Bruxism is a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism can occur during sleep (indicated as sleep Bruxism) or during wakefulness (indicated as awake Bruxism)and it can result in several orofacial lesions, such as tooth wear (loss of tooth surface or structure), fracture of restorations or teeth, hypersensitive or painful teeth, loss of periodontal support, periodontal lesions, temporomandibular joint disorders and muscle pain.

Teeth grinding is controlled by the brain, and although it is not clear why it occurs, there are some possible reasons:

-genetic factors,

-Neurochemicals,

-Psychological factors like stress, anxiety, depression

-Smoking, alcohol and caffeine.

-Medications (e.g. some antidepressants) and illicit drugs (e.g. ecstasy)

Although several therapeutic modalities have been employed to treat Bruxism, including oral splint, medications and behavioural approaches, none has been reported to be fully effective.

Recent advances have shown that Bruxism is caused by centrally mediated high levels of motor activity in the jaw muscles, indicating that reductions in this activity may be helpful. Botulinum toxins, proteases that block the release of acetylcholine, can ultimately inhibit muscle contraction, rendering them applicable to Bruxism.  Thus, the application of Botulinum toxins may be indicated as therapeutic modality to reduce the effects of grinding and clenching.

Bruxism in itself does not require treatment: management is only indicated where problems arise as a result of Bruxism.

Tooth wear is normal with age. However when the amount of wear is more than what it is usually seen for a person’s age (too much too early), it can cause pain and sensitivity, affect function and appearance. If treatment is needed, the earlier it is done, the easier and less expensive it may be. The treatment of great tooth loss is complex and lengthy.

Oral appliances primarily aim is to protect the dentition from damage caused by clenching/grinding, although they may reduce muscle activity. Irreversible occlusal adjustments have no basis in evidence in the management of Bruxism. Behavioural strategies include biofeedback, relaxation and improvement of sleep hygiene. Administration of botulinum toxin (Botox) to the masticatory muscles appears to reduce the frequency of Bruxism.

Do I suffer from Bruxism?

There are some questions you may ask yourself to elicit history of bruxism and suggestive clinical indicators:

– Are you aware of grinding your teeth during sleep?

– Are you aware of grinding your teeth whilst awake?

-Has anyone told you that you grind your teeth during sleep?

-On waking, do you have your jaws clenched or thrust forward?

-On waking, do you experience pain or stiffness in the jaw muscles?

 Signs and symptoms of Bruxism

– Worn down shorter teeth

-Chipped and cracked teeth, fillings or crowns.

-Pain and tenderness in the facial and neck muscles in the morning.

-Grinding noises during sleep

-Shiny spots on restorations

-Tongue scalloping and ridging on the cheek mucosa (‘linea alba’)

– Masticatory muscle fatigue or pain on waking

What should I do? Management of teeth grinding

-Protecting your teeth and crowns wearing a custom made hard night occlusal splint. Do not use a ready -made splint without consulting with your dentist. Poorly fitted splints can cause further damage and unwanted teeth movement.

-Restoring the damaged teeth with fillings or crowns when necessary.

-Consult with a TMJ physiotherapist.

-Relaxation techniques like Meditation, Yoga, and Breathing may help to relax your muscles and decrease the grinding and clenching of your teeth.

-Consult with a medical specialist in order to address stress, anxiety or depression.

-Visit your dentist regularly to check if Bruxism symptoms are present and to get help in protecting your teeth.

-Warm heat packs may help to relax tender muscles.

-Using over the counter anti-inflammatory medications for a short period of time

– Recent research literature suggests that Botox treatment is a safe and effective strategy for controlling jaw motor activities during sleep (Sleep Bruxism) for a period of time. It reduces the intensity rather than the generation of the contraction in jaw-closing muscles during sleep. A safe and effective management of Bruxism with Botox injections may include as well a protective device (occlusal splint) of the orofacial structures from excessive forces.

For further information, please don’t hesitate to contact our practice at 9827006.