscles and joints.
A night splint is a device made of acrylic or
silicone (see photo above). The splint is customized to fit the structure of
the patient's teeth.The dentist takes measurements of the teeth in the office
and a dental technician prepares the night splint according to these
measurements. A splint can be prepared for the teeth in either the upper or
lower jaw. The patient wears it at night while sleeping. A splint is not treatment,
but rather a means to reduce pressure and erosion of the teeth. It is recommended
to use a night splint even if the patient is undergoing treatment of any kind (medication,
psychological or dental treatment).
The night splint (called the NTI-tss ) device is U.S. FDA approved and is customized for each patient, and is placed over the front teeth of the upper jaw during sleep. The device helps to relieve people suffering bruxism and migraines.