Bruxism is a parafunction of the masticatory apparatus characterized by grinding, rubbing or clenching of the teeth, during the night or during the day, consciously or unconsciously.
Tooth wear is an important sign of bruxism and is present in all teeth in several forms: dental abrasion, dental erosion, abfraction and dental attrition.
Clinically, in the early phase of the disease, “tooth grinding” is observed, by increasing the translucency of enamel surfaces due to the thinning of the enamel.
Later, as the disease progresses, the teeth become yellowish, the color of the exposed dentin.
At this stage, the loss of tooth tissue causes the patient to experience a number of problems:
hypersensitivity and dentinal hyperesthesia,
cracks, fractures,
inflammation of the pulp or even pulp necrosis.
In extreme cases, in patients who have neglected this bruxism for very long periods of time, the teeth end up being chipped down to the gum line.
Symptoms
Do you have frequent headaches or pain in the ear and temporomandibular joint area?
Do you have increased tooth sensitivity?
Do you feel fatigue in your chewing muscles, especially in the morning?
Do you sometimes feel that your jaws are clenched?
These are just some of the symptoms of bruxism, often present at night during sleep and noticeable by a characteristic grinding sound, often not given the appropriate importance.
Most of the time, during a dental check-up, you find out that you suffer from bruxism. Your dentist can tell you what causes it, what symptoms you experience, what complications may arise and, above all, how it can be treated.
Classification
There are two types of bruxism:
nocturnal (the most common), characterized by teeth grinding accompanied by regular contractions of the jaws
diurnal, which is described as a reaction to various stimuli.
The initial signs of bruxism are observed at dental level: the first obvious aspects are cracks in the enamel and changes in the dental anatomy, by grinding of the posterior teeth, and levelling of the front ones, followed by the appearance of slight dental sensitivity, then by pain in the auricular area, caused by problems, at the level of the temporomandibular joint, amplification of the masseter muscle volume, and headaches.
These changes in the masticatory apparatus are insidious. For this reason, about 80% of patients do not realize that they suffer from bruxism.
Causes of bruxism
Although many studies have been carried out on the subject, it has not been possible to determine the precise causes of this habit, but bruxism has been associated with several factors:
Stress, emotions, demanding tasks, anger, tension, pain, grief, irritation, frustration, anxiety, agitation, fear, milestone events, family disharmony, etc.
Some drug treatments
Aggressive, obsessive, perfectionist or anxious people are more likely to develop bruxism
Insufficient or poor quality of sleep
Tooth inconsistencies or tooth eruption
Changing from temporary to permanent teeth
Disproportionate development of the jaw bones
Recent fillings or recent prosthetic work that is improperly occlusally adapted
Partial airway obstruction, through adenoid vegetations (polyps) or tonsillar hypertrophies.
How is bruxism treated?
The treatment plan for bruxism is determined by considering the potential source of the problem. Depending on the degree of tooth wear and the potential cause, your dentist may recommend:
The use of a sleep guards. The device is custom-made of a plastic material that molds to the patient’s teeth and covers the teeth to prevent them from being damaged by grinding. The device is intended to control the bruxism parafunction, but does not cure it permanently.
Relaxation. Everyday stress is a major cause of bruxism, so it is advisable to reduce stress through relaxing activities. Applying a warm, moist compress to your face to relax tense muscles can also help.
Rebalancing the occlusal relief to correct the bite. An unbalanced occlusion, when the upper teeth do not overlap correctly over the lower teeth, can also be improved by fillings, reducing the crown height by selective grinding, orthodontic treatment or dental crowns.
