Bruxism
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
Bruxism is a periodically occurring grinding of teeth, a manifestation of increased tonic tension of the chewing muscles, intense clenching of the jaws and (or) their movement relative to each other.
In terms of the severity of the clinical course, bruxism ranks first in the structure of the parafunctions of the masticatory muscles (unconscious, inappropriate muscle activity not associated with chewing or speech).
The disease is widespread: it affects an average of 10 to 20% of the adult population and about 30% (according to other sources - 50%) of children. At the same time, in different age groups, the incidence of bruxism varies significantly: for example, it accounts for up to 42% of all visits to orthopedic dentistry in patients aged 20 to 30 years, while in elderly people the frequency of visits is several times lower.
Tooth wear with bruxism
Causes and risk factors
The causes of the disease can be problems in the otolaryngological, neurological, dental spheres; also a predisposing psychological background plays an important role in the occurrence of bruxism. The pathogenetic substrate of the onset of the disease is a dysfunction of the neuromuscular synapses.
Despite the fact that the etiology of bruxism can be talked about with a high degree of probability, all causal factors have not been fully identified. The most studied are:
- deformation of the dentition;
- bite defect;
- partial absence of teeth;
- irrational prosthetics;
- disorders of the central and peripheral nervous system;
- extrapyramidal side effects of drugs;
- endogenous and exogenous intoxication;
- defects in the structure of the facial skeleton;
- diseases of the temporomandibular joints;
- sleep disorders;
- perinatal CNS injuries;
- psychoemotional stress (internal anxiety, anger, agitation before bedtime, etc.);
- persistent stress;
- epilepsy.
Forms of the disease
There are 2 main types of bruxism:
- day;
- night (sleep bruxism).
The main difference between the daytime form is the absence of abrasion of the hard tissues of the teeth and the rhythm of the involuntary contraction of the chewing muscles, characteristic of the nocturnal form.
Signature
Due to the connection with the previous pathology, the disease can be of a primary or secondary nature.
Clinical forms of nocturnal bruxism:
- noisy (with grinding) - patients make creaking sounds when the dentition is closed, sliding relative to each other. There is a high probability of developing premature abrasion of the chewing surfaces of the dental crowns;
- quiet (with compression) - predominantly squeezing of the jaws without their involuntary movement, which leads to the appearance of microcracks, enamel chips;
- mixed - predominant, noisy and quiet episodes can be repeated many times during one night or alternate on different days.
Compression bruxism promotes microcracking
Symptoms
The main manifestations of bruxism:
- periodic tension of the chewing muscles, accompanied by grinding or excessive clenching of the teeth;
- on the teeth - areas of pathological abrasion of the enamel;
- inflammatory processes in periodontal tissues;
- cracks and chips of enamel;
- ceramic chips on artificial prostheses.
Periodic tension of the chewing muscles with bruxism leads to facial fatigue and headaches.
Since the phenomena of bruxism often occur during sleep, the patient may not be aware of the problem for a long time. Alarming symptoms in this case:
- morning headaches, migraine attacks;
- pain in the temporomandibular joints;
- facial muscle fatigue;
- pain, ringing and tinnitus;
- diffuse pain in the dentition;
- episodes of morning dizziness;
- feeling of "stale head";
- pain in the maxillary, frontal sinuses, especially intense in the morning;
- soreness, discomfort in the muscles of the neck, back, shoulders;
- astheno-neurotic states;
- sleep disturbances, sudden awakenings at night;
- daytime sleepiness, decreased performance.
Diagnostics
Diagnosis is usually made by interviewing the patient and examining the oral cavity. Laboratory and technically complex instrumental research methods are not used in this case.
Treatment
Treatment of the disease should be complex, implemented in parallel in several directions:
- pharmacological and physiotherapeutic relaxation of the chewing muscles;
- elimination of defects of the dentition;
- psychotherapeutic effect;
- using a dental guard while you sleep.
Patients with bruxism are advised to wear a mouth guard during sleep.
Possible complications and consequences
Since bruxism is accompanied by force contact of the surfaces of the teeth, this can lead not only to pathological wear and trauma to the hard tissues of the teeth, but also to damage to the periodontium, gum recession, traumatic inflammatory processes in the pulp, occlusion pathology and dysfunction of the temporomandibular joint.
Forecast
With an integrated approach to the treatment of the disease, the prognosis is favorable, often bruxism is resolved on its own.
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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
