Bruxism

Bruxism, a common oral parafunctional activity, involves the grinding and clenching of teeth, which can occur during both daytime and nighttime. This condition is considered one of the most prevalent sleep disorders, causing significant damage during sleep. The clenching and grinding associated with bruxism result from a malfunctioning chewing reflex, which is normally inactive during sleep for individuals without the condition. However, bruxism sufferers experience activation of the reflex pathways and turning off of the reflex nerve control center in the brain during deep sleep or even naps.

Typically, the front teeth, including the incisors and canines of opposing arches, grind against each other in a side-to-side motion. This lateral grinding puts excessive strain on the medial pterygoid muscles and temporomandibular joints. Common symptoms of bruxism include earaches, depression, headaches, eating disorders, and anxiety. Bruxism often occurs alongside chronic stress, Alzheimer’s disease, and alcohol abuse.

Diagnosing bruxism can be challenging as it is frequently misdiagnosed or not diagnosed at all. It is essential to differentiate between tooth wear caused by bruxism and other factors such as aggressive brushing, consumption of acidic soft drinks, and abrasive foods. A BiteStrip® is a cost-effective device used for at-home diagnosis of bruxism. This small electromyography device monitors jaw muscle activity during sleep, allowing for assessment of the frequency and severity of the condition and formulation of an appropriate treatment plan.

Prompt treatment of bruxism is crucial for several reasons:

Gum recession and tooth loss: Bruxism can directly damage the soft tissue and contribute to loose teeth and deep pockets where bacteria thrive, leading to gum recession and tooth loss.

Occlusal trauma: Abnormal wear patterns caused by bruxism can result in fractures in the teeth, requiring restorative treatment.

Arthritis: Severe and chronic bruxism can lead to painful arthritis in the temporomandibular joints, affecting jaw movement and causing discomfort.

Myofascial pain: Grinding associated with bruxism can lead to tooth shortening and blunting, causing muscle pain in the myofascial region and debilitating headaches.

Treatment options for bruxism aim to alleviate symptoms and prevent further damage. Common approaches include:

Mouthguards: Customized acrylic mouthguards minimize tooth surface abrasion during sleep and help stabilize the occlusion. Long-term use is recommended to prevent tooth damage and temporomandibular joint problems.

NTI-tss device: This device, fitted by a healthcare professional, covers only the front teeth and limits the contraction of the temporalis muscle, preventing grinding of the rear molars.

Botox®: Injections of Botox® into the muscles relax and weaken them. This treatment weakens the muscles enough to prevent grinding without interfering with normal functions like chewing and speaking.

Other treatment methods include relaxation exercises, stress management education, and biofeedback mechanisms. Dental procedures like crowns, gum grafts, and crown lengthening can enhance the aesthetic appearance of the smile once bruxism is under control.

If you have any questions or concerns about bruxism, don’t hesitate to consult your dentist for guidance and assistance.