Health Information

Summary/Definition

Bruxism is the involuntary grinding or clenching of teeth during sleep. It is thought to be one of the main causes of temporomandibular joint dysfunction and a variety of jaw and facial pain. Along with other bad habits such as nail biting or tongue protrusion, bruxism can be the cause of many problems, including abnormal tooth wear, periodontal disease, damage to the chewing muscles and the onset of headaches.

The exact causes of bruxism are still unknown, and many factors influence its development. The most common causes include social and psychological factors such as emotional stress, anxiety, depression and individual personality traits. In addition, physiological factors such as sleep disorders, central nervous system and brain disorders, trauma and certain diseases can contribute to the development of bruxism. Alcohol consumption, smoking, the use of certain medications and genetic factors can also influence the onset of this disorder.

Symptoms

Bruxism does not always manifest itself in the same way. Even in the same person, the frequency, duration and intensity of bruxism can vary depending on the time of day and the environment. Therefore, a general definition of the frequency of bruxism has its limitations. Although bruxism may not be uncomfortable for the individual, there are a number of cases where spouses, family members or friends complain that they cannot sleep because of the grinding and creaking. Prolonged bruxism can lead to enamel erosion, tooth damage, periodontal disease and jaw pain. The characteristic symptoms of bruxism are pain and sensitivity, especially to cold, caused by abrasion of the occlusal surfaces of the teeth and inflammation of the pulp (pulpitis). One of the possible consequences of this disorder is temporomandibular joint dysfunction, accompanied by jaw and neck pain and hypertrophy of the masticatory muscles. Bruxism can also cause headaches and lead to temporomandibular joint problems.

Diagnostics

Bruxism is usually diagnosed based on statements from a spouse, family member, or the patient’s own reports. However, there are situations where neither the patient nor the family is aware of the disorder. In such cases, the dentist can identify bruxism by looking for associated signs and symptoms, such as abnormal positioning of teeth that appear to be intertwined and other features.

Electromyography and polysomnography can be used to record abnormal chewing muscle activity and confirm the diagnosis of bruxism. However, these methods are expensive and are mainly used for research purposes. The most practical way is to collect a variety of information and then analyze and evaluate the available data.

Treatment and course of the disease

There is currently no radical treatment for bruxism. The focus is on prevention and management of the signs and symptoms associated with the condition. Methods to control and treat bruxism include

• Pharmacotherapy: the use of benzodiazepines and sedatives to normalize muscle contractile activity.
• Dental approach: involves correction of fillings, dentures and other dental aspects.
• Cognitive behavioral therapy: the patient learns relaxation and self-regulation techniques and controls risk factors.
• Physiotherapy: specialized treatments and exercises to improve the condition.
• Psychotherapy: helps the patient understand which aspects of their behavior and emotions may be exacerbating bruxism.
• Regular training and exercises: Aimed at reducing muscle tension and strengthening the jaw.
• Other methods: depending on individual characteristics and clinical presentation.

It is important to note that medications prescribed for bruxism are recommended to be used for a limited time to relieve symptoms such as headaches or toothaches caused by bruxism, but not to treat the bruxism itself.

Non-pharmacological treatments include:

• Avoidance of stimulants: smoking, alcohol, caffeine, etc.
• Use of special devices, e.g., mouth guards, trainers, splints.
• Behavioral modification to change bad habits.
• Specific exercises as an independent treatment.
• Psychotherapy to help the patient understand and change their behavior and thinking.

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