Bruxism, like teeth grinding, is a destructive habit that left uncorrected can , over time, cause significant damage to the mouth and jaw. Possible undesirable sequelae include tooth sensitivity, tooth erosion (both of enamel and dentin), cracked tooth syndrome, gingival recession, and a gradual attrition of the edges of the anterior teeth creating a less attractive smile.
The two syndromes are not intimately related. Bruxism is more common and can occur during the day or night. It involves a patient clenching his teeth together by flexing the masseter muscles. Often lateral pressure is exerted on the inclines of the occlusal surfaces of the teeth.
Over time burxism can cause a number of destructive problems. It causes accelerated attrition of the enamel edges, as well as the development of abfractions in the cervical region of teeth involved. Patients whose occlusion is ‘cuspid guided’ are though to be somewhat protected from the worst effects of bruxism. Patients with a cuspid guided occlusion usually have only their cuspid teeth contacting when they make side to side excursions. Even these patients with initial cuspid guidance will have problems if they engage in clenching long enough Their occlusion can gradually shift as they age, to ‘group function,’ an occlusion that allows patients to clench their teeth together comfortably with greater force. Probably this causes increases in buxism as patients gets older, due to a shift from a ‘cuspid protected’ occlusion to group function.
Bruxism and possibly tooth grinding have habits that may in some way function as tension relievers. Just as some people when nervous tap their pencils, bite their nails, chew their cheeks, and bite on their lips. It seems that small repetitive actions do distract people from thinking about what is making them tense. Many of these actions can result in slight discomfort (cheek biting, lip biting, pinching oneself)
Bruxism (and tooth grinding) can cause inflammation of the masseter muscles and can cause permanent destructive changes to the temporomandibular joint.. Often patients with inflamed masseter muscles complain of a feeling of soreness in their cheeks.
Treatment for this acute soreness is two fold. Patients can and should take ibuprofen to relieve the pain and to cut down on the inflammation. Also patients suffering from this symptom should realize that their symptoms are stemming from an over use syndrome. They are over taxing their jaw muscles by too much flexing and over use of their masseter muscles.
During an acute flare up, patients should literally give their “mouth a rest”. They should consume soft foods that do not require a great deal of chewing effort, no gum chewing and consciously attempt to avoid clenching their jaws during times of stress.
It is well known that exercise is a good stress reliever and moderate exercise is good for us. Swimming or walking, or any low impact exercise will lesson a person’s tendency to diminish stress. Meditation or Yoga may help as well. I also counsel patients to try to substitute a different stress reliever, such as sucking on a sugarless candy or a lollypop; many other obnoxious habits will work such as tapping a pencil, drumming your finger on a desk, biting your lips or cheeks. Unfortunately most of these also have somewhat undesirable consequences.
Night guards should be made for and worn by people who brux their teeth. These can be worn at home at night and should be kept on while sleeping. Night guard usually has an occlusion built in that discourages bruxism (cuspid guidance). Also they are designed to open the bite by approximately 3mm which gives aching masseter muscles some relief.
