Bruxism: What is it?
Have you noticed your teeth wearing down? Do you suffer from headaches, earaches and inflamed gums? You might be suffering from Bruxism.
Commonly known as grinding your teeth, bruxism is fairly common and can have a huge impact on the look and health of your teeth. It impacts around 10% of adults and 15% of children.
Around 80% of bruxism cases are sleep related, as in, the actual teeth grinding takes place subconsciously during the hours that we sleep and 70% of cases are stress or anxiety related. Though it isn’t always clear what exactly is causing the grinding, as well as psychological factors, it is believed that lifestyle factors and sleep disorders are common causes.
Lifestyle and demographic factors such as young age, higher educational status, smoking, caffeine intake and heavy alcohol consumption are associated co-factors of bruxism. Tobacco, alcohol, caffeine, or medications for sleep, depression, and anxiety can cause an increased rate arousal during the hours we are meant to sleep. This can cause issues with staying asleep and actually getting to sleep. Bruxism is higher in those who have a more common rate of sleep arousal. Suffers of existing sleep disorders (like snoring, sleep apnoea, sleep paralysis etc) also are at a higher risk of Bruxism.
Stress, illness and an individuals coping style with them also relate to bruxism.
For example those suffering from an illness or stress at work are more likely to grind their teeth than those who do not. Although you may be suffering from stress or illness you may not know you are grinding your teeth. Bruxism manifests itself in other ways in the body, symptoms to tell you that it’s happening and those include:
• Abnormal tooth wear
• Fracture of teeth
• Inflammation and recession of gums
• Excess tooth mobility and premature loss of teeth
• Obstructive nasal and breathing symptoms (mainly children)
• Facial myalgia
• Ear ache
• Limitation of mouth opening
• Sleep disruption
• Joint disorder (TMJ)
• Muscle aches
There have been many treatments over the years; however, the only proven treatments for bruxism are mandibular advancement devices, hypnosis and occlusal splints. Occlusal splints (also known as night guards) are small plastic mouth guards, they protect the teeth from premature wear, reduce jaw muscle activity and the noise of teeth grinding. This prevents premature wear and the need for advanced medical treatment. Though they are the treatment of choice, it should be known that they are a control and not a cure.
Mandibular advancement devices (MADs) are mainly used for the management and control of sleep apnoea and snoring.
Their use in the control of bruxism has been researched and many studies report highly effective outcomes in the reduction of sleep bruxism but with undesirable side effects. One study compared the effectiveness between a MAD and occlusal splint. A moderate reduction in sleep bruxism was found with the occlusal splint but a large reduction in bruxism activity with the MAD.
If you’d rather go for a behavioural approach psychoanalysis, autosuggestion, hypnosis, progressive relaxation, meditation, self-monitoring, sleep hygiene and habit reversal/habit retaining have been prescribed for the management of bruxism. Giving autosuggestion before falling asleep such as ‘I will wake up if I grind my teeth’ is reported by psychoanalysts to help the sufferer become aware of the habit, even while asleep. Unfortunately, autosuggestion lacks scientific strength and is not recommended. Hypnosis has long been under review and some bruxists have found profound relief from problems related to sleep bruxism. One study reviewed the long-terms effects of hypnosis and a positive outcome was still applicable even after 36 months. This treatment has promise, and for some it may be successful.
If you think you have bruxism, consult your dentist as soon as possible, it is a manageable condition with some professional insight.
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