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A profile of a smile, exhibiting significant wear, especially on the maxillary incisors. Even though the teeth are in an edge-to-edge position, the teeth are in maximum intercuspation; this patient possesses a Class III occlusion.

Bruxism (from the Greek βρυγμός (brugmós), gnashing of teeth) is grinding of the teeth, typically accompanied by clenching of the jaw. It is an oral parafunctional activity that occurs to some extent in most humans.^{[citation needed]} Bruxism is caused by the activation of reflex chewing activity; it is not a learned habit. Chewing is a complex neuromuscular activity that is controlled by reflex nerve pathways, with higher control by the brain. During sleep, the reflex part is active while the higher control is inactive, resulting in bruxism. In most people, bruxism is mild enough not to be a health problem; however, some people suffer from significant bruxism that can become symptomatic. The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... Image File history File links Acap. ... Image File history File links Size of this preview: 800 × 517 pixelsFull resolution‎ (2,457 × 1,589 pixels, file size: 621 KB, MIME type: image/jpeg) I, the copyright holder of this work, hereby release it into the public domain. ... Image File history File links Size of this preview: 800 × 517 pixelsFull resolution‎ (2,457 × 1,589 pixels, file size: 621 KB, MIME type: image/jpeg) I, the copyright holder of this work, hereby release it into the public domain. ... Incisors (from Latin incidere, to cut) are the first kind of tooth in heterodont mammals. ... In dentistry, maximum intercuspation refers to the occlusal position of the mandible in which the cusps of the teeth of both arches fully interposition themselves with the cusps of the teeth of the opposing arch. ... Occlusion is the relationship between the maxillary and mandibular teeth that exists when they approach each other, as occurs during chewing or at rest. ... A para-functional habit or parafunctional habit is the habitual exercise of a body part in a way that is other than the most common use of that body part. ... Mastication or chewing is the process by which food is mashed and crushed by teeth. ...

Bruxism often occurs during sleep and can even occur during short naps. Bruxism is one of the most common sleep disorders: 30 to 40 million Americans grind their teeth during sleep.^[1]

Associated factors

The etiology of bruxism is unknown; the following factors may be associated with the condition. This article is about the medical term. ...

• Disturbed sleep pattern/Other Sleep disorders^[2][3](Obstructive sleep apnea^[4], Snoring ^[5], moderate daytime sleepiness^[2])
• Malocclusion, in which the upper and lower teeth fit together in a dysfunctional way, typically through lateral asymmetry and dysocclusion of the front teeth through premature contact of back teeth.
• Relatively high levels of consumption of caffeinated drinks and foods, such as coffee, colas, and chocolate^[2]
• High levels of alcohol consumption^[2]
• Smoking^[2]
• Consumption of MDMA and Cocaine
• High levels of anxiety and/or stress^[2]
• Digestive problems
• Hypersensitivity of the dopamine receptors in the brain
• Consumption of drugs and medications of the amphetamine-based family, such as MDMA^[6]
• Excessive use of (i.e., frequent redosing and dependancy on) GHB and similar GABA-inducing analogues such as Phenibut ^{[6][citation needed]}
• Disorders such as Huntington's and Parkinson's diseases ^[7]

This article needs cleanup. ... Snoring is the act of breathing through the open mouth in such a way as to cause a vibration of the uvula and soft palate, thus giving rise to a sound which may vary from a soft noise to a loud unpleasant sound. ... Somnolence (or drowsiness) is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods. ... Occlusion is the relationship between the maxillary and mandibular teeth that exists when they approach each other, as occurs during chewing or at rest. ... For the food preparation, see Smoking (cooking). ... ecstasy and religious ecstasy MDMA, most commonly known today by the street name ecstasy, is a synthetic entactogen of the phenethylamine family whose primary effect is to stimulate the brain to rapidly secrete large amounts of serotonin, causing a general sense of openness, empathy, energy, euphoria, and well-being. ... Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. ... Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components (Seligman, Walker & Rosenhan, 2001). ... In medical terms, stress is the disruption of homeostasis through physical or psychological stimuli. ... For other uses, see Dopamine (disambiguation). ... Amphetamine or Amfetamine(Alpha-Methyl-PHenEThylAMINE), also known as beta-phenyl-isopropylamine and benzedrine, is a prescription stimulant commonly used to treat Attention-deficit hyperactivity disorder (ADHD) in adults and children. ... ecstasy and religious ecstasy MDMA, most commonly known today by the street name ecstasy, is a synthetic entactogen of the phenethylamine family whose primary effect is to stimulate the brain to rapidly secrete large amounts of serotonin, causing a general sense of openness, empathy, energy, euphoria, and well-being. ... Gamma-Hydroxybutyric acid (4-hydroxybutanoic acid, C4H8O3), commonly abbreviated GHB, is a neuroprotective therapeutic drug that is illegal in a number of countries[1], and is a naturally-occurring substance found in the central nervous system, wine, beef, small citrus fruits, and almost all living creatures in small amounts. ... Gaba may refer to: Gabâ or gabaa (Philippines), the concept of negative karma of the Cebuano people GABA, the gamma-amino-butyric acid neurotransmitter GABA receptor, in biology, receptors with GABA as their endogenous ligand Gaba 1 to 1, an English conversational school in Japan Marianne Gaba, a US model... Phenibut (beta-phenyl- gamma-aminobutyric acid, also spelled fenibut, originally known as phenigamma) is a derivative of the neurotransmitter GABA that crosses the blood-brain barrier [1]. It was developed in Russia, and there it has been used clinically since the 1960s for a range of purposes. ... Huntingtons disease, known historically as Huntingtons chorea and chorea maior, is a rare inherited neurological disorder affecting up to approximately 1 person per 10,000 people of Western European descent and 1 per 1,000,000 of Asian and African descent. ...

Signs, symptoms and sequelae

Bruxism can result in abnormal wear patterns of the occlusal surface, abfractions and fractures in the teeth. This type of damage is categorised as a sign of occlusal trauma. There are numerous commonly used terms of relationship and comparison that refer to different aspects of teeth and are frequently utilized in articles about dentistry. ... Abfraction is the loss of tooth structure from flexural forces. ... Occlusal trauma is a dental term that refers to the damage incurred when teeth are left in traumatic occlusion without proper treatment. ...

Over time, dental damage will usually occur. Bruxism is the leading cause of occlusal trauma and a significant cause of tooth loss and gum recession.

In a typical case, the canines and incisors of the oppsoting arches are moved against each other laterally, i.e. with a side-to-side action by the lateral pterygoid muscles that lie medial to the temporomandibular joints bilaterally. This movement abrades tooth structure, and can lead to the wearing down of the incisal edges of the teeth. People with bruxism may also grind their posterior teeth, which will wear down the cusps of the occlusal surface. Bruxing can be loud enough to wake a sleeping partner. Some individuals will clench the jaw without significant lateral movements. In mammalian oral anatomy, the canine teeth, also called cuspids, dogteeth, fangs, or (in the case of those of the upper jaw) eye teeth, are relatively long, pointed teeth. ... Incisors (from Latin incidere, to cut) are the first kind of tooth in heterodont mammals. ... The lateral pterygoid is a muscle of mastication with two heads. ... There are numerous commonly used terms of relationship and comparison that refer to different aspects of teeth and are frequently utilized in articles about dentistry. ... There are numerous commonly used terms of relationship and comparison that refer to different aspects of teeth and are frequently utilized in articles about dentistry. ...

Eventually, bruxing shortens and blunts the teeth being ground, and may lead to myofacial muscle pain and headaches. In severe, chronic cases, it can lead to arthritis of the temporomandibular joints. A headache (cephalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. ... The temporomandibular joint (From the Latin for too much jaw) is a diarthrodial joint that connects the condyle of the mandible (lower jaw) to the temporal bone at the side of a skull. ...

Most bruxers are not aware of their bruxism and only 5-10% go on to develop symptoms such as jaw pain and headache.^{[citation needed]} Teeth hollowed by previous decay (caries), or dental drilling, may collapse, as the cyclic pressure exerted by bruxism is extremely taxing on the tooth structure. Caries is a progressive destruction of any kind of bone structure, including the skull, the ribs and other bones. ...

Diagnoses

Bruxism is not the only cause of tooth wear. Over-vigorous brushing, abrasives in toothpaste, acidic soft drinks and abrasive foods can also be contributing factors; each has characteristic wear patterns that a trained professional can identify. Modern toothpaste gel Toothpaste is a paste or gel dentifrice used to clean and improve the aesthetic appearance and health of teeth. ...

The effects of bruxing may be quite advanced before sufferers are aware they brux. Abraded teeth are usually brought to the patient's attention during a routine dental examination. If enough enamel has been abraded, the softer dentine will be exposed and abrasion will accelerate. This opens the possibility of dental decay and tooth fracture, and in some people, gum recession. Early intervention by a dentist is advisable. The word enamel can mean more than one thing: Tooth enamel Vitreous enamel Enamel (markup language) Enameled wire This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ... Dentin (BE: dentine) is the name of substance between the enamel (crown) or cementum (root) of a tooth and the pulp chamber. ... Types of teeth Molars are used for grinding up foods Carnassials are used for slicing food. ... Receding gums (gingival recession) refers to a loss of gum tissue resulting in an exposure in the roots of the teeth. ...

A recently introduced device called the BiteStrip enables at-home overnight testing for sleep bruxism. It is proposed that this might help diagnose bruxism before damage appears on the teeth. The device is a miniature electromyograph machine that senses jaw muscle activity while the patient sleeps. A dentist can establish the frequency of bruxing, which helps in formulating a treatment plan. Anyone having major occlusal rehabilitation should be aware that bruxism can easily ruin prosthetic dental work. The BiteStrip is a disposable self-use home test for Sleep Bruxism. ... Electromyography (EMG) is a technique for evaluating and recording physiologic properties of muscles at rest and while contracting. ... A United States soldier demonstrates Foosball with two prosthetic limbs In medicine, a prosthesis is an artificial extension that replaces a missing part of the body. ...

Treatment

There is no accepted cure for bruxism.^[8]

Mouthguards and repositioning splints

Ongoing management of bruxism is based on minimizing the abrasion of tooth surfaces by the wearing of an acrylic dental guard or splint, designed to the shape of an individual's upper or lower teeth from a bite mould. Mouthguards are obtained through visits to a dentist for measuring, fitting, and ongoing supervision. There are four possible goals of this treatment: (1) to constrain the bruxing pattern such that serious damage to the temperomandibular joints is prevented; (2) to stabilize the occlusion by minimizing the gradual changes to the positions of the teeth that typically occur with bruxism; (3) to prevent tooth damage; and (4) to enable a bruxism practitioner to judge — in broad terms — the extent and patterns of bruxism, through examination of the physical indentations on the surface of the splint. A dental guard is typically worn on a long-term basis during every night's sleep. mouthguards is a device that fits into the mouth over one or both arches of teeth to protect against injury while playing contact sports. ...

Professional treatment is medically recommended to ensure proper fit, make ongoing adjustments as needed, and check that the occlusion (bite) has remained stable.^[9] Monitoring of the mouthguard is suggested at each dental visit.^[9] A term indicating that the state of something, which is normally open, is now totally closed. ...

Another type of device sometimes given to a bruxer is a repositioning splint. A repositioning splint may look similar to a traditional night guard, but is designed to change the occlusion, or "bite," of the patient. Randomly controlled trials with these type devices generally show no benefit ^[10][11]over more conservative therapies and they should be avoided under most if not all circumstances.

The NTI-tss device is another option that can be considered. The NTI covers only the front teeth and prevents the rear molars from coming into contact, thus limiting the contraction of the temporalis muscle. The NTI must be fit by your dentist.

The efficacy of such devices is debated. Some writers propose that irreversible complications can result from the long-term use of mouthguards and repositioning splints.^[12]

Vitamin supplements

There is limited evidence that suggests taking certain combinations of vitamin supplements may alleviate bruxism.^[13]

Biofeedback

Various biofeedback devices are curently available, but their effectiveness is as yet unproven. While anecdotal evidence suggests that they may be useful, some bruxism authorities remain unconvinced.^[14]

One biofeedback mechanism that has significant promise was developed by Moti Nissani, PhD and is called "The Taste-Based Approach to the Prevention of Teeth Clenching and Grinding." The therapy involves suspending sealed packets containing a bad-tasting substance (e.g. hot sauce, vinegar, denatonium benzoate, etc.) between the rear molars using an orthodontic-style appliance. Any attempt to bring the teeth together will rupture the packets and alert the user to the habit. While no cure exists for bruxism, this approach, if implemented properly and rigorously, has promise to be an infinitely effective treatment for bruxism. Importantly, the Taste-Based Approach does not suffer from the risk of desensitization that other available sound-based biofeedback approaches may have. (There is effectively no limit to the aversive taste of certain substances. We can therefore be sure that some harmless substance exists that will alert anyone to the habit.)

One of these devices, the Oralsensor, comprises a pneumatic pouch embedded in a soft polymer plate that fits over upper or lower teeth. When the teeth come together—to a threshold pressure set each night by the user—an alarm is sounded in an earpiece worn by the user. Another biofeedback device, GrindAlert, is a battery-powered device that sounds a tone when it senses EMG (electromyographic) muscle activity in the temporalis muscles of the forehead. This device delivers nightly data on (1) the number of bruxism events that last for at least two seconds, and (2) the total duration of those events. The volume of the alarm and the sensitivity of the piezo device to EMG signals from the muscles are adjustable. EMG can refer to: electromyography, the recording of the extracellular field potentials produced by muscles E-Mail Games EMG, Inc. ... The temporalis muscle is one of the muscles of mastication. ...

In 2005, a new type of occlusive device was patented that produces a movement incompatible with teeth clenching. When nighttime bruxism occurs, people breathe through the nose. The device forces people to breathe through the mouth; by forcing the opening of the mouth, the device is claimed to stop clenching. The occlusive device has an electromyogram system that monitors the electric activity of the jaw muscle via wireless electrodes. These electrodes transfer jaw-muscle activity by radio frequency to an external monitoring system. Once the signal has been interpreted by the monitoring system, if a patient clenches (i.e., if the signal transmitted by the electrodes is higher than a given threshold), the monitoring unit sends a radio frequency signal to a transceiver integrated in a mechanical actuator. The mechanical actuator has two occlusive flaps that block the nostrils, forcing breathing to occur through the mouth. Once the patient stops clenching (i.e., once the signal is under the threshold), the flaps open, allowing breathing through the nose again. The occlusive device does not wake up people since it blocks nostrils slowly, and it never closes them completely to avoid sleep disruption.^[15]

Meditation and relaxation techniques

Sufferers may find that meditation and relaxation techniques may help to reduce teeth grinding. For other senses of this word, see Meditation (disambiguation). ... Relaxation techniques are used by people who wish to relax, for a wide variety of reasons. ...

Repairing damage to teeth from bruxism

Damaged teeth can be repaired by replacing the worn natural crown of the tooth with prosthetic crowns. Materials used to make crowns vary; some are less prone to breaking than others, and can last longer. Porcelain fused to metal crowns may be used in the anterior (front) of the mouth; in the posterior, full gold crowns are preferred. All porcelain crowns are now becoming more and more common and work well for both anterior and posterior restorations. To protect the new crowns and dental implants, an occlusal guard should be fabricated to wear during sleep. Crown A crown, or full-coverage restoration (sometimes incorrectly called a cap) is a prosthetic tooth designed by a dentist and usually created by a lab technician (or more recently, a CAD-CAM machine). ... In zootomy, several terms are used to describe the location of organs and other structures in the body of bilateral animals. ... The English word POSTERIOR is identical to the original Latin adjective, and has two different uses : as an ADJECTIVE, it indicates that someone or something is behind another, either spatially or chronologically it also became a SUBSTANTIVE, indicating the rear-end, especially of a person, i. ... A term indicating that the state of something, which is normally open, is now totally closed. ...

References

1. ^ [1]
2. ^ ^{a b c d e f} Maurice M. Ohayon, MD, DSc, PhD; Kasey K. Li, DDS, MD and Christian Guilleminault, MD: "Risk Factors for Sleep Bruxism in the General Population";Stanford University School of Medicine, Sleep Disorders Center, Stanford, CA;
3. ^ Y. Kobayashi, M. Yokoyama, H. Shiga, and N. Namba: 1198 Sleep Condition and Bruxism in Bruxist, Nippon Dental University, Tokyo, Japan
4. ^ Oksenberg A, Arons E.: "Sleep bruxism related to obstructive sleep apnea: the effect of continuous positive airway pressure.";Sleep Disorders Unit, Loewenstein Hospital-Rehabilitation Center, P.O. Box 3, Raanana, Israel
5. ^ Ng DK, Kwok KL, Poon G, Chau KW "Habitual snoring and sleep bruxism in a paediatric outpatient population in Hong Kong." Department of Paediatrics, Kwong Wah Hospital, Waterloo Road, Hong Kong, SAR China.
6. ^ ^{a b} Winocur E, Gavish A, Voikovitch M, Emodi-Perlman A, Eli I: "Drugs and bruxism: a critical review.";Department of Occlusion and Behavioral Sciences, Maurice and Gabriela Goldschleger, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
7. ^ [2]
8. ^ Nissani, Moti: "When the Splint Fails: Non-Traditional Approaches to the Treatment of Bruxism",Author's website, Wayne State University.
9. ^ ^{a b} Capp, N.J. (1999-03-13.) "Tooth surface loss; Part 3: Occlusion and splint therapy". British Dental Journal, Vol. 186, No. 5, via nature.com. Retrieved on 2007-10-14.
10. ^ Clark, GT, Minakuchi, H: Oral Appliances, TMDs An Evidence-Based Approach to Diagnosis and Treatment, Chicago, 2006, Quintessence, pp. 377-390
11. ^ Dao, TTT, Lavigne, GJ.: Oral Splints: The Crutches For Temperomandibular Disorders and Bruxism? Crit Rev Oral Biol Med 9:345-361, 1998
12. ^ Widmalm, Sven E. "Use and Abuse of Bite Splints", (Website, lectures from author's homepage), University of Michigan, 2004-10-27. Retrieved on 2007-10-14.
13. ^ Ploceniak, C. (1990.) " Bruxism and magnesium, my clinical experiences since 1980" Rev Stomatol Chir Maxillofac, 1990;91 Suppl 1:127. Translation from French by James Michels, Wayne State University. Retrieved on 2007-10-15.
14. ^ Nissani, Moti. "Unrecommended bruxism treatments." Author's website, Wayne State University. Retrieved on 2007-10-15.
15. ^ "Abfrageergebnisse". Retrieved 2007-10-15.

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External links

• Private page with a great deal of information on Bruxism & treatments
• New York Times article on bruxism