Bruxism, or more commonly know as "grinding of the teeth," is on the rise. Although I have always seen the effects of this in my practice, it appears that the economic woes of our globe have started to impact individuals that up until now, didn't understand living paycheck to paycheck, or selling assets to feed your family and pay your mortgage. Bruxism can affect most people at some point in their lives. In most people, bruxism is mild and goes completely unnoticed by the individual and their dentist. While bruxism may be a daytime or sleep-time habit; it is bruxism during sleep which causes the majority of health issues and dental deterioration
The most common cause of bruxism is anxiety. I see a significant increase in a patients grinding habit when there is stress and turmoil in their personal and professional lives. Take a look at the news broadcast on any television channel and you'll find plenty of topics to fuel your anxiety! Most bruxers are not aware of their bruxism and only small percentages develop symptoms, such as jaw pain and headache, which will require treatment. In many cases, a sleeping partner or parent will notice the bruxism before the person experiencing the problem becomes aware of it. Many times, the simple recognition that one is grinding in their sleep its enough to subconsciously curtail the habit.
Patients may present with a variety of symptoms, including:
Morning migraines, morning headaches, jaw pain, TMJ pain, facial muscle and nerve pain, earache, sinus pain, tinnitus (ringing in the ear), vertigo, neck pain, shoulder pain, back pain, poor sleep patterns, depression, and/or insomnia
Eventually, bruxing shortens and blunts the teeth being ground, and may lead to myofacial muscle pain, temporomandibular joint dysfunction and headaches. In severe, chronic cases, it can lead to arthritis of the temporomandibular joints. The jaw clenching that often accompanies bruxism can be an unconscious neuromuscular daytime activity, which should be treated as well, usually through physical therapy.
Bruxism can sometimes be difficult to diagnose by visual evidence alone, as it is not the only cause of tooth wear. Over-vigorous brushing, abrasives in toothpaste, acidic soft drinks and abrasive foods can also be contributing factors, although each causes characteristic wear patterns that a trained professional can identify. Additionally, the presenting symptoms may be difficult for a dentist to attribute to bruxism.
The effects of bruxing may be quite advanced before sufferers are aware they brux. Abraded teeth are usually brought to the patient's attention during a routine dental examination. If enough enamel has been abraded, the softer dentin will be exposed and abrasion will accelerate. This opens the possibility of dental decay and tooth fracture, and in some people, gum recession.
Once bruxism has been identified and verified, the most common treatment is the fabrication of an acrylic splint that the patient will sleep with. Patients will continue to grind on the splint - but the splint will prevent any dental damage or wear and also balances the muscle forces utilized to minimize muscle fatigue. Once the bruxing habit has been controlled -- we than consider options to rebuild the affected teeth with either porcelain veneers, crowns or a combination of both.