Bruxism

Bruxism is the involuntary habit of grinding or squeezing the upper teeth with the lower ones without functional purposes.

It is a growing problem in today’s society, due to the increasingly intense pace of life, which increases the stress and emotional stress suffered by the patient. In fact, it can become a chronic disorder that occurs with periods of exacerbation in periods of higher academic or work stress.

What types of bruxism are there?

Bruxism can be:

• Day or wakefulness bruxism : occurs during the day. In this case, you tend to clench your teeth, but rarely to grind them,
• Night or sleep bruxism : occurs at night and usually coincide both activities, clenching and grinding teeth.

In many cases, both types coexist.

In addition, bruxism can be classified into:

• Central: tightening of the two dental structures without lateral mandibular movement.
• Eccentric:  Grinding or rubbing of some teeth against others occurs. It can be nocturnal or diurnal, although it usually occurs during sleep.

Who has it?

According to data from the Spanish Sleep Society (SES), waking bruxism could affect between 22% and 31% of the general population, with a slight predominance in women. On the other hand, the bruxism of the dream is suffered by men and women equally and would affect 8.2% of the population.

The spontaneous remission of this problem usually occurs after 40 years, although it can also disappear only at any time. In any case, according to the SES, bruxism decreases with age and, after 65 years, the percentage of incidence is significantly reduced until reaching only 3% of the elderly.

What causes bruxism?

There does not seem to be a single cause that causes this disorder, but its origin can be due to multiple factors:

• The age : bruxism is common in children, but usually goes away over the years.
• Genetic and family or hereditary factors .
• Suffer alterations in dental occlusion and / or joint and bone abnormalities .
• Suffer mandibular disorders .
• Suffer stress, anxiety or personality problems.
• Have sleep disorders and / or apnea.
• Smoking or consuming caffeine or alcohol .
• The abuse of drugs such as cocaine or amphetamines.

What are your symptoms?

Although often the person affected by bruxism is not aware of them, this disorder can cause signs and / or symptoms such as the following:

• Wear of the dental structure , especially on the edges of incisors and canines, as well as on the cusps of molars and premolars.
• Wedge-shaped lesions at the gingiva of some teeth.
• Dental mobility
• Sensation of “noticing the teeth” when getting up in the morning.
• Muscle pain that intervenes in chewing.
• Disorders in the mandibular joints such as difficulty opening the mouth, noises or clicks in the opening or closing.
• Headaches , especially in the temporal region, on both sides of the head at times upon awakening.
• Gingival recession ( moving away from the gum of the tooth).
• Dental sensitivity with cold or sweet.

How is bruxism diagnosed?

The diagnosis of bruxism is made through a clinical assessment in which the symptoms expressed by the patient and the signs of the condition that manifests itself are collected.
It must be taken into account that there is not a single sign or symptom that implies the presence of the problem, but all the parameters involved must be considered: dental wear, headache, muscle pain and / or joint noises.

How is it treated?

The treatment of bruxism varies depending on its cause, since it can be associated, in addition to morphological aspects, to sleep or behavior alterations or environmental and emotional stress. For this reason, a prosthetic treatment, a prosthetic-periodontal approach or a multidisciplinary approach may be necessary, which may include psychiatric or behavioral measures.

In general, the most widespread treatment is the use of a splint to deprogram or discharge, a rigid acrylic plate that is placed in the upper structure or in the lower one, elaborated and adjusted to the patient’s measurement. Although this splint does not prevent the tightening of teeth, it does relieve the signs and symptoms it produces and prevents tooth wear.

In very advanced cases, in which there has been a very severe wear of the teeth, restorative odontological treatments may be necessary.

Ten tips to relieve bruxism

Although bruxism occurs involuntarily, there are several habits that can help the patient to prevent it or mitigate its symptoms:

Plant face stress.

This is one of the main factors that can cause or worsen the problem, so it is advisable to try to remain calm in complicated situations and to go to sleep relaxed. It can help you achieve it by learning relaxation and breathing techniques and practicing activities such as yoga, tai chi or meditation.

Try to keep your face and jaw relaxed.

Although most of the time they clench or grind their teeth without us noticing it, try to make the conscious effort to relax your facial and jaw muscles during the day, until it becomes a habit.

Avoid movements that irritate the jaw joint.For example, do not chew gum or eat your nails.

Perform stretching regularly.

Learning and practicing physiotherapeutic stretching exercises can also help you to recover the action of the muscles and joints on each side of the head, which will help you to mitigate the symptoms.

Massage on the neck, shoulders and face.

Look in them small and painful nodules, known trigger points, which can cause discomfort and pain in these areas of the body

Apply heat to the joints.

It will help relieve inflammation. Applying ice to the muscles of the jaw can also be effective.

Use toothpaste for sensitive teeth.

It may help to alleviate some of the symptoms of bruxism such as sensitivity to cold or candy.

Sleep in the proper posture.

Better, face up and using a cervical pillow can help you relax the muscles of the jaw.

Do not remove the splint during the night.

At the beginning of the treatment, it is normal to notice pressure on the teeth, but it is important to keep the splint on throughout the night and, even, to use it during the day in times of stress.

Go to periodic check-ups to your dentist.

If you suffer bruxism, it is necessary that your dentist follow the treatment. In case you do not have any specific problem, it is also advisable to have a review at least once a year.