Everyone grinds their teeth or clenches them once in a while. Occasionally grinding of teeth is a common occurrence and not a matter to be alarmed about. But, regularly grinding the teeth is a matter of concern as it may lead to a condition called bruxism.
What is Bruxism? (Teeth Grinding)
According to the National Institutes of Health, Bruxism can be defined as a movement disorder characterized by involuntary, unconscious, and excessive grinding of teeth. Bruxism is often associated with psychological factors more often as compared to other etiological factors causing it. This condition if left untreated can affect the surrounding orofacial structures like:
Temporomandibular joints (TMJs), it is a joint that connects the jawbone to the skull and helps in the opening and closing of the mouth
Types Of Bruxism-
Wakeful Bruxism- Gnashing or clenching of teeth when a person is awake is termed as wakeful or diurnal bruxism. This type of jaw grinding is semi-voluntary in nature and the person is aware of jaw clenching. It is less of a common type and is easier to identify and manage.
Nocturnal Bruxism- It is the most common type of bruxism where the teeth grinding occurs only or mostly at night when the person is asleep. It is involuntary in nature and sleep-related action.
Causes Of Bruxism-
Some of the probable causes of bruxism include:
• lifestyle choices like excessive alcohol consumption, smoking, recreational drugs, and excessive consumption of caffeinated drinks
• psychological factors that include mental health issues like stress, anxiety, emotional distress, depression
• Sleeping disorders like obstructive sleep apnea or snoring
• Abnormal bite caused by misaligned teeth, missing or crooked teeth
• certain medications like antianxiety drugs and antidepressants
• certain medical conditions and neurological disorders like Parkinson's disease and Hutchinson's disease
Symptoms Of Bruxism-
Certain signs and symptoms of bruxism that help with identifying the condition include
• toothache and tooth sensitivity
• headache and earache
• grating or grinding sound
• stiffness and tenderness of facial muscles
• soreness and stiffness in the neck
• wearing of enamel
• swelling in the jaw and gums
• loosening of teeth or chipped enamel
• fractured teeth
• popping and clicking sound on opening and closing of the mouth
• pain while eating and difficulty in swallowing
• jaw locking
Management Of Bruxism-
Depending upon the severity of the condition, different approaches are employed to treat bruxism. In some cases, the person outgrows the habit while in others the condition is not severe enough to require an intervention. However, one should consult a dentist and let them evaluate the severity and the management of approaches. Some approaches employed to help manage bruxism are -
Dental Approaches - The dentist suggests treatment options that might help prevent the wearing of teeth and improve the condition of teeth, but it may not stop the bruxism itself.
Mouth guard- Mouth guards also known as night guards and dental splints help manage bruxism by creating a barrier between the teeth and cushioning the muscles of the jaw from the pressure put by clenching of teeth and thus, protect the teeth from pain and occlusal wear.
Dental corrections- In cases where bruxism has caused teeth sensitivity and pain, hindering the ability to eat, then the dentist might proceed with dental correction where they reshape the occlusal surface of teeth or use crowns to help repair the damage.
2) Psychological and physical approaches-
• Cognitive Behavioral Therapy- In the case where stressors and psychological factors are the leading cause of bruxism, behavioral counseling is employed which helps deal with the psychological factors causing the symptoms.
• Physical therapy and oral exercises- Once the condition has been identified, dentists or physical therapists advise certain oral exercises for maintaining proper mouth and jaw position.
Medications are used in refractory and severe cases where conventional treatment is not effective. Medications like muscle relaxants and botox injections may be considered in severe cases where they act by decreasing the activity of orofacial muscles. Antianxiety and antidepressant drugs in the case where stress, anxiety, or depression is the leading cause of the condition, and the condition can't be controlled by the above-mentioned methods. But in general, the medications are not very effective in treating bruxism and have certain side effects.
Discussion with the healthcare professional about the risks and benefits of the treatment modality is highly recommended before starting any of the above-mentioned treatments.
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