An axe to grind on bruxism – Ten Dental

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  Posted by: The Probe      3rd July 2018

The vast majority of us will have unconsciously ground our teeth at least once in our lifetime and in most cases, we do it in our sleep. Scientifically referred to as bruxism, the action of grinding teeth together and clenching the jaw is a habit that can affect anyone of any age, but is most common in people between the ages of 25 and 44.[i]As practitioners are aware, occasional tooth grinding during the day or night is unlikely to cause harm, but persistent bruxing can have detrimental consequences on our teeth and general health.

There are many causes of bruxism, which is prevalent in approximately 8 to 10% of the population.iVarious studies link psychological factors such as stress and anxiety with bruxism, as we tend to bite down hard when we feel under pressure.[ii]Bruxism can also be triggered by excessive smoking, as well as heavy consumption of caffeine, alcohol and illicit drugs like cocaine and ecstasy.[iii],[iv]Some people are unaware that they regularly grind their teeth while asleep – those individuals who already suffer from disorders such as snoring or sleep apnoea are more likely to brux.[v] 

While most people might complain of the odd headache after grinding their teeth or clenching their jaw, others can suffer from more serious problems. These include oral symptoms such as abnormal tooth wear, tooth fracture, inflammation and gingival recession, as well as tooth mobility and premature loss of teeth.[vi]It might be easy for some patients to ignore minor symptoms, but in the long-term, bruxism can lead to muscle aches in the face and pain in the temporomandibular joint (TMJ). This may impact the way a person speaks or eats, thereby adversely affecting their overall quality of life.

It is evident that bruxism can be a cause for concern if left untreated, but thankfully, there are ways patients can manage their tooth grinding habits. Psychotherapy with regard to habitual changes (e.g. relaxing before sleeping or avoiding caffeine) is suggested as one of the best ways to treat the behavioural aspect of bruxism.[vii]Hypnosis has also been under review as to whether it could help patients modify their routines and avoid grinding their teeth, but there is currently no conclusive scientific evidence to prove that this is effective.

As all practitioners will know, some patients simply avoid going to the dentist altogether, even if they see signs of their teeth beginning to move. Whether out of fear or because they cannot afford treatment at the time, patients might choose to overlook any dental issues caused by bruxism – until it begins to have a negative effect on their self-image or on their oral health.

What some patients might not realise is that slight misalignment can cause loss of attachment of the soft tissue, which increases the risk of developing periodontal pockets that can become infected by bacteria.[viii]This is a problem that can be immediately addressed by a GDP (General Dental Practitioner), but only if patients understand their responsibility to attend regular dental examinations and cleanings – which will provide a way for clinicians to identify any problems early. Moreover, GDPs can offer professional advice and guidance on how to manage bruxing, in order for patients to avoid any future complications with their teeth.

In addition, existing misalignment of their teeth can effect bruxism patients’ symptoms. These patients may occasionally brux during the day or in their sleep, but malocclusion could further impact their tooth grinding habits, which can cause extreme tooth wear.[ix]Malocclusion and a patient’s tendency to grind their teeth could also lead to muscle disorders in the TMJ.[x]

In these cases, referral to a specialist who will be experienced enough to deal with complex problems may be required. The patient is likely to feel more confident knowing that you truly emphasise with their need for advanced treatment, which can only enhance your reputation as an ethical and trustworthy practitioner. Plus you can be confident that your patient is receiving the best possible care, even if it is outside your personal remit. Of course, finding a referral practice you can rely on is essential. Ten Dental, for instance, won Best Referral Practice 2017 at the Private Dentistry Awards. You can rest assured knowing any patients referred to Ten Dental’s highly experienced team of specialists will be well looked after.

While there is no cure for bruxism, practitioners can help patients alleviate the effects of the condition. Patients should be made aware of the consequences that can be presented as a result of unaddressed tooth grinding, so that any treatment sought after can be provided immediately.   

 

For more information visit www.tendental.comor call on 020 33932623

 

 

[i]The Bruxism Association. (Unknown) What Is Bruxism? Link: http://www.bruxism.org.uk/what-is-bruxism.php. [Last accessed: 18.04.18].

[ii]Ahlberg, J., Lobbezoo, F., Ahlberg, K., Manfredini, D., Hublin, C., Sinisalo, J. and Savolainen, A. (2013) Self-reported bruxism mirrors anxiety and stress in adults. Medicina Oral, Patología Oral y Cirugía Bucal. 18(1):E7-E11. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3548648/. [Last accessed: 18.04.18].

[iii]Dinis-Oliveira, R.J., Caldas, I., Carvalho, F. and Magalhães, T. (2010) Bruxism after 3,4-methylenedioxymethamphetamine (ecstasy) abuse. Clinical Toxicology. 48(8):863-4. Link: https://www.researchgate.net/publication/44642447_Bruxism_after_34-methylenedioxymethamphetamine_ecstasy_abuse. [Last accessed: 18.04.18].

[iv]The Bruxism Association. (Unknown) Causes Of Bruxism. Link: http://www.bruxism.org.uk/causes-of-bruxism.php. [Last accessed: 18.04.18].

[v]Winck, M., Drummond, M., Viana, P., Pinho, J.C. and Winck, J.C. (2017) Sleep bruxism associated with obstructive sleep apnoea syndrome – A pilot study using a new portable device. 23(1):22-26. Link:https://www.sciencedirect.com/science/article/pii/S2173511516300847?via%3Dihub. [Last accessed: 18.04.18]. 

[vi]The Bruxism Association. (Unknown) Symptoms Of Bruxism. Link: http://www.bruxism.org.uk/symptoms-of-bruxism.php. [Last accessed: 18.04.18].

[vii]Mesko, M.E., Hutton, B., Skupien, J.A., Sarkis-Onofre, R., Moher, D. and Pereira-Cenci, T. (2017) Therapies for bruxism: a systematic review and network meta-analysis (protocol). Systematic Reviews. 6:4. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237268/. [Last accessed: 18.04.18].

[viii]Ajay, M., Negi, K.S., Saroj, T. and Kanwarjeet, A.S. (2016) A successfully treated case of severe periodontitis using interdisciplinary approach: Report of a case. J Indian Soc Periodontol. 20(1):95-97. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795146/. [Last accessed: 18.04.18].

[ix]Kiliaridis, S., Johansson, A., Haraldson, T., Omar, R. and Carlsson, G. E. (1995) Craniofacial morphology, occlusal traits, and bite force in persons with advanced occlusal tooth wear. American Journal of Orthodontics and Dentofacial Orthopedics. 107(3):286-292. Link: https://www.researchgate.net/profile/Ridwaan_Omar/publication/15318989_Craniofacial_morphology_occlusal_traits_and_bite_force_in_persons_with_advanced_occlusal_tooth_wear/links/5a268664a6fdcc8e866bedc6/Craniofacial-morphology-occlusal-traits-and-bite-force-in-persons-with-advanced-occlusal-tooth-wear.pdf. [Last accessed: 20.04.18].

[x]Caldas, W., Conti, A.C. de C.F., Janson, G. and Paulo César Rodrigues, C. (2016) Occlusal changes secondary to temporomandibular joint conditions: a critical review and implications for clinical practice. J Appl Oral Sci. 24(4):411-419. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990372/. [Last accessed: 18.04.18].


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