Victorian government portal for older people, with information about government and community services and programs. Type a minimum of three characters then press UP or DOWN on the keyboard to navigate the autocompleted search results. The cause of bruxism can involve biological e. Your dentist or other oral health professional can assess the influence of these factors. Teeth grinding is also common in children. However, because their teeth and jaws change and grow so quickly it is not usually a damaging habit that requires treatment and most outgrow it by their teenage years.
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Parafunctional activities associated with the stomatognathic system include lip and cheek chewing, nail biting, and teeth clenching. Bruxism can be classified as awake or sleep bruxism. Patients with sleep bruxism are more likely to experience jaw pain and limitation of movement, than people who do not experience sleep bruxism.
Faulty occlusion is one of the most common causes of bruxism that further leads to temporomandibular joint pain. Bruxism has been described in various ways by different authors. This article gives a review of the literature on bruxism since its first description. Activities of the masticatory system can be divided into two types: Functional, which includes chewing, speaking, and parafunctional, which includes clenching or grinding of the teeth referred to as bruxism.
Parafunctional activity is also known as muscle hyperactivity. The functional activities are very controlled muscle activities, which allow the masticatory system to perform necessary functions with minimum damage to the structures of this system. However, some interfering tooth contacts have inhibitory effects on functional muscle activity. Therefore, functional activities are considered to be directly influenced by the occlusion. Occlusion affects the function of jaw muscles, which in turn affects the way the temporomandibular joint TMJ functions.
Parafunctional activities like bruxism apparently are controlled by entirely different mechanisms. The etiology of bruxism is not completely clear.
Other distinguishable etiologic factors of bruxism are: Psychosocial factors such as stress and certain personality characteristics, central factors and special neurotransmitters, patho-physiological factors i. One thing seems certain: There is no single factor that is responsible for bruxism.
It is also rather evident that there is no single treatment that is effective for eliminating or even reducing bruxism. An oral habit consisting of involuntary rhythmic or spasmodic nonfunctional gnashing, grinding or clenching of teeth, in non-chewing movements of the mandible, that can lead to occlusal trauma.
Clenching of the teeth is forceful closure of the opposing dentition in a static relationship of the mandible to the maxilla in either maximum intercuspation or an eccentric position. Grinding of the dentition is forceful closure of the opposing dentition in a dynamic maxillomandibular relationship as the mandibular arch moves through various excursive positions.
The sleep and awake bruxism have to be considered as separate entities, probably with different etiologies, and with different presumed risk factors. Miller suggested a differentiation between nocturnal grinding of the teeth that he called bruxism and habitual grinding of the teeth in the daytime, which he called bruxomania. He claimed that the functional cusps of maxillary and mandibular teeth of bruxists wear faster on the balancing side than on the working side, because of the planar nature of tooth contact on the balancing side point type of contact on working side.
He said that it affected large percentage of the population and all age groups. The etiology may be of local, systemic, psychological, or occupational in nature. However, the major etiological factor is psychological. Bruxism includes all abnormal grinding and clenching habits chewing gum, pencil biting, clenching foreign objects. Bruxing in some patients may be considered as an attempt to cope with frustration and tension.
It has been suggested that deflection points are a stimulus to these oral habits. Certainly the high point on an inlay will elicit a persistent semi-voluntary grinding or clenching. They are anterior to centric occlusion and are familiarly known as the lateral and protrusive movements. It is within this group that patients rub the teeth together under pressure when they are under stress or are emotionally disturbed.
All rubbing, excursion movements to and from centric occlusion should be free from premature contacts. He suggested the use of these for a chronic bruxing patient who has natural dentition opposing a removable partial denture.
It was said that bruxism is difficult to identify because most of the patients are unaware of it during the early stages. Many factors contribute to the etiology of the disorder, but, none could be considered accurate. He suggested the use of occlusal splints for the treatment of nocturnal bruxism. He studied the use of hard and soft occlusal splints and their effects on nighttime muscle activity.
He stated that the nocturnal muscle activity decreased in patients wearing hard splints whereas it increased in soft splint wearers. In his study, EMG-measured bruxing activity was decreased by splint therapy but the effect essentially disappeared when the treatment was removed.
He stated that stabilization appliances do not stop nocturnal parafunctional activities in bruxism patients. He stated that various neurotransmitters in the central nervous system appeared to modulate bruxism. Especially, disturbances in the central dopaminergic system had a greater influence on bruxism. Smoking, alcohol, drugs, diseases and trauma also were considered as major etiological factors. To reduce the chance of implant failure, bruxism has to be reduced or eliminated.
The occlusal design, bruxism, articulation, and the protection of the final outcome with a hard occlusal stabilization splint also have to be considered during implant placement. Although lateral pterygoids are intended to depress the mandible, a voluntary unilateral activity causes excursive movement to the contralateral side.
During chewing and swallowing, the mandible moves in a vertical direction. Most of the functional activity of mandible occurs at or near the centric occlusion position. The forces related to the functional activity are distributed to many teeth that minimize potential damage to a single tooth. Bruxism occurs in eccentric positions. Few tooth contacts occur during the activity and in this activity, the mandibular position is far from its stable position. This position of mandible causes more strain on the masticatory system, making it more susceptible to breakdown.
This causes the application of heavy forces to a few teeth. Most functional activity occurring in jaws consists of well-controlled, rhythmic contraction and relaxation of the muscles. This rhythmic activity permits adequate blood flow, which supplies oxygen to the tissues and eliminates by-products accumulated at the cellular level.
Bruxism, by contrast, results in sustained muscle contraction for long periods. This type of activity reduces oxygenation within the muscle tissues as there is reduced blood flow. As a result, the levels of carbon dioxide and cellular waste by-products increase within the muscle tissue creating the symptoms of fatigue, pain, and spasms.
Neuromuscular reflexes are present during functional activities, protecting the dental structures from damage. During bruxism, however, the neuromuscular protecting mechanisms appear to be absent, or at least the reflex thresholds are raised, resulting in less influence over muscle activity. Therefore, the same tooth contacts that inhibit muscle activity during function do not inhibit Parafunctional activity. This increases the levels of parafunctional activity that can cause a breakdown of the structures involved.
After the dentures have been in use for several days, the occlusion is tested for premature contacts during the lateral and protrusive movements. This is accomplished by placing strips of gauge casting wax over the occlusal surfaces of the lower teeth and then asking the patient to rub his teeth together for several minutes. If an incisal edge or a buccal cusp appears through the wax, it indicates the location of a premature contact. This area is marked and reduced with a suitable stone.
Treatment of occlusal related disorders is often a challenge for both the dentist and the patient. As the presenting symptoms of these conditions are, usually, variable, they are difficult to diagnose. But, treatments based on behavior modification such as a habit awareness, habit reversal therapy, relaxation techniques, and biofeedback massed therapy, may eliminate awake bruxism. To reduce the deleterious effects of bruxism, various methods have been proposed.
The most common method is by use of different interocclusal appliances such as occlusal splints, night guards, etc. Bruxism is a common parafunctional habit with multifactorial etiology. It occurs during both sleep and wakefulness, but, nocturnal bruxism and diurnal bruxism should be differentiated. Bruxism, usually, has no serious effects, but it may, in some patients, have pathological consequences such as tooth wear, occlusal trauma and hypertrophy of the masticatory muscles.
Correct diagnosis is very much necessary to treat bruxism. Occlusal splint therapy is being used widely for treating the faulty occlusion in bruxism patients. Though it is not in general agreement that the splint therapy has beneficial effects, it is being used by many practitioners.
If the treatment does not seem to treat the condition, at least the adverse effects have to be controlled or minimized. Source of Support: Nil. Conflict of Interest: None. National Center for Biotechnology Information , U. J Int Oral Health. Find articles by D Sravanthi. Find articles by Abdul Habeeb Bin Mohsin. Find articles by V Anuhya.
Author information Article notes Copyright and License information Disclaimer. Correspondence: Dr. Kumar MP. Email: moc. Received May 25; Accepted Aug Int Oral Health. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. This article has been cited by other articles in PMC. Abstract Parafunctional activities associated with the stomatognathic system include lip and cheek chewing, nail biting, and teeth clenching.
Keywords: Bruxism, clenching, parafunctional activity, temporomandibular disorders. Introduction Activities of the masticatory system can be divided into two types: Functional, which includes chewing, speaking, and parafunctional, which includes clenching or grinding of the teeth referred to as bruxism.
In a distinction was made between clenching and grinding: Clenching - centric bruxism Grinding - eccentric bruxism. Clenching 8 Clenching of the teeth is forceful closure of the opposing dentition in a static relationship of the mandible to the maxilla in either maximum intercuspation or an eccentric position.
Sleep bruxism: challenges and restorative solutions
Parafunctional activities associated with the stomatognathic system include lip and cheek chewing, nail biting, and teeth clenching. Bruxism can be classified as awake or sleep bruxism. Patients with sleep bruxism are more likely to experience jaw pain and limitation of movement, than people who do not experience sleep bruxism. Faulty occlusion is one of the most common causes of bruxism that further leads to temporomandibular joint pain. Bruxism has been described in various ways by different authors. This article gives a review of the literature on bruxism since its first description. Activities of the masticatory system can be divided into two types: Functional, which includes chewing, speaking, and parafunctional, which includes clenching or grinding of the teeth referred to as bruxism.
Bruxism: A Literature Review
About Bruxism Bruxism is the medical term for the grinding Directory of Open Access Journals Sweden. Full Text Available Sleep Bruxism is a significant etiology of temporomandibular disorder TMD and causes many dental or oral problems such as tooth wear or facet. There is no study analyzing the relationship between sleep bruxism and TMD. Objective: To investigate any relationship between occlusal grinding pattern during sleep bruxism and temporomandibular disorder.
Special Offers. Bruxism is a dental condition that causes you to clench or grind your teeth, and can become a habit when awake or when asleep. The latter type is known as nocturnal bruxism or sleep bruxism. According to the National Sleep Foundation , about 8 percent of adults suffer from this form of bruxism. After a long night of clenching and grinding, you may wake up in the morning with a stiff jaw, headache or sensitive teeth. Your partner may even be able to hear you grinding your teeth in the middle of the night. If your teeth feel sensitive or look flatter or smaller than they used to, the issue may have been persisting for a while.