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Bruxism – Treatment for Bruxism

Bruxism is the term that refers to an incessant grinding and clenching of the teeth, unintentionally, and at inappropriate times. Bruxers (persons with bruxism) are often unaware that they have developed this habit, and often do not know that treatment is available until damage to the mouth and teeth has been done. Damage caused by bruxism often includes the following symptoms. However, each individual may experience symptoms differently.

The cause of bruxism is not completely agreed upon, but daily stress may be the trigger in many people. Some people probably clench and never feel symptoms. Whether or not bruxism causes pain and other problems may be a complicated mix of factors — how much stress you are under, how long and tightly you clench and grind, whether your teeth are misaligned, your posture, ability to relax, diet, sleeping habits, and other factors. Each person is probably different.

Here is not a scale of bruxing that exists, but, we could imagine that there is such a scale. This scale could run from a 1 indicating a very slight habit to a 10+ which would indicate a severe bruxer. A person at level 1 would not show any signs of bruxing at all. On the other hand the people in the higher end on the scale would show one or several signs. The pressure that can be generated across the teeth can range from 100 to 600psi (pounds per square inch) this is an incredible amount of force. The problems outlined below occur as a result of these forces being applied over many years – slowly – and it can be difficult to recognize the cause/effect sequence.

Symptoms of Bruxism

The most obvious bruxism symptom is the unattractive flattening of the upper front teeth. This flattening is common in older people and is very apparent when the patient smiles. Continued grinding causes severe shortening of the teeth and shortening of the patient’s face. Another bruxism symptom shows up as the patient’s face becomes shorter, the lips thin and shorten and the face looks older than the actual age of the patient.

Sleep bruxism often exerts remarkably powerful forces on teeth, gums, and joints. One estimate puts it at three times the forces generated during chewing (Castaneda, 1992, p. 46), while another puts it at ten times–powerful enough to crack a walnut.

For many people, bruxism is an unconscious habit. They may not even realize they’re doing it until someone comments that they make a horrible grinding sound while sleeping. For others, a routine dental checkup is when they discover their teeth are worn or their tooth enamel is fractured.

Treatment for Bruxism

Treatment approaches include biofeedback exercises, massed negative practice, change in sleep positioning, drug therapy, psychotherapy, hypnotherapy, occlusal orthotics, and stress reduction and coping techniques.
While the symptoms of bruxism in adults can be treated, the condition usually cannot be cured. Treatment focuses on relieving acute symptoms and limiting permanent sequelae. Treatment should be provided jointly by the patient’s family physician and dentist.

Some patients brux because of dental problems, such as abnormal alignment of the upper and lower teeth (malocclusion). These patients may require oral surgery or other dental work to correct the problems or may be fitted with a protective mouth guard.

Medications. In general, medications aren’t very effective for treatment of bruxism. In some cases, your doctor may suggest taking a muscle relaxant before bedtime. If you develop bruxism as a side effect of an antidepressant medication, your doctor may change your medication or prescribe another medication to counteract your bruxism. Botulinum toxin (Botox) injections may help some people with severe bruxism that hasn’t responded to other treatments.

Dental treatments – If bruxism is associated with dental problems like teeth misalignment, your dentist may recommend orthodontic treatment to correct misaligned teeth.