BRUXISM is defined as:

to grind the teeth, a clenching of the teeth, associated with forceful jaw movements, resulting in rubbing, gritting, or grinding together of the teeth, usually during sleep.

This is a very difficult question to answer. Some researchers say that if the  bite (occlusion) is not correct, that this will cause them to brux. Others say that it is a central nervous system disorder. In reality it is probably a  multifaceted problem.

EVERYONE bruxes sometime. The question is NOT whether a person "bruxes", but  to what degree they brux. We look for signs and syptoms and try to determine the severity of damage that is present.

Possible signs, complications or damage that may occur due to bruxing are:

1. Wearing of teeth.

Wear occurs from the movement of the teeth harshly against one another. Although all teeth may show this type wear, it is especially noticeable when a person has front teeth that appear having the same length - as if they were filed down.

2. Breaking of teeth.

As teeth wear, the edges of front teeth and the cusps or corners of back teeth will begin to show microfractures or cracks. These cracks can not be seen on x-rays. It takes magnified vision and/or an intraoral magnified image to diagnose them. Where this becomes especially important, is that teeth with these type of fractures will either eventually chip, break a corner, or yet require root canal therapy. The reason for root canal therapy is that the fracture begins on the surface of the tooth and eventually deepens until the crack enters the area of the nerve.

3. Sensitive teeth.

Usually a generalized soreness and/or a cold sensitivity..

4. Teeth with gum line “notches”.

These are referred to as abrasion areas. Despite the fact that most people have been told that these are a result of hard bristle toothbrushes - the fact is that when teeth grind hard against each other, they flex at the gum line and the enamel (which ends thinly at the gum line) microfractures away. The end result is an area at the gum line that you can catch your fingernail in and may get extremely sensitive to touch and/or cold.

5. Loose teeth.

Teeth loosen because of the "rocking" back forth that occurs. The best analogy is the example of getting a fence post out of the ground by rocking it back and forth.

6. Periodontal (Gum) pockets-loss of supporting bone around the teeth.

Sometimes instead of the tooth getting loose, there may be small areas of bone that are slowly lost.

7. Sore muscles-especially in the cheek, base of the skull, and temple area.

When the Massiter and Temporal muscles are overused, they may get sore and ache,  just like excessive exercise will cause other muscles get sore.


8. Headaches-especially upon waking.

Instead of soreness, the muscle aches will take the form of a headache.

9. TMJ problems-pain and problems in the jaw joint itself.

The TM Joint may be over loaded causing problems to occur in the joint itself.

Not everyone show every problem,  we are all very different. Some of us will exhibit none of these problems, others will exhibit severe problems. Instead of losing bone support - some people actually form "extra" bone to support the teeth which appears as bony ridges that can be seen and felt on the jaw bones as a smooth raised area about at the level of the roots. Problems can occur in any combination, or NO problems may exist for any one person.

What should anyone do about bruxism?
Is there a cure?

This is a very difficult thing to answer since every individual is different. Many people brux because their bite is not correct, this triggers through a series of physiological signals, a dramatic increase in the amount of bruxing.

STRESS is a huge factor when it comes to bruxing,  the mouth can show stress before any other area of the body. The more stress, the more bruxing and the harder the bruxing. The tendency to brux or grind may vary according to the amount of stress in a persons life at a particular time. Physical stress such as being sick may also lower the bodies ability to accomodate to the actual stress of bruxing.

SPLINT (NIGHTGUARD)

A plastic splint  is an appliance that when placed over the upper or lower teeth - provides an "ideal" correct bite and will shut down the signals that cause bruxing. This will cause bruxing to decrease or stop in most people. It is important to understand  that a slint is NOT a cure, but a way to greatly decrease damage caused by bruxing. In those individuals where a splint is helpful other ways of altering the bite relation can be investigated such as orthodonics or a type of bite adjustment called Equilibration, the treatment for each case must be individualized.