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BRUXISM

Unconscious clench of teeth together during day and/or night


Bruxism is usually a subconscious behavior characterized by the excessive grinding of the teeth and/or clenching of the jaw.
It is a habit that affects around 8-15% of the population and occurs in both children and adults.

Occasional teeth grinding, may not require treatment and medically does not usually provoke injury, but when it becomes frequent and on a regular basis it can lead to jaw disorders, headaches, damaged teeth and other problems.

TYPES OF BRUXISM

Awake bruxism
Occurs during wakefulness in 22.1–31% of population and is more common in females. It is characterized by involuntary clenching of the teeth and jaw bracing and is associated to psychiatric condition such as Parkinson's disease, depression, excessive stress and major anxiety. There is generally no tooth grinding with awake bruxism.

Sleep bruxism
Considered a sleep-related movement disorder which is prevalent in 9.7–15.9% of population.
It is characterized by automatic teeth grinding with rhythmic and repeated jaw muscle contractions.
Sleep bruxism occurs as a response to arousals during sleep, it might be the consequence of sleep disorder such as snoring and pauses in breathing (sleep apnea).

CAUSES

Psychological causes
• 70% is caused by emotions, such as anxiety, stress, anger or tension
• Aggressive, competitive or hyperactive personality type.
• Uncommon side effect of some psychiatric medications, such as phenothiazines or certain antidepressants.
• Complication resulting from Huntington's or Parkinson's disease.
Awake bruxism is thought to be usually semi voluntary and associated with stress caused by family responsibilities or work pressures.

Physical causes
• Abnormal alignment of upper and lower teeth (malocclusion).
• Sleep problems, such as sleep apnea.
• Response to pain from an earache or teething (in children).
• Stomach acid reflux into the esophagus.
• Excessive use of alcohol, tobacco and caffeine.
Sleep bruxism is to sleep arousal and neurotransmitter abnormalities.

SYMPTOMS OF BRUXISM

• Severe headache originating in the temples
• Confusing earache
• Tired or tight jaw muscles
• Muscle tenderness, especially in the morning
• Facial myalgia (muscle pain)
• Tightness and stiffness of the shoulders
• Teeth grinding or clenching, loud enough to be heard
• Flattened, fractured, chipped or loose teeth
• Increased tooth sensitivity
• Cheek’s damage
• Tongue’s indentation

TREATMENT

Dental approaches
These methods may prevent the teeth, but may not stop the bruxism:
• Splints and mouth guards
• Dental correction

Medications
In general, medications aren't very effective
• Muscle relaxants
• (Botox) injections

Therapies
• Stress management.
• Behavior therapy. Practicing proper mouth and jaw position
• Biofeedback. Monitoring procedures and equipment teaching how to control jaw’s muscle activity

PREVENTING BRUXISM
The following self-care steps may help relieve pain
• Apply ice or wet heat to sore jaw muscles. Either option can help.
• Avoid eating hard foods like nuts, candies, and steak.
• Avoid stimulating or caffeinated substances in the evening
• Avoid or cut back alcohol and smoking during the evening.
• Avoid chewing gum.
• Drink plenty of water every day.
• Get plenty of sleep.
• Learn physical therapy stretching exercises to help restore the action of the muscles and joints on each side of the head.
• Massage the muscles of the neck, shoulders, and face.
• Relax your face and jaw muscles throughout the day. The goal is to make facial relaxation a habit.
• Reduce daily stress and learn relaxation techniques.