Bruxism is a condition which involves the grinding, gnashing or clenching of teeth.  As such activity is habitual and not the most common use of the teeth and jaw, it is referred to as oral parafunctional activity.  While most people will experience such oral parafunctional activity at some point during their lives, some experience it to a severe degree.

While tooth grinding and jaw clenching can occur during the day or night, bruxism causes the most damage during sleep.  In non-sufferers, the chewing reflex is turned off during sleep.  However, for those who suffer from bruxism, the chewing reflex malfunctions and remains active during sleep, resulting in the grinding and clenching associated with this disorder.

Symptoms of Bruxism

People who suffer from bruxism will typically grind their upper and lower incisors and canines from side to side.  This results in strain on the medial pterygoid muscles as well as the temporomandibular joints and can lead to earaches, headaches and depression.  Chronic facial pain, increased tooth sensitivity, anxiety and eating disorders are also common symptoms of bruxism.  Bruxism often accompanies conditions such as chronic stress, Alzheimer's disease and alcoholism.

Diagnosis of Bruxism

Since there are many potential causes of tooth wear, bruxism can often be misdiagnosed.  Bruxism may also go undiagnosed as many patients are unaware that a problem exists until complications develop.  However, trained dental professionals are able to differentiate wear caused by bruxism and wear caused by acidic drinks and aggressive brushing.

A BiteStrip® can be used to assess the severity of bruxism in order to formulate an effective and customized treatment plan.  A BiteStrip is a home screening device which utilizes electromyography to monitor the activity of jaw muscles while the patient is asleep.

Why Prompt Treatment Is Important

Bruxism should be treated promptly in order to prevent the following from occurring:

• Tooth loss and gum recession: The jaw clenching and tooth grinding associated with bruxism can cause damage to the gums, resulting in the formation of deep pockets.  Bacteria can then colonize within those pockets, leading to infection, bone destruction and even tooth loss.

• Occlusal trauma: The wear that bruxism causes to the occlusal (chewing) surfaces of teeth can result in tooth fractures and the need for restorative dental treatment.

• Arthritis: When bruxism is severe and chronic, it can eventually cause arthritis in the temporomandibular joints, which are the joints that allow the jaw to open and close smoothly.

• Myofascial pain and headaches: Tooth grinding can cause teeth to become shortened and blunted.  Eventually, this can in turn cause muscle pain in the myofascial region as well as severe headaches.

Treatment Options

There are a variety of tools and treatment methods available to manage bruxism and to reduce its negative effects.  These tools and treatment methods include:

• Mouthguards: Mouthguards can be obtained from your dentist and can be custom made from tooth impressions.  Mouthguards minimize the abrasive effects of tooth grinding during sleep and should be worn on a long-term basis.

• NTI-tss device: The NTI-tss or nociceptive trigeminal inhibitor device is an appliance which fits over the front teeth and alters the angle of the jaw.  This device needs to be fitted by a dental professional and will prevent the rear molars from grinding against each other by limiting contractions of the temporalis muscle.

• Botox®: Injecting Botox into the muscles causes them to relax and weaken.  While this prevents tooth grinding, the effects are not significant enough to interfere with daily functions such as speaking or chewing.

• Stress management: For those who grind their teeth as a result of stress, professional counselling and stress-reduction strategies can help to reduce or prevent such oral parafunctional activity.

If you have questions or concerns about bruxism, please ask Santa Monica Cosmetic Dentist Cameron Torabi.