Bruxism or Teeth grinding is an abnormal human behavior wherein the human being gnashes, grinds or clenches his teeth in a habitual manner. Both the adults and children are affected by this. It has been assessed that the number of persons affected by bruxism is between 30M and 40M and this includes both children and adults.
This habit can occur both in the day (diurnal) and the night (nocturnal). It occurs in children mostly in the night when the individual is in deep asleep whereas the adults get affected both during day and night. The individual is conscious of this habit when it occurs during the day whereas they hardly realize it when it occurs during sleep. This sleep related bruxism is also known as nocturnal bruxism. If this habit is severe it could fracture dental fillings or cause damage to the tooth.
- Tooth wear - Tooth attrition will cause wearing of tooth thereby making the tooth short.
- Tooth flattening – occurs that make the yellow/ creamy dentine visible.
- Tooth chipping – occurs due to grinding of teeth.
- Tooth sensitivity, pain and looseness – increases because of worn out/ cracked tooth.
- Fractured fillings, crowns, prosthesis, etc.
- Restricted jaw movement – occurs because excessive tooth wear cause the jaws to close too far and this results in facial changes.
- Eating Disorders – restricted jaw movement causes pain while eating.
- Untreated bruxism – might cause the teeth to wear to the level of the gums.
- Unsightly creasing – is seen at the mouth corners.
- Nuisance to others - Clenching or grinding of teeth in the night might cause discomfort to persons sleeping in the same room.
- Tenderness and Pain – earache, facial pain, headache, jaw pain etc.
- Prominent jaw muscles – are likely to develop.
- Chewing of the tissue inside the cheek
The following are the possible causes for bruxism in adults
- Abnormal alignment of upper and lower teeth
- Medical conditions - Cerebral palsy and Learning difficulties
- Persons who are aggressive, competitive and hyperactive
- Psychological – Anger, anxiety, frustration, stress and tension
Parents would be interested in seeing their child sleep peacefully with easy breathing. However, there are parents who find that their child gnashes and grind their teeth. Bruxism is very common in kids under the age of five and according to experts 2% to 3% of the kids in this age group are affected by bruxism. Fortunately, most of the children overcome this problem after they get adult teeth.
Some of the reasons for this disorder in children are as follows:
- Malalignment of top and bottom teeth at the time of tooth eruption
- Hyperactive children
- Children having tooth pain or earache
- Stressful situations due to tension, anger, etc.
- Medical conditions such as cerebral palsy
Most bruxists do not require any treatment. Children overcome bruxism without any special treatment once they get adult teeth; on the other hand adults rarely have severe bruxism.
In severe cases, it has to be treated dentally, psychologically and with medication. Psychological and medical issues have to be attended to by the specialists in their respective fields – medical practitioners, psychologists etc.
The dental treatments will depend on the severity of tooth wear. Preventive measures can be taken in the initial stages where as if the attrition is severe it is essential to restore the teeth with root canal treatment and/or crowns. This will bring the size of teeth to normal thereby making the jaws normal and also improving the aesthetics of your teeth and face.
- Mouthguards – your dentist might ask the child to wear a mouthguard or splint to avoid any damage occurring to the teeth. The mouthguard can either be a standard one or custom built. Custom built mouthguard is expensive but fits well.
- Repositioning Splint – this appears like a traditional night guard; this is basically meant for changing the bite or occlusion of the patient. This has not shown any extra advantage over conventional methods and hence to be used only if essential.
- NTI-tss Plus™ - this suppresses the contraction of parafunctional muscle by 70% thereby protecting your teeth, joints and muscles. The NTI covers only the front teeth and prevents the rear molars from coming into contact, thus limiting the contraction of the temporalis muscle.
- Stress Management – stress related grinding of teeth can be prevented by exercising, meditation and counseling by a professional. If the child grinds his/ her teeth due to fear or tension you must talk to the child or read a story book before the child goes to sleep so that the child relaxes.
- Correction of malaligned teeth - if bruxism is due to malalignment of teeth
- Use of overlays and crowns to correct the chewing surface
- Behavior therapy – you can prevent bruxism by adjusting the position of mouth and jaw. Rest your tongue in such a way that it keeps your teeth apart and keeping your lips closed.
- Medications – generally medications are ineffective for bruxism. If this is caused as a side effect for taking antidepressants your doctor might change the prescription.
- Botox – Botulinum Toxin or Botox can be used for treating bruxism. Botox is an injectable medicine which weakens the muscles; this is largely used in cosmetic procedures for relaxing the facial muscles so as to reduce the facial wrinkles. You could consider bruxism as a disorder wherein the masseter muscle i.e. the large muscle that moves the jaw has repetitive and unconscious contraction. Botox can be used for weakening this muscle sufficiently to stop the grinding and clenching; however it should not cause problems for chewing and facial expressions. The Botox gets into the muscle and weakens it but does not get absorbed in the body. The procedure involves five or six injections into the masseter muscle.
- Dietary Supplements – some dietary supplements containing pantothenic acid, magnesium and calcium have been useful in treating bruxism.