BRUXISM

Bruxism is an oral para-functional activity of teeth grinding which consists of involuntary spasmodic clenching of teeth. It can cause tooth wear and breakage and is generally seen between 25 to 45 years of age. Prolonged habit leads to TMJ disorder (Temporomandibular joint disorder) with pain and headache.
There are two types of bruxism: awake bruxism or sleep bruxism. While awake it occurs as an immediate response to some stimuli whereas night grinding is habitual and leads to TMJ syndrome and other complications.

CAUSES OF TEETH GRINDING

Teeth grinding is most often associated with mental or psychological problems, such as stress and anxiety but abnormal occlusion is one of the most important triggering factors. Missing or crooked teeth puts extra stress on jaw muscles leading to clenching of teeth. Other causes can be habitual, trauma, allergic reactions and some medical conditions, such as digestive ailment or earache and teething in children. People with other sleeping disorders, such as Obstructive sleep apnoea, are at high risk of sleep bruxism.

EFFECTS OF TEETH GRINDING

Many cases of teeth grinding remain undetected without any adverse effects. Sometimes it is pointed out by some family member as horrible gnawing sounds at night. However, in most of the cases facial myalgia, TMJ pain and stiffness, earache, headaches and sleep disruption are the major symptoms; which is diagnosed by oral and TMJ examination. Enamel loss, flattened tooth surfaces, loose or sensitive teeth, fractured restorations, receding gums and difficulty in opening mouth are found during the dental examination.

BRUXISM TREATMENT

Stress Management
Professional counselling, if required, should be done. Daily exercise and yoga may help relieving stress. Relaxation of face and jaw muscles by keeping upper and lower teeth apart with lower jaw dropping is a good way to avoid bruxism. Pharmacologically stress can be managed by sedative, anxiolytic or antidepressant drugs.
Mouth Guards
Mouth guards create physical barrier between upper and lower teeth and even out the occlusal forces. It prevents distressing noises and protects teeth from further damage. These are custom-made dental appliance made up of rubber or plastic
Occlusal Splint/Bite Plate
Occlusal Splints/Bite Plates are made up of hard plastic that fits precisely over upper and lower teeth. These devices help in reducing the muscular activity at night but they are only able to control the condition, not cure it.
Treating Dental And Occlusal Problems
Bruxism could also be present only as a symptom of untreated orthodontic issues which can further lead to erosion, hypersensitivity, enamel fracture and TMJ disorders. It can cause headache, earache or neck pain also. Proper interdigitation of teeth is required for jaw to be in relaxed state. All missing teeth need prosthesis and loose fillings should be replaced.
Behavioral Approach
Meditation and hypnosis are alternative methods to stop teeth grinding. Sleep hygiene i.e. avoiding tea, coffee or other stimulants before bed and regular sleep schedule to avoid stress. Biofeedback by auditory or visual stimulus stop patients when they grind teeth. However, there is sleep disruption which is not very safe treatment.