BRUXISM

INTRODUCTION

Bruxism is an oral parafunctional activity. We grind our teeth while eating, but there are many instances when people grind their teeth when they are anxious or angry or in deep thoughts. People also grind when they are in sleep.
Bruxism is described as excessive teeth grinding that is unrelated to normal function. It is a very common condition among children and adults now a days.

CAUSE OF BRUXISM

There are many factors that causes bruxism. Some of them are as follows :

Occlusal Factor : Occlusion is defined as an ideal positioning of upper teeth in relation to lower teeth. Malocclusion is a medical term that refers to the abnormal position of upper teeth in relation to lower teeth. Earlier it was said that the defective contact of teeth were the cause for bruxism. But malocclusions are  natural and do not cause any problems. People those who wear dentures can also suffer from bruxism as denture also change the original bite. No proper evidence or study have proved occlusal factor as the sole reason for bruxism.

Genetic Factors : Most of the people with sleep bruxism have a direct family relation who had sleep bruxism during childhood.

Psychosocial Factors : People with stressful lifestyle and emotional stress is considered as the main reason for bruxism. Stress , anxiety , frustration and anger are the main trigger points for bruxism.

Medication Factors : Drugs such as dopamine , antidepressants​ , cocaine ,  amphetamines , selective serotonin reuptake inhibitors are said to be the cause for bruxism. Excessive use of caffeine can also lead to bruxism.

Neurological and Psychiatric Factors : These cases have been rarely reported. Some examples are autism , down syndrome , epilepsy , rett syndrome , cerebral palsy , parkinson's disease.

SIGNS AND SYMPTOMS

1. Grinding sound at night while sleeping.
2. Rythmic  contraction of jaw muscle.
3. Jaw muscles are tight and painful.
4. Clicking sound of Temporomandible   
      joint ( TMJ )
5. Headache.
6. Tooth enamel to be worn out
7. Jaw or neck soreness.
8. Earache

COMPLICATIONS RELATED TO BRUXISM

In most cases bruxism is not related to cause serious complications. But sometimes severe bruxism can lead to problems such as

• severe facial and jaw pain
• damage to teeth , restoration and jaw
• severe headache or earache
•  TMJ disorders

TREATMENT

Occlusal splints ( dental guards ) are commonly prescribed by dentists for the treatment of bruxism. However, it is not effective for awake bruxism as it is worn only during sleeping. It is advised to the patients to start wearing the splint before 30 mins of going to bed.

Medications such as benzodiazepines , anticonvulsants , beta blocker , antidepressants , muscle relaxant are commonly used to treat bruxism.

Botulinum toxin ( botox ) reduces the myofacial pain symptoms. The toxin partially paralyze the muscles and lessen their ability to clench and grind the jaw.

Some dentists attempt occlusal adjustment to distribute the forces and  reduce the  amount of damage on dentition. It is a complex procedure as it may include orthodontic treatment , restorative dentistry and in some cases orthognathic surgery. There are many disagreement to this procedure as it further damages the dentition.

Psychosocial intervention such as relaxation therapy , stress management , hypnosis  have also been suggested for treatment of bruxism.

PREVENTION

1. Avoid foods and drinks that contain caffeine.
2. Train yourself not to clench or grind your teeth. If you notice yourself doing this contact your dentist.
3. If related to stress , go for relaxation and stress therapy.

                         

                            DR. ANJUSHA SHARDA