Bruxism or grinding
Bruxism is now viewed as an umbrella term for different jaw muscle activities, both during sleep and during wakefulness.
Evidence shows that the central nervous system is related to sleep bruxism and psychological aspects are involved with awake bruxism. Medications and addictive substances are among external risk factors that can either aggravate or reduce the presence of bruxism. Previously, interferences from uneven tooth contact (occlusal problems) was considered the main causative factors for bruxism.
The prevalence of tooth grinding and/or clenching in children and adolescents with neurodevelopmental disorder and other developmental anomalies are Attention-deficit hyperactivity disorder: 57.6%, Autism spectrum disorder: 50%, cerebral palsy: 67%, Down syndrome: 68%.
Awake bruxism (AB) is described as a jaw muscle activity during wakefulness that is characterised by repetitive or sustained tooth contact and/ or by bracing or thrusting of the mandible. The reported prevalence rates range from 22% to 30%.
Sleep bruxism SB is defined as a jaw muscle activity during sleep that is characterized as rhythmic (phasic) or non-rhythmic (tonic), and is not a movement disorder or a sleep disorder. Sleep bruxism is higher in children (14-46%), adults (8%) and the elderly 3%.
Awake bruxism (AB) is described as a jaw muscle activity during wakefulness that is characterised by repetitive or sustained tooth contact and/ or by bracing or thrusting of the mandible. The reported prevalence rates range from 22% to 30%.
Sleep bruxism SB is defined as a jaw muscle activity during sleep that is characterized as rhythmic (phasic) or non-rhythmic (tonic), and is not a movement disorder or a sleep disorder. Sleep bruxism is higher in children (14-46%), adults (8%) and the elderly 3%.
Consequences of bruxism
Grinding (bruxism) can occur both during sleep and during wakefulness.
Awake bruxism (AB) is described as a jaw muscle activity during wakefulness that is characterised by repetitive or sustained tooth contact and/ or by bracing or thrusting of the mandible. The reported prevalence rates range from 22% to 30%.
Sleep bruxism SB is defined as a jaw muscle activity during sleep that is characterised as rhythmic (phasic) or non-rhythmic (tonic), and is not a movement disorder or a sleep disorder.
Intrinsic mechanical tooth wear (i.e., attrition-related) is unlikely to be related to AB, as teeth grinding rarely occurs during wakefulness
The Joints
TMJ noises suggestive of disc displacement or joint degeneration)
The presence of pain (e.g., jaw-muscle pain, TMJ pain, and headache)
Functional symptoms (e.g., difficulty opening the mouth wide).
Evidence inside the mouth includes
Tooth wear, tooth enamel chipping, cracks and fractures of natural teeth
Restoration failures,
Tooth mobility, and periodontal ligament widening on radiographic imaging
Inspection of the mucosa of the cheek, lip, and tongue (e.g., linea alba, tongue scalloping, and traumatic lesions),
the presence of intraoral pain (e.g., teeth soreness and/or hypersensitivity)
Patients with awake bruxism are more likely to experience jaw pain and/or limitations of movement than patients with sleep bruxism. Anxiety appears to be the most consistent psychological factor involved in awake bruxism.
Awake bruxism might play a positive role in stress coping, which would be compatible with the hypothesis of mastication as a means of relieving psychological tension.
Previously interferences from uneven tooth contact were considered as causative factors for bruxism but the current view is that psychosocial factors are considered to be the most important factor in bruxism.
Psychosocial factors include anxiety, sensitivity to stress, depression, and some personality characteristics that have been clearly demonstrated for awake bruxism, whereas evidence linking psychosocial factors and sleep bruxism is less clear.
Grinding (occlusal) splint
If your grinding or clenching occurs during the day, try to become conscious of it and post reminders around your workplace/station reminding you to stop.
It’s a form of Biofeedback which is a mind–body technique in which individuals learn how to modify their behaviours. Occlusal grinding splints can also be worn during the day if you grind your teeth while working or studying as long as you are not speaking or interacting with others.
Biofeedback would not work if you’re grinding at night.
For night time treatment an occlusal splint should be used. A grinding splint protects your teeth from further wear, chipping and cracking by covering one arch with acrylic material so the opposing teeth don’t touch each other. They contact the acrylic on the splint. It also opens your bite up to remove some pressure from your jaw joints and muscles. It evens out your bite as the splint is made so there is even contact on both sides thus taking the pressure off your teeth which might improve some forms of toothache or pain on chewing.
Muscle relaxants injections
People who suffer from bruxism often report daily headaches, TMJ pain, ear and facial pain, worn down teeth and dental problems. They suffer from daily pain and discomfort which has previously only been treated with special splints and physiotherapy.
In addition, the overuse of the masseter muscles from chronic grinding results in hypertrophy of the muscles (enlargement of the muscle) which causes an enlarged, square shape to the lower face.
Masseter reduction with muscle relaxants is a non-invasive procedure that uses injections to slim the jaw and reduce teeth grinding
This relaxes the muscles, making them appear smaller and softer. Over time, the muscles will shrink, making the jaw appear slimmer and more V-shaped.
It can stop or reduce teeth grinding and clenching, which can help prevent tooth damage and long-term damage to the joint. The procedure can also help with tension type headaches.
The procedure involves cleaning the skin and injecting the muscle with a thin needle. Generally Dr Basil uses one injection on each side for the masseter muscle and four- five injections in the forehead and temporal regions to relieve tension headaches.
You can expect to see a reduction in teeth grinding and headaches within two weeks, and a slimmer face within four weeks. The results can last up to five months or more if done regularly.
Muscle relaxant injections - can treat:
Resulting in muscle spasms, pain & limited opening
Tension type headaches around the joint
2. Bruxism (clenching/grinding teeth)
Can occur in the day and night time and is caused by the over activation of the masseter muscle resulting in further pain in the TMJ, extensive wearing of teeth causing sensitivity, reduced chewing ability and a change in your facial appearance.
