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Fundamental concepts of sleep Bruxism

Bruxism describes the clenching, grinding and gnashing of teeth without functional purpose. It is something that could occur during sleep and wakefulness. Both share similar risks and consequences while they have different etiologic and pathophysiology mechanisms. Sleep bruxism plays a role in temporomandibular joint disorders, stomatognathic muscle pain, tooth wear and damage and dental restoration breakdown. Facts about bruxism
  • Between 8 and 31% of the adult population grinds their teeth while up to 40.6% of children grind their teeth during sleep.
  • A factor that influences bruxism is family history with rates as high as 50% if it has been diagnosed in a family
  • Bruxism is a very common sleep disorder
  • Untreated bruxism can lead to cracked teeth and nerve damage
Symptoms and signs of bruxism
  • Shortened teeth
  • Tooth sensitivity
  • Headaches
  • Jaw muscle pain
  • Pronounced bruxism leads to extensive destruction of a tooth crown
  • Dental implants or prosthesis and fillings can be damaged
In previous years, dentistry considered sleep bruxism as an anatomical etiology as there is no evidence that it has a pathophysiologic reason. Previous data indicated that bruxism involves environmental and genetic factors only. A central nervous system stimulant like coffee and caffeine also increase bruxism by 1.5 times. Adults and children that report self-awareness of grinding their teeth are often hyperactive, aggressive and anxious individuals. Factors that are also associated with bruxism are psychological, for example, poor coping mechanisms, emotional lability, competitive behaviour and nervousness. Attempts to eliminate bruxism is usually done by treating the cause, which could be difficult to diagnose. Treatment could include crunchy splints that are prescribed by a dentist. These are placed over the lower jaw to cover the teeth and prevents clenching. It is only effective while it is worn and could not be seen as a permanent solution that will stop clenching altogether. Behavioural therapy and psychological counselling are often prescribed but it is a controversial long-term therapy. Drug treatments are also known to show positive effects but often used as short-term treatment.