Bruxism is the unconscious grinding or clenching of the teeth that occurs most often at night.
The prevalence in the general population is reported to be from 8 to 31.4% (Manfredini and al, 2013).
It is particularly common among people under the age of 40, especially females, and decreases over the age of 65.
The causes and origins of bruxism are still a subject of discussion.
Summary:
- Definition of bruxism
- Symptoms of bruxism
- Causes of bruxism
- How to diagnose bruxism?
- Does bruxism only occur at night?
- How to treat bruxism?
- How to prevent bruxism?
- Are kids concerned by bruxism?
- What are the risks for oral hygiene and general health?
What is bruxism?
Bruxism is an uncontrollable functional disorder resulting in the grinding and clenching of teeth.
It is a temporo-mandibular dysfunction.
It is considered a parafunction: an activity that occurs arbitrarily with no purpose.
This activity often occurs at night (nocturnal bruxism) but can also occur during the day.
There are two types of bruxism:
- The unintentional grinding of the inferior teeth against the upper teeth;
- The continuous clenching of the jaws.
This occurrence is the result of the manducatory muscles contracting outside of the mastication.
Symptoms of bruxism
Bruxers display, usually, the same symptoms:
- Jaw pain;
- Pain in the cheeks;
- Pain in the temple;
- Pain in front of the ear, especially upon waking up;
- Rapid wear of the dental surface.
Causes of bruxism
Stress and anxiety can lead to bruxism.
According to the journal of periodontology and oral implantology [1], ” Bruxism could be the manifestation of anxiety, life troubles and frustrations”.
Other factors responsible for bruxism are: alcohol and tobacco, visceral problems, parasites, endocrine disorders, neurological problems…
According to the AAP (American Association of Psychiatry), bruxism can be linked to a behavioral disorder [2].
It can also be associated with sleep disorders (insomnia…).
How to diagnose bruxism
Usually, the spouse hears the grinding sound when the bruxer is asleep.
Bruxism can lead to significant tooth wear, shorter teeth, resulting in tooth pain.
Bruxers usually complain from facial pains, especially in the jaw.
Does bruxism only occur at night?
Bruxism is usually nocturnal.
But, some patients manifest parafunctions during the day.
Diurnal and nocturnal bruxism have different muscular activities.
In the morning, bruxism consists of the clenching of the jaws.
At night, it consists of grinding and friction.
In some exceptional cases, in patients with neurological disorders or brain damage, bruxism manifests itself by a diurnal grinding.[3]
How to treat bruxism?
Bruxism itself isn’t treatable. The treatment focuses on dealing with bruxism’s consequences and preventing its damage.
In the future, we hope that medication influencing neurotransmitters will be developed, limiting the grinding and destruction of the teeth.
When the destruction is advanced causing infectious or esthetic problems, a dental restoration will be necessary.
How to prevent bruxism?
Bruxism, especially nocturnal bruxism, occurs before paradoxical sleep. It is unconscious and therefore uncontrollable.
It is possible to limit or prevent the effects of grinding by using occlusal gutters.
In some cases, botulinic toxin (Botox) is used to relax the manducatory muscles.
Relaxation sessions and psychotherapy can also be beneficial for bruxers.
Are kids concerned by bruxism?
Kids are indeed concerned by bruxism. It is possible to encounter completely abraded milk teeth.
It is necessary to consult a doctor as soon as possible.
What are the risks for oral hygiene and general health?
- Loosening or even fracture of the teeth.
- The wear of the teeth.
- Dental hypersensitivity (to the heat, cold, etc.).
- Loss of dental tissue (enamel, dentin, pulp).
- Damage to the gums and temporo-mandibular joints.
- Joint and muscular pains.
- Cervical pains.
- Headaches.
References:
1 – “Bruxisme du sommeil: aspects fondamentaux et cliniques”, Bernard CHAPOTAT, Jian-Sheng LIN, Olivier ROBIN, Michel JOUVET, Journal de parodontologie & d’implantologie orale Vol. 18 N°3/99 – pp. 277 à 289.
2 & 3 – Thèse “Le bruxisme : étiologies et traitements complémentaires au port de la gouttière”, 2017, Agathe DEAN, Faculté de chirurgie dentaire, Université de Lille.
