Loukas Skyllouriotis – Dentist

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4 Markou Botsari Street, 1080 Nicosia, Cyprus
+00357 2266 3535
SKY Dental @sky.dental
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GENERAL DENTISTRY

Bruxism (Teeth Grinding)

It is a parafunctional habit of the stomatognathic system, in which the teeth are clenched or ground, or both, without the person's intention, and which is difficult to notice. It occurs both during night-time sleep and during the day, at moments of subconscious activity. It often leads to functional problems of the temporomandibular joint.
The signs and symptoms vary depending on the intensity, frequency and duration of the grinding. Micro-fractures of the teeth appear, along with slight flattening of the cusps, larger fractures, more pronounced flattening of the teeth, and cervical erosions of varying extent and depth. Fractures of the tooth roots may also be observed, as well as fractures of fillings and prosthetic work of varying extent and degree. Unexplained pain in the teeth and alveolar bone, which, without a correct diagnosis, can lead to unnecessary root canal treatments or even tooth extractions. There are also effects on the muscles: headaches and muscle pain (masseter, temporalis, medial and lateral pterygoid) on palpation, sometimes accompanied by hypertrophy and a strong sensitivity response.

Problems also occur in the temporomandibular joint: pain, sounds, difficulty opening the mouth, or restricted movement. If left untreated, this can lead to damage to the disc or even the bones of the temporomandibular joint. The forces exerted during bruxism can be up to ten times greater than the forces exerted during chewing.

When tooth wear occurs at a fast rate and the pulp does not have time to defensively deposit secondary dentin, intense pulp sensitivity occurs.
There are also effects on the periodontium. Injury to the periodontal membrane may occur, along with increased mobility of the affected teeth.

CAUSES OF BRUXISM

Stress plays a significant role. Heredity, to a small extent, as well as the use of certain medications, can also affect bruxism. Local occlusal factors also play a role, especially when there are lateral interferences on the non-working side. A change in the bite after a filling or prosthetic work can also have an effect.

BRUXISM IS TREATED

mainly with the use of full-coverage occlusal splints. This allows balanced forces to be exerted on the stomatognathic system, avoiding injury to the muscles, teeth, bones, periodontium or temporomandibular joint. The splint only works when the patient wears it. It should be checked at regular intervals of around six months to confirm it is functioning well. In cases of intense, troublesome interferences on the non-working side, selective grinding helps. Relaxation exercises are also beneficial, especially for patients who clench their teeth during the day.

In general, the treatment of bruxism (splints, exercises, psychological support) is symptomatic. We do not treat the cause, but the symptoms. 

In the literature, as well as in practice, other treatment approaches can also be found, either on their own or in combination with the splint.

Bruxism is observed not only in adults but also in children. However, the use of a splint is not recommended except in particularly extreme cases.