Health

Living with Bruxism

Bruxism is the medical term for grinding, gnashing or clenching your teeth. This condition affects both kids and adults.

Some people with bruxism unconsciously clench their teeth together during the day, often when they feel anxious or tense. Most kids who have bruxism and some adults with the condition grind or gnash their teeth during sleep, usually in the early part of the night. This is called sleep bruxism.

In most cases, bruxism is mild and may not even require treatment. However, it can be frequent and violent and can lead to jaw disorders, headaches, damaged teeth and other problems. Unfortunately, people with sleep bruxism usually aren't aware of the habit, so they aren't diagnosed with the condition until complications occur. That's why it's important to know the signs and symptoms of bruxism and to seek regular dental care.

Signs and symptoms
The signs and symptoms of bruxism may include:

• Teeth grinding or clenching, which may be loud enough to wake your sleep partner.
• Teeth that are worn down, flattened or chipped
• Worn tooth enamel, exposing the inside of your tooth
• Increased tooth sensitivity
• Jaw pain or tightness in your jaw muscles
• Earache because of violent jaw muscle contractions, not a problem with your ear
• Dull morning headache
• Chronic facial pain
• Chewed tissue on the inside of your cheek

Doctors don't completely understand the causes of bruxism. In some adults, abnormal alignment of upper and lower teeth (malocclusion) may contribute to the problem.
More often, psychological factors cause bruxism, including:

• Anxiety, stress or tension
• Suppressed anger or frustration
• Aggressive, competitive or hyperactive personality type

In some cases, bruxism isn't caused by stress or dental problems. It can be a complication of another disorder, such as Huntington's disease or Parkinson's disease. It can also be an uncommon side effect of some psychiatric medications including antidepressants.

These factors increase your risk of bruxism:

• Stress. Increased anxiety or stress can lead to teeth grinding. So can anger and frustration.
• Age. Bruxism is common in young children, but usually goes away by age 10. In adults, the condition is common between the late teen years and the 40s. It tends to decrease with older age.
• Caffeine, nicotine and other drugs. Using caffeine, tobacco, cocaine or amphetamines seems to increase the risk of bruxism.

Because bruxism often goes unnoticed, be aware of its signs and symptoms. See your doctor or dentist if you have worn teeth or pain in your jaw, face or ear.

If you notice that your child is grinding his or her teeth or has other signs or symptoms of this condition be sure to mention it at your child's next dentist appointment.

Unusual grinding sounds during sleep are symptoms of bruxism.

During regular dental exams, your dentist likely will check for physical signs of bruxism, such as unusual wear and tear on your teeth, broken dental restorations and tooth sensitivity. If you have any of these signs, your dentist will look for changes in your teeth and mouth over the next several visits to see if you need treatment. You may also be asked to return for additional exams.

If your dentist suspects that you have bruxism, he or she will try to determine its cause by asking questions about your stress level, your general dental health, your daily medications, and whether you routinely drink alcohol or caffeinated beverages, especially during the evening. If you share your bedroom, your dentist may also ask your roommate or partner about your sleep habits, especially about any unusual grinding sounds heard during the night.

In most cases, bruxism doesn't cause serious complications. But severe bruxism may lead to:

• Damage to your teeth or jaw
• Tension-type headaches
• Facial pain

Treatment
In many cases, no treatment is necessary. Many kids outgrow bruxism without special treatment, and many adults don't brux badly enough to require therapy. However, if the problem is severe, treatment options include:

• Stress management. If you grind your teeth because of stress, you may be able to prevent the problem with professional counselling or strategies that promote relaxation, such as exercise and meditation. If your child grinds his or her teeth because of tension or fear, it may help to talk about your child's fears just before bed or to help your child relax with a warm bath or a favourite book.
• Dental approaches. If you or your child has bruxism, your doctor may suggest a mouth guard or protective dental appliance (splint) to prevent damage to your teeth. Your dentist can make a custom mouth guard to fit your mouth. In severe cases when tooth wear has led to sensitivity or the inability to chew properly your dentist may need to use overlays or crowns to entirely reshape the chewing surfaces of your teeth.
• Behaviour therapy. Once you discover that you have bruxism, you may be able to change the behaviour by practicing proper mouth and jaw position. Concentrate on resting your tongue upward with your teeth apart and your lips closed. This should keep your teeth from grinding and your jaw from clenching. 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.

Self-care
These self-care steps may prevent or help treat bruxism:

• Limit alcohol, tobacco and caffeine. Cutting down on your daily intake of alcohol, tobacco and caffeine or giving up these substances entirely may help, because they seem to make bruxism worse.
• Reduce stress. Keeping your life stresses to a minimum can reduce your risk of developing bruxism. The less anxiety and tension you feel, the better chance you have of avoiding bruxism.
• Consult your partner. If you have a roommate or partner, ask him or her to be aware of any grinding or clicking sounds that you might make while sleeping. Your partner can then let you know if he or she notices any teeth-grinding sounds in the night.
• Have regular dental exams. Dental exams are the best way to screen against bruxism, especially if you live alone or don't have a partner who can observe bruxism at night. Your dentist can best spot signs of bruxism in your mouth and jaw with regular visits and examinations.

Source: mayoclinic.com

Copyright (R) thedailystar.net 2006