Bruxism

Bruxism is a fairly common disorder that relies on involuntary contraction of the chewing muscles. It occurs predominantly at night and can cause a variety of discomforts: tooth wear, jaw pain, headache.

What is bruxism?

People suffering from bruxism clench their teeth involuntarily. There is no specific cause for this movement of the muscles and jaw, which is in fact called parafunction.

Bruxism in many cases causes dental problems, so it must be counteracted with the use of special devices called bite guards or splints. Bruxism can sometimes be noisy enough that it is the partner who first becomes aware of the condition during sleep.

Causes

It is difficult to pinpoint the cause of bruxism. Scientific studies have indicated numerous factors that can often contribute to this disorder, such as anxiety and stress, emotional and psychological problems, sleep disturbances, misalignment of the dental arches (malocclusion) and a muscular response to a neurodegenerative disease. When children grind their teeth, it may be due to an attempt to relieve earache or toothache. Smoking, alcohol abuse, caffeine abuse and drug use can also cause this phenomenon.

Symptoms of bruxism

Although bruxism has very clear symptoms, it is actually not easy to diagnose because sufferers often do not realize it. A person who is asleep may not realize that they are grinding their teeth and this increases the risk of irreversible damage to the teeth and jaw. Often, it is people who sleep next to someone with bruxism who notice the problem, but only in cases where the grinding is loud and annoying. In some cases, the disorder is only noticed during a dental examination, as the dentist can detect tooth abrasion caused by bruxism.

Thus, the main symptoms of bruxism can be summarized in the following list:

• Intense pain in the jaw.
• Pain of the masticatory muscles.
• Increased tooth sensitivity due to loss of the enamel layer.
• Fracture or wear of one or more teeth.
• Migraine and generalized headaches.

In addition to the dentist, to accurately diagnose nocturnal bruxism it can be useful to perform a specific test such as polysomnography, which can detect all sleep disturbances. Electromyography of the masticatory muscles can also be used to make a fairly accurate diagnosis of the disease.

Treatment

Since it is multifactorial in origin, the treatment of bruxism varies in each individual and is aimed at reducing the symptomatology in patients. Each case is treated individually and, if possible, it is important that several specialists, including sleep disorder physicians, neurologists and dentists, evaluate the therapy to be adopted. And, in any case, treatment is never completely conclusive.

Normally, the first intervention performed is to safeguard the health of the teeth and the masticatory system. For this purpose, a special custom-made protective mouth splint made of transparent resin is placed which, when worn during sleep, prevents contact between the two dental arches when grinding the teeth. It is essential that the thickness of the splint is adequate to prevent damage to the jaw and posture.

If, on the other hand, bruxism is caused by a malocclusion or malformation, orthodontic treatment is usually necessary.

Since bruxism is also closely related to situations of anxiety and stress, practices such as meditation, yoga, massage or breathing exercises can be useful in trying to solve the problem. In cases where the patient's emotional sphere is also involved, it is necessary to consult a specialist such as a psychologist or psychotherapist.

In general, pharmacological treatment is not particularly effective in treating bruxism, mainly because some drugs have side effects that make their prolonged use difficult.

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Prevention of bruxism

Although bruxism sometimes occurs at an early age, certain measures can be taken to prevent the onset of the disorder or, at least, alleviate its symptoms. The main ones are:

• Anxiety management.
• Physical activity.
• Reduce the consumption of alcohol and exciting beverages.
• Sleep in a comfortable environment.
• Have regular and periodic check-ups with the dentist.

Stress is one of the main triggers, so it can be crucial to reduce the level of anxiety and learn to manage it through relaxation techniques, listening to classical music or practicing meditation. Regular light physical activity also helps to de-stress and release all the tensions accumulated during the day. Reducing the consumption of alcohol and stimulant drinks, especially in the evening hours, can promote a calmer and more peaceful sleep. For good sleep hygiene, it may be helpful to sleep in a quiet and comfortable environment, without bright lights, electronic devices or television.

Taking a warm bath before going to bed, even for children, is undoubtedly a good way to promote a peaceful sleep.

Finally, it is also useful to undergo periodic check-ups at the dentist, or a polysomnographic examination both for detection of the disorder and for possible malocclusion problems of the teeth.