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BRUXOMANIA - THE GNASHING OF TEETH
Bruxism, or bruxomania, is the medical term for tooth-grinding (also gnashing or clenching of teeth) that is not a normal part of chewing movements. This usually occurs during sleep or situations that make you feel tense or anxious, often without the person being aware of it (although family members may be). It can also occur when a person is awake, as a way of releasing tension. It can be mild and occasional or frequent and violent.
Bruxism most often occurs in the early part of the night and can be very disturbing for sleep partners. Some people brux so loud that they cannot duplicate the sound while awake or relaxed. Others make no sound while bruxing and will often deny having the condition even after tooth or jaw damage is discovered. Over time, chronic tooth-grinding can result in excessive wear on the teeth, loosened teeth with damage to the supporting bones in the jaw and receding gums. The teeth may be pushed out of line and the bite may need adjusting. Eventually, tooth loss can occur. Long-term tooth-grinding can cause Temporomandibular Joint (TMJ) Syndrome. this usually occurs in the muscles, joints, and discs of the jaw, and may cause pain while chewing.
MoonDragon's Health & Wellness: Temporomandibular Joint (TMJ) Syndrome
THE FUNCTION OF THE JAWS
Three muscle groups are associated with bruxism (as shown above). The temporalis and masseter muscles bring the jaws together. The lateral pterygoid muscles move the jaw from side to side. The strength of jaw clenching determines the force of tooth grinding. Grinding does not occur if the person clenches, or if the mouth is open. Slight relaxation of the clenched jaw allows grinding movements across the teeth as the jaw is moved slightly forward and slightly to the side.
The way your upper and lower teeth touch together (occlusion) can affect the health of your teeth and jaw. Research data suggests that natural enamel wears nearly 0.3 mm in ten years. In patients with bruxism or clenching, the wear rate may be 8 to 10 times greater. An estimated 30 million to 40 million Americans are affected by bruxism and 5 to 10 percent grind or clench their teeth severe enough to fracture dental restorations or cause other types of tooth damage. Severe bruxism also may cause facial pain, tension type headaches, and temporomandibular disorders, which occur in the temporomandibular joint (TMJ) located just in front of your ear and felt when opening and closing.
Some people with bruxism do not clench their teeth regularly, but might go days or weeks without a reoccurrence. A person with bruxism may also routinely bite or chew his or pencils, bite nails, or the inside of the cheek.
Bruxism is the third most common form of sleep disorder after sleep talking and snoring. Research has indicated that people who brux are more likely to snore and have sleep apnea (pauses in breathing during sleep).
BRUXISM FREQUENT SIGNS & SYMPTOMS
TOOTH & JAW DAMAGE
Severe or loud teeth grinding or clenching that occurs during sleep or while awake during times of anxiety or stress. Tips of teeth worn down, chipped, broken or flattened. Loose teeth with possible damage to the tooth sockets. Abnormal alignment of teeth, caused by abnormal tooth wear. Enamel of teeth worn off with exposing inside of tooth. Microfractures of the tooth enamel. Increased tooth sensitivity. Muscle contractions or jaw clenching. Tightness in the jaw muscles or jaw joint pain. Earache, due to violent jaw muscle contractions, but not the ear itself. Chewed tissue on the inside of the cheek in the mouth. Chronic muscular facial pain, often with tension headaches, caused by intense muscle contraction. Dull morning headache. Clicking, popping, or locking of jaw joint. Stiffness and pain in the jaw joint (temporomandibular joint or TMJ) that cause restricted opening and difficult chewing. Sometimes the jaw joint may suffer damage that is slow to heal. Women may have a higher incidence of bruxism since they are more prone to tissue alterations in the jaw joint resulting from teeth clenching and grinding.
The variation in signs and symptoms reflects the strength of clenching and grinding involved in bruxism. People who clench their teeth tightly may experience tension-related headaches but may have little or no damage to the teeth or jaw joint. Tight clenching alone puts minimal pressure on the jaw joint. Those who experience severe grinding may have damaged teeth and jaw joint problems. People with mild tooth grinding may have worn teeth surfaces but no jaw joint pain or teeth sensitivity. These individuals may not even realize that they have bruxism.
A VARIETY OF PHYSICAL & PSYCHOLOGICAL CAUSES
Bruxism can develop if the teeth are sensitive to heat and cold. Allergies and nutrient deficiencies are often the cause of tooth-grinding. Fluctuations in blood sugar levels may be involved. Stress, tension, and anxiety are often the cause of tooth-grinding. Abnormal alignment of upper and lower teeth (malocclusion). Hypoglycemia, related to low adrenal function, is often the cause of bruxism. Follow the Hypoglycemic Diet. Bruxism can sometimes occur as a complication of severe brain injury. A symptom of rare neuromuscular diseases involving the face.
Suppressed anger or frustration. Aggressive, hyperactive, or competitive personality type. It can be an uncommon side effect of some psychiatric medications including antidepressants such as sertraline (Zoloft), paroxetine (Paxil), fluoxetine (Prozac, Sarafem), and others.
In children, bruxism may be related to growth and development. Misalignment of top and bottom teeth. As a response to pain such as from an earache or teething.
Most children outgrow bruxism, but even short-term teeth grinding or clenching can cause damage to permanent teeth. Of all children who brux between the ages of 3 and 10 years, more than half stop spontaneously by age 13.
BRUXISM RISK FACTORS
RISK INCREASES WITH
Abnormally aligned top and bottom teeth. Increased stress, tension and anxiety. Hyperactive personality type. Stimulants such as tobacco and caffeine may cause your body to produce more adrenaline, which may worsen bruxism. There is little evidence that hereditary or genetic factors play a part in bruxism.
HELPFUL PREVENTIVE MEASURES
As much as possible, avoid stress. Learn stress management and relaxation techniques. Seek professional counseling if necessary. Avoid caffeinated and alcoholic beverages and substances that contain these substances. They often make the problem worse. Wear a mouth guard or bite plate to prevent tooth damage caused by bruxism.
Wear mouth guard dental appliances whenever you are most likely to brux, such as times of stress. The over-the-counter mouth guards are available, but may not fit well or can be dislodged during bruxing. A dentist can make a custom mouth guard to best fit your mouth.
TOOTH DAMAGE & PAIN REDUCTION MANAGEMENT
The goal of treatment is to prevent permanent damage to your teeth and reduce pain caused by bruxism. Treatment for bruxism varies depending on the cause.
If you have bruxism that is stress related, your health care provider or dentist may recommend professional counseling, psychotherapy, stress reduction through relaxation techniques, biofeedback, hypnotherapy, or other strategies to help you relax. Keeping your life stresses to a minimum can reduce your risk of developing bruxism. The less anxiety and tension you feel, the better chance you have of avoiding bruxism problems.
Inform your sleep partner or roommate to make them aware of any grinding or clicking noises you might make while sleeping. Your partner should inform you if they notice any sounds in the night.
Practice proper mouth and jaw positioning. Learn to rest your teeth, tongue and lips properly and it may help you to change your behavior and relieve bruxism. Resting your tongue upward with teeth apart and lips closed can relieve discomfort by keeping your teeth from grinding or your jaw from clenching.
Have regular dental exams. This is the best way to screen against bruxism. Signs of bruxism can be spotted in your mouth and jaw with regular visits and examinations. This is especially important if you live alone or do not have a sleep partner who can observe bruxism at night.
Belladonna, a homeopathic remedy, is known to be an effective treatment for this condition.
CONSULTING YOUR DENTIST OR HEALTH CARE PROVIDER - BEFORE TREATMENT
Your dentist or health care provider needs to know your medical history to plan the best treatment. Fully disclose any health problems you may have had. Tell the dentist/health care provider if you have had:
- An allergy or bad reaction to antibiotics, anesthetics, or other medicines.
- Previous treatment related to bruxism or jaw surgery.
- Psychological distress or psychiatric illness.
Give the dentist/health care provider a list of ALL medicines you are taking or have recently taken. Include medicines prescribed by your family practitioner and those bought "over-the-counter" without prescription. Include nutritional supplements and herbal therapies you are using.
CONSULTING YOUR DENTIST OR HEALTH CARE PROVIDER - TREATMENT OF BRUXISM
Treatment aims to find and remove the causes of bruxism, change the behavior that causes bruxism, and repair the damage that bruxism often causes.
Finding and Removing the Causes of Bruxism: Your dentist/health care provider will look for local problems likely to lead to abnormal contact among upper and lower teeth. Your bite may need to be improved. If pain is a symptom, your dentist/health care provider will look for related causes, such as an ear infection or a temporomandibular disorder. Your dentist/health care provider may prescribe:
- Painkillers for muscular facial pain, headaches and jaw joint pain.
- Muscle relaxant medication to help relax the jaw muscles.
If your dentist/health care provider suspects that you have general health problems, he or she may recommend an examination by another medical practitioner. Your dentist/health care provider may recommend counseling, stress management or relaxation methods for stress-related causes of bruxism.
Changing Bruxism Behavior: Therapy aims to achieve changes in behavior by teaching the patient how to rest the mouth.
- An occlusal splint (also called a night guard) is an option for someone with mild to severe grinding behavior. Worn at night, the splint is made from molded plastic that fits over the upper or lower teeth. It prevents further wear of the tooth surfaces.
- Biofeedback is a treatment option for people who primarily clench their teeth during the day. Biofeedback techniques use electronic monitors to measure tension in the jaw muscles. People use the monitors to learn how to relax their muscles and reduce tension. Newer biofeedback techniques are under development to treat night-time clenching.
- Patients with severe tooth grinding problems often use a combination of splint and biofeedback techniques.
- Some patients may require muscle relaxant tablets at night.
Repairing Damage to Teeth: Treatment may be necessary to repair damaged teeth. Dental fillings, crowns or inlays can replace damaged tooth surfaces. Root canal treatment may be required where tooth fractures extend into the pulp. In extreme cases, extraction of badly damaged teeth may be the only option. Partial dentures, dental bridges or implants can replace missing teeth. Orthodontic treatment can realign misplaced and crooked teeth.
MEDICATIONS & PROCEDURES
A muscle relaxant may be prescribed by your health care provider. This may temporarily help ease the spasm in your clenched jaw.
If a muscle relaxant does not help, your health care provider may inject botulinum toxin (Botox) directly into your jaw muscles to temporarily interfere with muscle contractions associated with bruxism. Studies have shown that the injections of Botox may effectively stop bruxism in 94 percent of those affected for periods ranging from 6 weeks to more than a year. Always ask your health care provider about side effects and contraindications of any medication before taking it.
Consider having a hair analysis done to determine if you have any mineral imbalances, such as abnormal levels of sodium or potassium.
If bruxism is related to dental problems, your dentist may treat it with orthodontic adjustment to your bite pattern to correct any misaligned teeth. In severe cases, you may need to use overlays or crowns to entirely reshape the chewing surfaces of your teeth.
A mouth splint, mouth guard, or protective dental appliance may be helpful if bruxism is severe enough to cause extensive damage to your teeth.
Bruxism related to brain injury or neuromuscular illness may have to be treated with injections of Botox if more conservative treatments, such as mouth guard, fails.
If bruxism develops as a side effect of antidepressant mediation, you health care provider may change your medication or prescribe another to counteract your bruxism. The drug gabapentin (Neurontin) may successfully treat bruxism caused by antidepressant therapy.
You should have regular dental exams and have your dentist check for physical signs of bruxism if you suspect you have this problem, or if your roommate or partner complains of you making grinding noise while you are sleeping. The condition may be observed over several visits to be sure of the problem before therapy is started. If bruxism is confirmed, your dentist may ask about your current life stresses, your general dental health, and any medications you might be taking daily. Alcohol and caffeine consumption may be discussed, especially in the evening before bedtime. If you share your bedroom, your roommate or partner may be asked about your sleeping habits and whether or not they have heard unusual grinding sounds during the night.
During the exam, you will have a physical examination of your mouth and jaw. Tenderness of jaw muscles and dental abnormalities, such as broken or missing teeth and poor tooth alignment may be noted. In addition to checking your bite, x-rays may be taken of your mouth and jaw as well as your teeth, the underlying bone, and the inside of your cheeks for damage caused by bruxism. A dental exam may detect other disorders that can cause similar pain in the jaw or ear, such as an ear infection (otitis media), temporomandibular disorder of the jaw joint, and other dental disorders. If you have a suspected ear infection, you may need to see your health care provider for further examination and treatment.
ACTIVITY RECOMMENDATIONS & RESTRICTIONS
As much as possible, avoid stress. Learn relaxation techniques. If you can work of stress through exercise and physical activity, such as working out at the gym, taking a martial arts class, brisk walking in the park, and so on, this is a good way to let off steam. If you have been physically inactive for an extended period of time, check with your health care provider before beginning any exercise routine.
EXPECTED OUTCOME - THE PROGNOSIS
Management of stress and relief with treatment.
Damage to teeth or jaw. Development of and/or worsening of existing TMJ dysfunction. Worsening of existing dental disorders. Disturbing roommate or sleep partner.
DIET & NUTRITION RECOMMENDATIONS
REVIEW YOUR DIET
Adopt a Hypoglycemic Diet that is high in Fiber and Protein and includes plenty of resh vegetables and high-fiber fruits, plus legumes, raw nuts and seeds, skinless white meats, such as turkey, chicken, broiled fish. Whole grains are recommended. Consume starchy vegetables and very sweet fruits in moderation only. Eat six or eight small meals spread evenly throughout the day rather than 2 or 3 large meals. Hypoglycemia, related to Low Adrenal Function, is often the cause of bruxism.
Do not consume alcoholic beverages or products containing caffeine. Alcohol and caffeine make bruxism worse, especially consumed in the evening before bedtime.
Avoid fast foods, fried foods, processed foods, red meat, refined sugar, saturated fats, and all dairy products except yogurt, kefir, and raw cheese. Also avoid all foods with artificial flavors, colors, preservatives, and other chemicals.
Do not eat anything sweet within 6 hours of going to bed. If you are hungry, have a light protein-and-fiber snack.
Take supplemental Calcium and Pantothenic Acid (Vitamin B-5) as directed under Nutritional Supplements. Calcium is often effective for treating involuntary movement of muscles.
Unless otherwise specified, the following recommended doses are for adults over the age of 18. For children between the ages of 12 and 17, reduce the dose to 3/4 the recommended amount. For children between the ages of 6 and 12 years old, reduce the dose to 1/2 the recommended amount. For children under 6 years old, use 1/4 the recommended amount.
NUTRIENTS Supplement Suggested Dosage Comments Very Important Calcium 1,500 to 2,0000 mg daily. Deficiencies have been linked to tooth grinding. Necessary for health. Use in chelate form, if available. Magnesium 750 to 1,000 mg daily. Needed to balance with Calcium. Necessary for health. Use asporotate form, if available. Pantothenic Acid
500 mg twice daily. Reduces stress. Vitamin B-Complex 100 mg of each major B Vitamin twice daily (amounts of individual vitamins in a complex will vary). Necessary for proper nerve function. Use a high-stress formula. Very Important Vitamin C
3,000 to 5,000 mg daily, in divided dosages. Potentiates adrenal function, acts as an anti-stress vitamin. Helpful Chromium 200 to 400 mcg daily. Helps to normalize blood sugar levels. Hypoglycemia is often linked to this disorder. Use chromium picolinate form. L-Tyrosine As directed on label. An amino acid that reduces stress. Melatonin As directed on label. Aids restful sleep and may reduce tooth-grinding. Not recommended for anyone under 30, or for long-term use. Multivitamin
As directed on label. All nutrients are needed to reduce stress. Raw Adrenal Glandular As directed on label. To support adrenal function. SAM-e
As directed on label. Reduces stres and acts as an antidepressant. Caution: Do not use if you have manic-depressive disorder or take prescription antidepressants. Zinc 50 mg daily. Do not exceed a total of 100 mg daily from all supplements. Helps to support the immune system and reduce stress.
NOTIFY YOUR DENTIST OR HEALTH CARE PROVIDER
Because bruxism is often unnoticed, be aware of its signs and symptoms. If you have pain in the jaw, face, or ear, if your teeth appear misaligned or if you have difficulty biting or chewing, notify your health care provider or dentist.
Your bed partner complains that you make a grinding noise while you are sleeping.
BRUXISM SUPPLEMENTS & PRODUCTS
Information, products and supplements to help with bruxism, also known as tooth-grinding.
BRUXISM SUPPLEMENT PRODUCTS
QUALITY SUPPLIES & PRODUCTS
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BRUXISM RELIEF & MANAGEMENT PRODUCTS
Amazon: Bruxism Health Care Products
Nutrition Basics: Skin Care Supplement Information
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