John Murtagh, Patient Education, Third edition, McGraw-Hill Book Company

Teeth grinding (bruxism)

What is bruxism?
Bruxism is the habit of grinding, clenching or tapping teeth,
which may occur while awake (especially in children), or
while asleep (which is much more common).
What are the symptoms and signs?
The usual problem is annoying, teeth-grinding noises
during sleep. The person may be oblivious to it but family
members can be disturbed and annoyed by it, especially if it is
loud enough to awaken them. The muscles on the side of the
face may tighten and contract. This may cause headaches and
temporomandibular joint dysfunction during the day.
What are the causes?
Bruxism is basically a habit, usually beginning at an early
age. It may also be a response to subconsciously correct a
faulty 'bite' by making contact between the upper and lower
teeth when the jaws are closed. It is aggravated, maybe even
caused, by stress and anxiety as it is noticed to be worse during
stressful periods. It is also noticed to be associated with drug
dependence, especially in heavy alcohol drinkers.
What are the risks?
The teeth are usually damaged, with wearing down of the
crowns and loosening of the teeth. The supporting gums and
bones may also be damaged.
What is the treatment?
Step 1: Acceptance
It is important for the patient to recognise and understand
the problem and then make a conscious effort to overcome the
habit.
Step 2: SimpIe tricks
Practise keeping the jaws apart as often as you think about
it.
Slowly munch an apple before retiring.
Place a hot towel against the sides of the face before retiring
to achieve relaxation of the muscles controlling the jaw.
Step 3: Stress management
Learn ways to cope better with stress. Methods include
counselling, meditation, relaxation exercises, yoga and tai chi.
Although medicines are best avoided, your doctor may
prescribe a tranquilliser or sedative, especially before you
retire for the night, for short-term treatment.
Step 4: DentaI treatment
Dentists can fashion and fit a plastic night-guard
mouthpiece to prevent tooth grinding while asleep. This
device, which is quite simple, is a removable splint that fits
snugly over the teeth of each jaw to remove incorrect biting
pressure.
Are there any speciaI restrictions?
Apart from restrictions on alcohol and other drugs of
dependence, there are no restrictions. There is no special diet
and no restrictions on general activity.
What is the outIook?
The outlook is good. With proper, persistent treatment, the
problem is usually curable in 6 to 12 months.
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