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Bruxism

Bruxism (tooth wear) – Grinding Management

Bruxism or tooth grinding and clenching is a common problem that afflicts many of us at different stages throughout our lives. Bruxism is often stress related. Under certain circumstances alteration to the occlusion of the teeth (ie after a filling is placed) or after a traumatic injury to the temporomandibular joint (jaw joint or TMJ) can cause bruxism and lead to the classic signs and symptoms of this condition. In some cases the pain associated with bruxism can be confused with wisdom tooth pain. Although tooth grinding /clenching can occur during waking hours, this usually occurs whilst sleeping.

Signs and Symptoms

The main signs and symptoms of a bruxism problem are:

  • Biting surfaces of the teeth become flat and worn
  • The biting surfaces become sensitive to cold fluids and sugars
  • Tension and tenderness in the muscles surrounding the jaw and in the TMJ
  • Waking in the morning with headaches, and occasionally associated neck or jaw pain
  • Disturbed sleep patterns

What to do?

If you are suffering from any of these symptoms, or have noticed your teeth becoming worn, there are different treatment methods that can be adopted depending on the severity of the case. Once a patient has been diagnosed as suffering from a bruxism problem the first step is for the patient to become aware of it.

Step One – Awareness

  • Become aware of the problem
  • Attempt to decrease stresses in life
  • Begin a soft food diet
  • Cut food up into small pieces
  • Loosen jaw muscles with exercise
  • Ensure teeth are not touching when falling asleep and when waking up
  • Heat pads on the jaw muscles

Step Two – Appliance intervention

  • If the tooth wear persists, however no muscle or joint pain is experienced, a soft night guard can be constructed to protect the teeth during the night.
  • If muscle and joint pain persists with or without tooth wear a ‘hard’ night guard or splint should be constructed. This acts as a ‘crutch’, stretching the muscles and preventing them from bruxing the teeth.

Step Three

If pain persists a combination of analgesics and muscle relaxants maybe required.

Step Four

Where the above treatment fails, investigations into the TMJ it self may be carried out. Occasionally degenerative joints are found to be the underlying cause of the symptoms requiring correctional surgery, orthodontics and/or Full Mouth Bite Rehabilitation. This fortunately is very rare.

Other Concerns

Use of a splint is recommended for all people who suffer bruxism as well as patients with restorations requiring protection ie. Crowns, Veneers, Implants and fillings.

Factors that Increase the risk of Bruxism (and erosion)

There are several factors which increase the risk of future wear and damage from bruxism.

  • Medications – including antideppressants and stimulants. Certain types are known to trigger bruxism as well as reducing saliva causing a dry mouth.
  • Dry Mouth – Lack of lubrication from saliva increases the potential for tooth wear. This can be a result of dehydration, excessive alcohol, caffeine and certain medications.
  • Acidity in the Mouth – This can occur from a high intake of fruit juice, wine, cola, soft drinks, sport drinks or stomach reflux.
  • Stress and Anxiety – This can lead to increased levels of bruxism and reduced saliva.
  • Exposed Dentine – This is softer than enamel and wears at a quicker rate.

Fortunately Bruxism can be controlled in most cases. As stated bruxism is often stress related. I often say to my patients, “Before we begin any treatment for bruxism how about taking a holiday?”

If you have any further queries relating to this topic or any other please feel free to contact us. on 03 9866 1171.

Bruxism Video Animation

 

Bruxism Wear Examples

Mild Wear

Moderate Wear

Severe Wear

Extreme Wear

 

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