Bruxism: Do you have this condition? How to prevent it?

Bruxism is the condition pf excessive teeth grinding, clenching, gnashing, etc which can result in damage to the teeth & varying symptoms.

The condition when a person is awake is called Awake Bruxism, & during sleep is called Sleep Bruxism.

CLASSIFICATION OF BRUXISM & ITS FEATURES

AWAKE BRUXISM

  • While being awake, can be semi-voluntary.
  • Pain can get worse throughout the day.
  • Noise not associated.
  • Usually clenching
  • Can be mostly associated with stress
  • 22-30% of the general population
  • Mostly occurs in females
  • No clear evidence of genetic factors.

SLEEP BRUXISM

  • During sleep, around sleep arousal
  • Pain worst after awakening.
  • Commonly associated noises.
  • Clenching & Grinding
  • May or may not be associated with stress
  • 8-16 % of the general population
  • Occurs in both genders
  • Some evidence of genetics.

SIGNS & SYMPTOMS

  • Wearing & attrition of the teeth
  • Change in structure of the teeth
  • Tooth sensitivity
  • Grinding noise of the teeth that can cause sleep issue to self & people sleeping with or around you.
  • Burning sensation on the tongue
  • Indentations of the teeth against the tongue
  • Pain during chewing
  • Headache
  • Jaw pain, locked jaw.

CAUSES & RISK FACTORS FOR BRUXISM

  • Awake bruxism is usually associated with stress & is semi-voluntary.
  • In children awake bruxism can be due to teething.
  • Sleep bruxism is caused due to CNS & neurotransmitter abnormalities.
  • Morning stress
  • Emotional stress
  • Aggressive personality
  • Depression
  • Chewing of tobacco can stimulate bruxism
  • Genetic Factors
  • Stimulant prescription drugs or recreational drugs like levodopa, caffeine, MDMA, etc.
  • Occlusion, i.e the dental term for contact between the teeth.
  • Some risk factors that can be associated with Bruxism are;
  • Autism, Down’s Syndrome, Cerebral palsy, Sleep disorders, Epilepsy, trauma to the head, & many more conditions.

COMPLICATIONS

  • Tooth fractures
  • Inflammation of the tissue of the teeth & gums
  • Cheek biting
  • Increase in size of the muscles that move the jaw
  • Lockjaw
  • Pain behind the jaw & ear
  • Severe tooth wear & attrition which can lead to pain
  • Increase in chances of tooth decay
  • Loosening of the teeth
  • Acid reflux

DIAGNOSIS OF BRUXISM

  1. Primary diagnosis is done by noting the presence of characteristic symptoms & reports of teeth grinding.
  2. During dental exams, tooth wearing & attrition is looked for.
  3. A sound recording device is useful to record noises that may arise during sleep bruxism, therefore it can confirm the condition.
  4. Use of home devices like BiteStrip to record involuntary activity of the muscles
  5. EEG is done to record the electrical activity of the brain to rule out the possibility of epilepsy.
  6. Polysomnography to study the sleep patterns & activity of the brain during sleep, therefore it is done to rule out epilepsy, & similarly for confirming teeth clenching actions.
  7. X-ray can be done to rule out injuries to the jaw & jaw-ear joint.

TREATMENT

  • Medications like muscle relaxants, antidepressants, anticonvulsants are prescribed to manage symptoms & related conditions.
  • Botox injections are given to partially paralyze the muscles of the jaw.
  • Splints and mouth guards are designed to keep teeth separated to avoid the damage caused by clenching and grinding.
  • Dental correction & restructuring of the tooth surface.

PREVENTION & MANAGEMENT OF BRUXISM

  • Stress management
  • Cognitive behavioral therapy
  • Improvement of sleep pattern & habits
  • Hypnosis
  • Relaxation techniques like meditation
  • Biofeedback
  • Inhibition & controlled intake of Caffeine
  • Avoiding stimulant drugs like cocaine, ecstasy, meth, etc.
  • Inhibition from chewing tobacco & smoking
  • Management of related conditions & risk factors.