Bruxism is the medical term for a condition that involves grinding the teeth together (when not chewing) and/or clenching the jaw, either during the day or at night. Bruxism is frequently misdiagnosed or not diagnosed at all, because it is only one of several potential causes of tooth wear. Symptoms include earache, depression, headaches, eating disorders and anxiety and are often accompanied by chronic
stress, Alzheimer’s disease and/or alcohol abuse.
While, some tooth wear can result from overly aggressive brushing, acidic soft drinks and
abrasive foods, Dr. Couzens can determine whether tooth wear is from bruxing. To evaluate the
frequency and severity of the condition, an economical device that senses
and monitors any activity in the jaw muscles can be used at home during sleep. The results will allow her to recommend the best course of treatment.
Most of the damage caused by bruxism occurs during sleep. Typically, the incisors and canines (front 6 upper and lower teeth) of
opposing arches grind against each other laterally. This side to side
action puts undue strain on the medial pterygoid muscles and the
temporomandibular joints. The chewing reflex should be inactive during sleep, but in people who suffer from bruxism, the nerves of the reflex pathways remain active.
Bruxism should be treated promptly to avoid:
Gum recession and tooth loss
Bruxism is one of the leading causes of gum recession and tooth loss: first, it damages the soft tissue directly; and second, it leads to loose teeth and deep pockets where bacteria can colonize and erode supporting bone.
Abnormal wear patterns on the occlusal (chewing) surfaces can lead to fractures in the teeth, which will like lead to the need for restorative treatment.
In severe and chronic cases, bruxing can lead to painful arthritis in the temporomandibular (TMJ) joints (joints that allow the jaw to open smoothly).
The grinding associated with bruxism eventually shortens and blunts the teeth, resulting in muscle pain in the myofascial region, as well as severe headaches.
Treatment options for bruxism
A variety of helpful devices and tools are available. Some common ways bruxism is treated are:
Mouthguard, made from an impression mold, is designed to minimize the abrasive action of tooth surfaces during normal sleep. They are worn on a long-term basis to help prevent tooth wear and TMJ damage, as well as to help stabilize occlusion.
NTI-tss device is fitted by a health professional, covering only the front teeth, to prevent grinding of the rear molars by limiting the contraction of the temporalis muscle.
Botox® is an excellent treatment for bruxism because it weakens the muscles enough to prevent the grinding, but not enough to interfere with everyday functions like chewing and speaking.
Other methods of treatment include relaxation exercises, stress management education and biofeedback mechanisms. When the bruxing is under control, there are a variety of dental procedures such as crowns, gum grafts and crown lengthening that can restore a pleasant aesthetic appearance to the smile.
If you have questions or concerns about bruxism, please ask Dr. Couzens.