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
- 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.
- 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
- 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
- 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.
- Tooth fractures
- Inflammation of the tissue of the teeth & gums
- Cheek biting
- Increase in size of the muscles that move the jaw
- 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
- Primary diagnosis is done by noting the presence of characteristic symptoms & reports of teeth grinding.
- During dental exams, tooth wearing & attrition is looked for.
- A sound recording device is useful to record noises that may arise during sleep bruxism, therefore it can confirm the condition.
- Use of home devices like BiteStrip to record involuntary activity of the muscles
- EEG is done to record the electrical activity of the brain to rule out the possibility of epilepsy.
- 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.
- X-ray can be done to rule out injuries to the jaw & jaw-ear joint.
- 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
- Relaxation techniques like meditation
- Inhibition & controlled intake of Caffeine
- Avoiding stimulant drugs like cocaine, ecstasy, meth, etc.
- Inhibition from chewing tobacco & smoking
- Management of related conditions & risk factors.