Bruxism is involuntary teeth grinding. It occurs during nocturnal sleep and in no more than 10% of adults. This ailment may be based on various reasons and combinations, so the problem is investigated within the framework of dentistry. It may be necessary to consult a gastroenterologist, neurologist, ENT, and psychotherapist.

Causes of bruxism. There are several theories for the emergence of bruxism in adults. Psychological theory attaches great importance to a person’s emotional state in terms of the development of the disease. So, the factors conducive to the development of this disease may be the following:

  • stress
  • high psycho-emotional stress
  • social and domestic disorder, disadvantage
  • frequent affective states.

People are undergoing high psycho-emotional stress, who have taken on significant responsibility, experience tension, which leads to involuntary muscle spasms during sleep. The disease is called the disease of business people. But it is essential to understand that positive-minded patients can also suffer from this disease.

According to neurogenic theory, the causes of teeth grinding in adults lie in a malfunction of the central and peripheral nervous system; this leads to neurological and movement disorders, muscle spasms. The consistency of this theory is confirmed by the fact that, along with bruxism, sleep disorders (apnea, snoring, somnambulism) often occur, as well as tremor, epilepsy, enuresis, and bedwetting. Tonic muscle tension can also be associated with damage to the trigeminal nerve.

The dental theory of teeth grinding is based on the assumption that bruxism develops due to disorders in the structure and function of the dentition. These include the following:

  • bite defects
  • incorrect position of the teeth
  • supernumerary teeth
  • crowding of teeth
  • violations of the integrity of the dentition 
  • incorrectly selected dentures and orthodontic constructions in height
  • overestimation of fillings on the bite
  • diseases of the temporomandibular joint.

Dental diseases lead to an uneven distribution of the chewing load, and therefore the chewing muscles do not work properly. Overexertion leads to night cramps.

According to the osteopathic theory, muscle contraction is an attempt by the neuromuscular system to eliminate the cranial sutures’ blockage to restore the craniosacral rhythm; this can be the result of birth trauma, malocclusion and posture defects, diseases of the cervical spine, etc.

Other theories about the origin of bruxism are not widely accepted. Still, some researchers associate this problem with impaired nasal breathing, gastroesophageal reflux disease (GERD), parasitosis, frequent chewing of plates or pads, and other factors.

Diagnosis and treatment

Diagnosis and treatment of bruxism

An episode of night teeth grinding lasts about 10 seconds. The number of episodes can vary; they can occur every night or from time to time. Grinding or clicking teeth is a characteristic symptom, but the patient rarely notices such a feature because sleep is not interrupted. Usually, the patient learns about the problem from the lips of relatives and people living with them.

The accompanying symptoms of bruxism are as follows:

  • pain in the jaw, teeth
  • headaches
  • pain in the muscles of the face
  • dizziness
  • drowsiness.

Methods for diagnosing bruxism. Diagnosis of bruxism involves the study of patient complaints and the assessment of indirect signs based on the results of a routine visual examination. The leading method of objective diagnostics is Brux Checker special aligners, which are made based on a plaster cast of the patient’s jaw. These aligners allow you to detect occlusal obstructions. The doctor gives out brooks checkers for nightwear, after which the patient gives them to the clinic for analysis. With the help of diagnostic aligners, the specialist determines which teeth are subject to the most stress.

Electromyography and polysomnography methods allow registering the pathological activity of muscles and confirm the diagnosis of bruxism.

But to understand the reasons, as a rule, it is possible only with the help of comprehensive diagnostics. So, in the case of bruxism in adults, psychosomatics may take place, so consultation of a psychologist or psychotherapist will be required.

Complications of bruxism. If the disease is observed for a long time, pathological abrasion of the teeth’s enamel, increased enamel sensitivity, and the appearance of a wedge-shaped defect, cracks, and chips may develop. Permanent trauma to the tissues around the teeth can lead to periodontitis, loosening, and loss of teeth. The service life of fillings and orthopedic structures (prostheses) in patients with bruxism is shorter due to the high mechanical stress.

The consequence of the disease may be temporomandibular joint dysfunction, accompanied by pain in the jaw and neck and hypertrophy.

Frequent trauma to the soft tissues of the oral cavity can lead to inflammatory diseases such as gingivitis, periodontitis, and stomatitis.

Pathological closing of the jaws during sleep makes orthopedic difficult. Many methods of restoring the dentition may not be available to patients, so it is essential to pay attention to the disease to receive comprehensive assistance in case of dental diseases or tooth loss.

Bruxism treatment. Comprehensive bruxism treatment can include medication, psychotherapy, physical therapy, and dental methods. This approach is most effective.

The doctor will develop a treatment regimen based on the severity of the disorder. It is essential to identify the reasons to find adequate therapy.

In the case of the influence of psychogenic factors, the basis of treatment is cognitive-behavioral therapy: the patient’s mastering of relaxation and self-control methods, psychotherapeutic training, art therapy, etc.

Drug therapy is aimed at reducing the seizure activity of the muscles. The main groups of funds include:

  • magnesium and calcium preparations
  • B vitamins
  • mild sedatives
  • hypnotics, etc.

Bruxism treatment with botulinum toxin is also referred to as a drug method. Botulinum toxin injections block nerve impulses entering the muscles, which relieves the muscles of involuntary spasms. The effect of botulinum toxin preparations is inconsistent; after several months, the injections are repeated. It is crucial to understand that this is a way to deal with the symptom. Injections do not help to eliminate the causes of the disease.

In some cases, osteopathic treatment may be recommended:

  • manual therapy
  • massage
  • warming up muscles with compresses.

The dental approach involves the participation of different specialists: periodontist, dentist-therapist, orthopedist, orthodontist. In the absence of pathologies on the dentoalveolar system, protective rubber or plastic mouthguards are made, which makes it possible to prevent the consequences of bruxism in adults. According to the indications, the following activities can be carried out:

  • selective grinding of teeth
  • bite correction by wearing mouth guards, braces
  • restoration of the integrity of the dentition: prosthetics and implantation.

Correction of bite defects is possible only after the patient’s condition has improved. The installation of fillings and veneers, dental splinting can be postponed due to the high risk of damage to structures.

FAQ
  • How can bruxism be treated?

    For this, sedatives and hypnotics, magnesium, B vitamins, and others are prescribed. You may also need manual methods – massage and compresses. Often for treatment, special night guards are made for the patient to avoid damage to the teeth and enamel during sleep.
  • What causes bruxism?

    From the point of view of psychology, bruxism can be a consequence of emotional instability, stress, overload, frequent affective states, overexertion, which cause involuntary muscle contractions and teeth grinding.
  • Which doctor should I go to for bruxism?

    To deal with the problem of teeth grinding is necessary. First of all, visit an orthopedic dentist or an orthodontist. They will assess the features of the bite, the correct installation of dentures, crowns, and fillings, and, if necessary, make adjustments.
  • How to stop grinding your teeth while you sleep?

    To stop grinding your teeth in a dream, you should eliminate all dental problems. The most effective today is the treatment of bruxism with bioplastic night guards, for which they are put on the teeth and protect them from bruxism and abrasion.