Bruxism: What Does It Mean?

By: Dr. Abhishek Kumar Pandey, Asstt. Editor-ICN

LUCKNOW: Bruxism is a repetitive jaw-muscle activity characterized by clenching or grinding of the teeth. It is a clinical phenomenon that can manifest in both children and adults. Bruxism has 2 distinct circadian manifestations: it can occur during sleep (indicated as sleep bruxism) or during wakefulness (indicated as awake bruxism).

Bruxism is oromotor activity (clenching/grinding) that is most likely to occur at the transition of  deeper to lighter sleep.

Etiology is mainly dependent on central factors (stress sensitivity, emotions, personality features, sleep regulation, autonomic nervous system), rather than on peripheral nervous system or dental morphology and occlusion.

If not resolved, this activity can lead to weakened or cracked teeth, receding gums, damaged jaw joint, headaches, disrupted sleep and more. Occasional bruxism may not be harmful but when it occurs regularly, it may be associated with moderate to severe dental damage, facial pain, and disturbed sleep

The condition covers a pathophysiologic continuum, and treatment need depends on the presence of clinically relevant consequences rather than the presence of bruxism itself.

Bruxism may result in tooth wear or cracks, fracture of dental restorations, implant failure, muscle hypertrophy, pain and/or fatigue in jaw muscles, headache, toothache, disturbance of bed partner’s sleep, and reduction in overall quality of life.

CAUSESThe cause of bruxism remains unclear, but several factors may be involved. In children, grinding usually happens after the first teeth appear, and again when the permanent teeth emerge. It usually stops once the adult teeth fully erupt.

Clenching and grinding often happen at times of stress, for example at times of anger, anxiety, or concentration. Research has found that brain activity and heart rate may rise before an episode of bruxism, suggesting that the central nervous system (CNS) plays a role.

Bruxism may be related to an abnormal bite, which means the teeth do not meet properly when the jaw closes. If the top and bottom teeth do not come together properly, this is called an occlusal discrepancy.

Bruxism can be a side effect of certain medications, including some antidepressants and antipsychotics, and amphetamines.

Neurological such as Huntington’s disease or Parkinson’s disease can also cause it. Other factors that may be related include fatigue, alcohol consumption, smoking, sleep apnea, and snoring.

Why is teeth grinding harmful?

In some cases, chronic teeth grinding can result in a fracturing, loosening, or loss of teeth. The chronic grinding may wear their teeth down to stumps. When these events happen, bridges, crowns, root canals, implants, partial dentures, and even complete dentures may be needed.

Not only can severe grinding damage teeth and result in tooth loss, it can also affect your jaws, result in hearing loss, cause or worsen TMD/TMJ, and even change the appearance of your face.

What can I do to stop grinding my teeth?

At this time, there are no drugs or dental therapies to stop teeth grinding. However, dentist can fit you with a night guard  to protect your teeth, muscles and TMJs from excessive forces during the grinding episodes. Splints are another option. Some splints fit over the top teeth, some on the bottom. Depending on the design, a splint may keep the jaw in a more relaxed position or provide a barrier so that the splints, rather than the teeth, are damaged. Splints can be adjusted or replaced.

Daytime clenching or grinding may improve with increased awareness, physical therapy, or exercises.

If the underlying problem is stress or sleep apnoea, treating these conditions may help. After treatment, the situation can be reassessed.

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