Bruxism (Teeth Grinding)

Bruxism is the grinding/ clenching of teeth which an adult or child may experience throughout their lifetime. Some people grind their teeth at night, involuntarily. This is called sleep related bruxism or nocturnal bruxism. Others grind their teeth in the day, usually when they face stressful situations which makes them anxious.

They may not be aware of it, till the person sharing the room with them at night points out the horrible grinding sound they are making with their teeth. In some cases a routine dental checkup may help them discover this, as the dentist points out the unusual pattern and rate of enamel wear or damaged teeth.

If the dentist suspects that the patient is a bruxer he would first check the history of the patient asking

1. about any stressful situations in life
2. any history of medications as this could be a side effect of anti depressants
3. any habits like taking excess of beverages containing alcohol or caffeine as
4. both these chemicals increases the tendency to grind teeth
5. history of a brain injury which lead to a complication resulting in bruxism

The dentist would examine the patient’s face, mouth and teeth for

1. any tenderness of jaw muscles
2. any tenderness of the TMJ ie Temporo Mandibular Joint or any TMJ dysfunction
3. any dental problems which may be caused due to bruxism ie broken teeth, broken fillings, missing teeth, poor alignment of teeth
4. unexplained facial pain
5. any neuromuscular disease of the face for which bruxism may be a symptom

The symptoms of bruxism include the following;

1. Crowns, bridges and fillings which have chipped off
2. Sensitivity in teeth
3. Loose painful teeth
4. Facial pain due to clenching of jaw muscles
5. Headaches
6. Overall facial fatigue
7. Pain in the temporomandibular joint (jaw bone on either side of the mouth)

Rhythmic contractions of the jaw muscles

1. A grinding sound at night, which may disturb the sleep of someone who shares a bedroom with a “bruxer”
2. A dull morning headache
3. Painful and tight jaw muscles, especially in the morning
4. Facial pain which has become chronic
5. Damaged teeth, worn off teeth, injured gums

The duration of bruxism depends on the cause. If it is due to a dental reason, then it stops after the teeth are repaired and realigned ie within a few dental visits. Of all children who brux between the ages of 3 and 10, more than half will stop spontaneously by age 13. If it is related to a stressful life situation that does not go away, it can last for many years.

Treatment

The treatment of bruxism varies depending on its cause

Dental problems — If teeth problems are causing bruxism, dental treatment using crowns, onlays may be needed to correct the bite. The dentists in dental clinics in Delhi often use Occlusal therapy to treat mal alignment of teeth.

Stress — Professional counseling or other strategies and exercises to relax the patient help, if the bruxism is stress related. In severe cases, dentists in Delhi and dentists in India refer the patients to the oral surgeon. The oral surgeon may inject botulinum toxin directly into the jaw muscles, to temporarily interfere with muscle contractions.

Medication — If bruxism is a side effect of antidepressant medications, your doctor either can switch you to a different drug. Also, try cutting down on stimulants such as tobacco and caffeine.

In dental clinics in India and the dental clinics in Delhi, the most common and popular method of treatment of bruxism being used by dentists is, (in both children and adults) is use of a night bite plate or a bite splint (a dental appliance worn at night to stop teeth grinding). Dentists in Delhi are using this often as it prevents damage of the teeth. Though the use of a night splint does not cure the problem, dentists in India are using it routinely as it helps manage bruxism. The symptoms are relieved and further damage to teeth is prevented.

In some reputed dental clinics in Delhi like, ‘Smile Delhi-The Dental Clinic’, the dentist has an affiliate psychologist to help bruxism patients with proper counseling.

Some proactive dentists in India are offering counseling sessions in their dental clinics. Some dental clinics in India, especially the multispecialty dental clinics in Delhi, have fixed days in the week where counselors are made available to the bruxism patients where psychological problems is the cause.

Posted By – Dr. Suprriya B. Bhatia