Bruxism: When Tighten the Teeth, It's not Good!

I'm sure you've already heard of bruxism. Indeed, more likely you know that there is a phenomenon where some people tend to grind their teeth at night.

Let's get some clarity on the subject. 

First of all, bruxism means the involuntary habit of clenching or grinding the teeth and can be day or night.  Well, it seems that if we add nocturnal bruxism, which affects 12% of the population in the US to the day, we arrive at an estimate that in the USA one person out of three suffers from a form of bruxism.

If I have to tell you my impression as a clinician making 100-200 visits a month, you can do 50%.

The causes of the phenomenon are not known. If once blamed on occlusion problems, recent evidence has exonerated this problem and brought up factors like

• - sleep disorders
• - alterations of the neurological system
• - taking medications or drugs
• - excessive intake of alcohol, coffee or cigarettes
• - anxiety, stress, depression and personality disorders

 Certainly, the modern lifestyle leads to the release of tensions on the teeth. So much so that many children consume their milk teeth to the sound of gnashed sounds. And I say "sound" because the main factor that leads the person to notice that he suffers from bruxism is the noise that the teeth emit while you sleep.

But be careful! Noise is produced only in 25% of cases!  But it's hard to convince patients that the teeth are abraded because they grind their teeth day or night!

Even if it's true that during the course of life, bruxism can diminish or even disappear, the damage it causes is unequivocal. So it's useless to blame the strangest habits like biting your nails or tearing off the tape with your teeth. If the teeth are abraded, they are overloaded in some way.

Then there are cases also in which only a few teeth are consumed due to a particular malocclusion situation that leads to touching only a few teeth, which are therefore consumed selectively but are not the norm.

How to find out if it grinds itself? First of all, the teeth of the person suffering from bruxism are consumed. The first teeth to flatten are the canines, which are born sharp but immediately become flat in the grinder. Apart from the canines, the teeth on which the facets of wear are best seen are the premolars and incisors. Generally speaking, however, people only notice dental abrasion when the incisors shorten or crunch at the tip.

But there are other signs that betray the habit of grinding teeth. One of the most widespread is the enamel of the enamel at the level of the tooth collar. Said like this, it's a bit difficult to understand, but with a photo, you will perhaps understand better.

In practice, even if the tooth is coated with enamel, which is a very hard mineral, it can deform if subjected to excessive loads. Keep in mind that the forces exerted with bruxism are much higher than those used to eat. The tooth, subject to these excessive loads, imperceptibly flexes and cracks where the enamel is thinner, or at the base of the tooth, just above the gum, and usually on the outer walls, which are more curved and more involved in traumas that assist the process, like the widespread habit of brushing teeth by rubbing hard in a horizontal position.

Once the enamel exfoliates, revealing the inner part of the tooth, the dentin, which is slightly more yellowish, this area, which is softer, tends to wear out much more quickly than the surrounding enamel, and therefore wears out due to the intake of acidic foods (citrus fruits, tomatoes, carbonated drinks, etc.), due to acid saliva or gastro-oesophageal reflux, or mechanical abrasion due to incorrect brushing habits I mentioned earlier.

The abraded teeth in the collar can lead to sensitivity to the cold and must be repaired with fillings or other prosthetic solutions to avoid reaching the nerve and having to devitalize the tooth or, worse, to fracture the entire crown of the tooth, like a tree that is affected with the ax and, when it reaches halfway up the trunk, landslides down.

In addition to dental problems, bruxism can also cause pain in the masticatory muscles, which can lead to a pain similar to cramping, or to frequent headaches, which often occur as early as the morning, after a night of grinding and accumulation of lactic acid in the temporal muscles, which then extend to almost the entire head.

Also, cervical pains can derive from bruxism, due to the presence of a muscle, which is called digastric, which connects the anterior base of the jaw to the base of the skull, influencing the position of the first two cervical vertebrae according to the state of contraction of this muscle.

Finally, although in this case, it is difficult to say whether the chicken or the egg is born first, patients suffering from bruxism show significant differences compared to those who are not at the level of anxiety, depression, phobias, and paranoia.

What can we do to cure or prevent bruxism?

First of all, try to adopt healthy lifestyles. Sleeping right, limiting stress and taking coffee, alcohol, or cigarettes, especially in the evening.

Releasing tensions with the sport can help, especially in children.

The therapy of choice, however, is the application of a nightguard prepared by the dentist which is a kind of mouthguard in acrylic material, which is smooth prevents the teeth from rubbing against each other incarcerating with the cusps, which relieves muscle tension. Furthermore, the resin of the bite is consumed instead of the enamel because it is softer.

Beware of pharmacy bites, because not only does it seem that they do not work well or because they are not personalized, but they can even accentuate the phenomenon ... besides the fact that so many patients who have tried them tell me to find them on the pillow in the morning ...

In the most serious cases, in which there is acute pain in the masticatory muscles, it is possible to associate therapy with muscle relaxants and patches that release anti-inflammatories to be applied in the painful areas.

When bruxism generates excessive tooth abrasion, rehabilitation therapy involves prophesizing (re-size) all the teeth of an arch with inlays and veneers in composite or ceramic, to restore the correct height of the chewing, both to safeguard tooth health and vitality of nerves, both for aesthetic purposes, given that the shortened front teeth ruin the smile and a "lowering" of the closure of the teeth involves the formation of wrinkles on the contour of the mouth and sometimes painful fissures at the level of the labial commissure.

Nowadays it is possible to perform beautiful conservative rehabilitation to restore aesthetics and masticatory function without encapsulating, devitalizing and shrinking all the teeth

Obviously, at the end of the rehabilitation, it will be necessary to bring a bite to the night to avoid destroying even the new job of the dentist who, with what it costs, if he/she breaks he would increase the nervous and therefore also the bruxism!


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... by Massimo - Write us with your Panoramic X-Rays view for a free specialist quotation at our clinic by sending an email at meditur@icloud.com     http://www.freerdentalimplants.com   

DISCLAIMER
The Content above even if the above information is written or supervised by professional in dentistry, it's not intended to be a substitute for advice, diagnosis, or treatment since there is no direct contact with the patients. A physical examination is a procedure by which the dentists investigate the oral cavity of patients for signs of disease. - It generally follows the taking of the medical history and an account of all the symptoms as experienced by the patient. -- Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. -- Always seek the advice of your physician or other qualified health providers with any questions you may have regarding your medical condition.