Night-Time and Day-Time Bruxism
Bruxism can happen during sleep and in day time. Night-Time Bruxism usually happens without patient being aware of it. The American Academy of Sleep Medicine (AASM) classifies Sleep Bruxism as a sleep-related movement disorder. Sleep Bruxism is characterised by clenching or grinding teeth during sleep. The severity and frequency of Sleep Bruxism can vary considerably between nights.
The sound of the Sleep Grinding or Clenching is usually bizarre and unmistakable. The sound from Sleep Bruxism is usually loud enough to be audible from across the room whereas Awake Bruxism is usually with no sound. Day-Time clenching is mainly associated with life stress and anxiety. It is believed to be different from Night-Time clenching which is involuntary.
Bruxism Can Damage your Teeth
Sleep Bruxism can provoke toothache, jaw or facial pain. It also can damage or cause abnormal wear in your teeth. The sleeping person is normally unaware of the repeated clenching or grinding although they may experience some facial pain or even headache. The sound of sleep grinding is unpleasant and can impair the quality of the sleep of the bedpartners. People may experience sleep Bruxism infrequently, e.g. once a month, or frequently i.e. every night.
Prevalent Age and Gender for Bruxism
Bruxism can be seen in all ages, but it is more prevalent in younger ages and tends to decline with age. No gender difference has been observed in Bruxism patients and it can happen to boys or girls.
The Cause of Bruxism
According to World Health Organisation (WHO), Sleep bruxism is a sleep disorder with no definitive treatment. Bruxism is a parasomnia. It is said to have mental causes and a type of stress decomposition. Currently Bruxism has no known cure and enamel protective Mouthguards are the most common type of treatment.
Bruxism is Common
Most people experience Bruxism during their life-time, but it becomes clinically significant only for a small percentage of the population. Some studies report that around 85% of the population do experience various degrees of tooth grinding in their life. Bruxism is also common among infants, but it may not be problematic or important from a clinical point of view. Certain medical conditions or a period of unusual stress, like a car crash, can also trigger Bruxism, even in people who did not have the habit of Bruxism before.
Diagnosis of Bruxism
Diagnosis of bruxism is normally straightforward and can be easily made based on your clinical features. Dentists can identify Bruxism by finding wear facets that are not associated with the normal masticatory functions. The following issues can be caused by Bruxism and most patients may not be aware that they have been experiencing night Bruxism:
- Tooth Wear
- Fractured Tooth
- Fractured Tooth Restoration
- Disturbed Sleep Patterns in Bed Partners
Some people may self-report diagnosis of Bruxism based on grinding sounds. They may wake up from their own loud clenching sound or their bed partner may have brought their clenching habit to their attention.
Bruxism patients have specific signs and symptoms and the diagnosis of bruxism should be based on these established patterns and not based on transient stress. Commonly found symptoms include:
- Increased Mobility of the Teeth
- Discomfort and Pain in the Jaws
- Soreness of Masticatory Muscles
Your dentist may recommend Bite Plates or Occlusal Splints for the treatment. These devices can provide protection against destructive clenching forces and may change the habit, but they cannot cure Bruxism.
Dental Restorations and Bruxism
Bruxism is associated with a high failure rate of dental restorations. Bruxism may cause cusp fractures or may result in the failure of dental veneers. When dentists plan for implants or tooth restorations, they usually take excessive occlusal forces of Bruxism into account. According to recent studies, bruxers have a significantly higher rate of implant failure compared to non-bruxers.
A sleep Bruxist may complain from:
- Tooth Wear
- Orofacial pain
- Temporal headache
- Masticatory muscle tenderness
- Tooth Hypersensitivity to cold air or liquid
- Fractured Tooth Restorations (sometimes frequently)
These symptoms and complications may lead a Bruxist to consult with a GP or a Dentist eventually. Patients with Bruxism should be referred to a dentist to quantify and intervene with potential dental wear.
Dental Treatment of Bruxism
Protective dental appliances are effective and widely used by dentists to treat Bruxism. Appliances can control clenching forces and wear in the teeth and provide protection against sever attrition. Soft Vacuum-Formed Mouthguards are cost effective appliances and can also be used as a short-term diagnostic aid for Bruxism. Vacuum-Formed Mouthguard are not permanent and a determined Bruxist can wear them down quickly.
If you are experiencing severe sleep Bruxism, your dentist may prescribe a protective occlusal bite splint. Patient with an occlusal bite splint will continue to brux but with this protective appliance symptoms and severe damage to the teeth are reduced.
If your dentist finds your teeth excessively worn, he or she may recommend a dental crown for those teeth. Further psychiatric or psychological therapy may be beneficial
Bruxism – Before Bedtime
To ease muscle tension, a warm heating pad can be applied to the jaw area before you sleep. It is also recommended to avoid drinks and unnecessary medications that may worsen bruxism such as alcohol, caffeine, antipsychotic medications and chewing gum. Some substances or medications may worsen or induce Bruxism and the clenching of the jaws. For severe cases of Bruxism, you should consult with a professional and they may prescribe muscle relaxants as a Pharmacological intervention in more severe cases.
How to Care for your Bruxism Night Guard (Dental Splint)
Your dentist may provide you with a dental splint (also known as Bruxism Splint or Night Guard). Follow instructions below to protect your teeth and avoid tooth decay:
- Rinse your night guard immediately after you remove them from your mouth. Use lukewarm water and remove debris that are stuck to it.
- Brush the splint lightly using a soft tooth brush. Do not use tooth brush because it may contain abrasive materials that can damage your splint.
- Dry out your splint prior to storage. Bacteria can grow in wet splints.
- Store your splint in its case when not in use.
- Keep splint case dry and clean. You can use dish washing liquid to clean the case.
- Rinse your dental splint weekly using a mixture of mouth wash and water for at least 30 minutes (but no longer than 60 minutes).
Maintaining your dental splint may seem like a lot of work but once you get into the routine, it is going to be a breeze.