BRUXISM AND ITS BRUXISM AND ITS TREATMENTTREATMENT

DEFINITION:- IT CAN BE DEFINED AS DIURNAL OR

NOCTURNAL PARAFUNCTIONAL ACTIVITY THAT INCLUDES CLENCHING, BRACING, GNASHING AND GRINDING OF THE TEETH.

ETIOLOGY:-

Psychological and emotional stresses.

e.g.:- anxiety, anger, frustration .Occlusal interference or discrepancy.Pericoronitis and periodontal pain is said to trigger bruxism in some individuals.

CLINICAL FEATURES:-

Occlusal wear facets on teeth.

Fractures of teeth and restorations.

CLINICAL FEATURES:-

Temporomandibular joint pain and discomfort.

Mobility of teeth.

Tenderness and hypertrophy of masticatory muscle.

Muscle pain when patient wakes up in the morning.

Muscle activity becomes abnormal & also interfere with TMJ functions.

Bruxism causes disruption of the relationship or alignment of the condyle , disc, and articular surface of the temporal bone which is called an intracapsular disorder or internal derangement of the TMJ.

It has been estimated that during clenching or grinding the individual might impose a load of over 20 g on a tooth over period 2.5 sec at a time.

EFFECT ON IMPLANTS:-It has been associated with increased

risk of implant failure.Repeated lateral forces applied to the

implants can be detrimental to the osseointegration process, especially during the early healing period.

It may be due to result of their clenching or grinding.

So bruxism to be a contraindication to implant treatment, especially in the case of a short span fixed partial denture or a single tooth implant.

If implants are planned for a patient with bruxism habit, protective measures should be employed,

such as ; Creating a narrow occlusal table

with flat angles, Protected occlusion and

the regular use of occlusal guards.

Diagnosis of bruxism

There may be definitive history of bruxism but in an unaware patient a number of sings help in its detection.

1. Advanced attrition 2. Increased tooth mobility patterns3. The presence of widened periodontal

spaces in radiographs4. Hypertonicity of the muscles of

mastication-Electromyographic examination

5. TMJ discomfort

COMPLICATIONSIf bruxism is not treated then in future

life ,it can lead to- jaw discords, -damage to teeth and - heavy headaches.

People get warned about their condition only after some complication arises and many times they just neglect it.

constant headache, sore jaws are two important symptoms that indicate that the person is suffering from bruxism.

Once you get doubtful about your clenching of teeth in night, you will need to take help from your dentist. The dentist will examine your mouth and jaw and will decide whether or not you suffer from bruxism

Obstructive sleep apnea is a condition which is very often complicated by additional disorders or problems. Many patients with this common sleep disorder had a problem with severe teeth grinding (bruxism)!

According to a recent scientific study in Israel obstructive sleep apnea is even the

highest risk factor for sleep bruxism!

Treatment of bruxism

1. The first step in the control of any parafunctional habit must be discussion with the patient.

2. If occlusal disharmonies are there ,then the selective grinding may help to relieve the parafunction.

Further dental treatment involves the use of night-guards to limit the excessive occlusal stress. There are basically two forms of night-guards, both of which are made in acrylic:

A. The occlusal shield which fits ovre the occlusal surface , incisal edges & lingual tooth convexity.

where attrition is sever or where there has been collapse of the posterior segments so that the freeway space is increased ,the occlusal shield can be usefull.

B. the anterior bite plate. where there is an obvious bruxism habit with

symptoms of muscle spasm & where the lower anterior teeth are well supported with bone a night guard with an anterior bite plate is extremely useful.

To relax your jaws, hold one warm cloth on your cheeks and ears.

We can advise the patient to visit their dentist even if they have just hint about their clenching of teeth.