BRUXISM AND ITS TREATMENT

DEFINITION:-

IT CAN BE DEFINED AS DIURNAL OR NOCTURNAL PARAFUNCTIONAL ACTIVITY THAT INCLUDES CLENCHING, BRACING, GNASHING AND GRINDING OF THE TEETH.

ETIOLOGY:-

Psychological and emotional stresses.

e.g.:- anxiety, anger, frustration . Occlusal interference or discrepancy. Pericoronitis and periodontal pain is said to trigger bruxism in some individuals.

 CLINICAL FEATURES:-

Occlusal wear facets on teeth.

Fractures of teeth and restorations.

 CLINICAL FEATURES: Temporomandibular joint pain and discomfort. Mobility of teeth. Tenderness and hypertrophy of masticatory

muscle.

Muscle pain when patient wakes up in the morning. Muscle activity becomes abnormal & also interfere

with TMJ functions.

 Bruxism causes disruption of the relationship or

alignment of the condyle , disc, and articular surface of the temporal bone which is called an intracapsular disorder or internal derangement of the TMJ.

 It has been estimated that during clenching or

grinding the individual might impose a load of over 20 g on a tooth over period 2.5 sec at a time.

 EFFECT ON IMPLANTS: It has been associated with increased risk of

implant failure. Repeated lateral forces applied to the implants can be detrimental to the osseointegration process, especially during the early healing period. It may be due to result of their clenching or grinding.

 So bruxism to be a contraindication to implant

treatment, especially in the case of a short span fixed partial denture or a single tooth implant.
If implants are planned for a patient with bruxism

habit, protective measures should be employed, such as ; Creating a narrow occlusal table with flat angles, Protected occlusion and the regular use of occlusal guards.

Diagnosis of bruxism

1. 2. 3. 4.

5.

There may be definitive history of bruxism but in an unaware patient a number of sings help in its detection. Advanced attrition Increased tooth mobility patterns The presence of widened periodontal spaces in radiographs Hypertonicity of the muscles of masticationElectromyographic examination TMJ discomfort

COMPLICATIONS
If bruxism is not treated then in future life ,it

can lead to- jaw discords, -damage to teeth and - heavy headaches.
People get warned about their condition only

after some complication arises and many times they just neglect it.

 constant headache, sore jaws are two important

symptoms that indicate that the person is suffering from bruxism.

Once you get doubtful about your clenching of

teeth in night, you will need to take help from your dentist. The dentist will examine your mouth and jaw and will decide whether or not you suffer from bruxism

 Obstructive sleep apnea is a condition which is

very often complicated by additional disorders or problems. Many patients with this common sleep disorder had a problem with severe teeth grinding (bruxism)!
According to a recent scientific study in Israel obstructive sleep apnea is even the highest risk factor for sleep bruxism!

Treatment of bruxism
1.

The first step in the control of any parafunctional habit must be discussion with the patient. If occlusal disharmonies are there ,then the selective grinding may help to relieve the parafunction.

2.

Further dental treatment involves the use of night-guards to limit the excessive occlusal stress. There are basically two forms of nightguards, both of which are made in acrylic:
The occlusal shield which fits ovre the occlusal surface , incisal edges & lingual tooth convexity. where attrition is sever or where there has been collapse of the posterior segments so that the freeway space is increased ,the occlusal shield can be usefull.

A.

B. the anterior bite plate. where there is an obvious bruxism habit with symptoms of muscle spasm & where the lower anterior teeth are well supported with bone a night guard with an anterior bite plate is extremely useful.

To relax your jaws, hold one warm cloth on your cheeks and ears. We can advise the patient to visit their dentist even if they have just hint about their clenching of teeth.