Bruxism is a problem that is not fully understood. It involves the abnormal, involuntary clenching and grinding of the teeth by the patient. There are two types of bruxism which are generally considered to be separate disorders. One occurs while the patient is awake, the other while the patient is asleep. Some researchers suggest that between 10% and 30% of the population may have some degree of bruxism. Bruxism used to be considered part of the TMJ (Temporomandibular Joint) syndrome but while there is some connection; the two problems should be considered separate.
There is concern for dental patients for two reasons:
Causes of Pain and Discomfort - While often bruxers do not have any symptoms and may not even believe that they grind: eventually most bruxers develop symptoms such as muscle soreness, stiff neck, and headaches. They can also have sensitive teeth and soreness in their Temporomandibular joint.
Excessive Wear of the Teeth - If left unchecked, the patient can severely wear and fracture their teeth. These are very difficult and expensive problems to fix so we like to prevent if we can.
- Four Main Symptoms - Sensitive teeth, stiff, sore neck (especially in the mornings), headaches, and sometimes soreness of the jaw joint.
- Less Common Symptoms - Fractured teeth, tooth mobility, tooth wear, Masseter Muscle Hypertrophy, indentations on the tongue, clicking in the TM joints, ringing in the ears.
- Partners or Parents - may actually hear the patient grinding in their sleep.
The cause of this abnormal behaviour is simply not known at this time. It is thought to be caused by some central nervous system disorder possibly in same area of the brain where Parkinsonism problems originate. Since the cause is not known; there is also no known definitive treatment. However, we do know of several contributing factors which do not by themselves cause the problem, but which have been shown to make matters worse.
OTHER CONTRIBUTING FACTORS:
- Certain Prescription and Non-prescription Drugs - May make grinding worse. These include dopamine agonists and antagonists, tri-cyclic anti-depressants, selective serotonin reuptake inhibitors (SSRI), alcohol, cocaine, amphetamines, caffeine, nicotine, narcotics, and ecstasy.
- Stress - Has long been associated with this disorder and seems to make things worse especially in the "Awake Version".
- Some Personality Traits - have been identified as a contributing factor. These include aggressiveness, competitive and hyperactive personality types.
- Other Sleep Disorders - Such as obstructive sleep apnea are sometimes associated with bruxism.
Trifecta of Problems
Bruxism, GERD (Gastro-Esophageal Reflux Disease), and Sleep Disorder Breathing occur together too often to be ignored and are probably connected in some unknown way. When dealing with any of these problems, you should always check for the other two.
- No Known Cure - For this disorder at this time.
- Contributing Factors - Listed above should be looked at seriously and attempts should be made to reduce or eliminate as many as possible.
- Damage Control - Prevent as much damage as possible from wear by using a well fitted night guard. This will also reduce some of the painful symptoms.
- Acid Erosion - Should also be looked at. A combination of tooth grinding plus acid weakened teeth can lead to even faster wear of teeth. Some sleep centres have reported that episodes of sleep bruxism may be accompanied by gastro-esophageal reflux (GERD).