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Τρίτη 30 Οκτωβρίου 2012

Clenching or grinding of teeth .Am I a bruxist?

   The theme of today's post is the habit that some people have and that is to clench or/and grind their teeth. And the proper medical terminology is "Bruxism"





                                             

  When we talk about bruxists,there are several categories.Some people only grind their teeth, others just clench them, and others clench and grind together. Bruxism is a para-functional habit.A para-functional habit is one  means that that we do and don't feel that we do it (unconsciously), which doesn't serve a particular cause.For instance when we bite and eat our food,it is a functional habit.Otan we bite our nails it is a para-functional or nonfunctional habit. Other parafunctional habits range from bitting the internal part of our cheeks, biting pen or pencil chewing ice (which we will deal in a separate post ) and of course clenching or gnashing of teeth.
  Especially as for the clenching or grinding of our teeth, it usually occurs during the night when we can't control it.It is possible to do it during the day (day clenchers), so it is easier to treat, since we realize that we are doing it. It is certainly a result of stress and becomes worse (more intense) in times of stress; a noise like a rubbing stone on another is heard, so our roommate / friend / parent / our brother tells us that he hears something like that during the night,coming from us so we then seek treatment for our condition. This sound can only be heard if you grind or clench and grind your teeth,because if you only clench your teeth there won't be a sound         

               "But how do para-functional habits cause problems in the mouth?"

                                                 

   Para-functional habits cause muscle and joint function when it is not necessary.


                                        

  So the muscles and the joints(TMJ TemporoMandibular Joints)are constant motion and contraction.That means that they get more burden when they don't have to,and less relaxation.Then fatigue kicks in.
Continuous muscle contraction can lead to headaches and migraines as well as problems in the joint (temporomandibular joint disorders or TMD) resulting in a clicking sound every time we open or close our mouth.Pain might co-exist when we open or close our mouth.Also as a result of the strain and the fatigue our jaws might feel a bit stiff when we wake up in the morning.     
                     
                       " But what happens to the teeth and what can we do? "

                                          
The prolonged clenching or teeth grinding teeth causes damages.Let us see examples of patients suffering from bruxism.
The first patient in the early stages of bruxism

                                                     



   


                                          



                                    
                              




 

The only thing is that we can notice are some cracks in the teeth and slight wear on the incisal edges of the teeth.
   If  treatment is not sought the problem will escalate and visible damage to the teeth will start to show.
 The teeth,due to the clenching and grinding begin to decline in height and appear slightly smaller,with a further wear of their incisal edges.

                         
If even the treatment is not sought,and we leave the condition untreated for a long period of time, then the teeth end up like this



 
See how worn and damaged the teeth are.And for a better understanding of the last picture let us process it a bit.
  Notice how much dental structure(tooth) has been lost length-wise. The patient has a fixed bridge in the upper teeth and this worsens the problem, because prosthetic restorations (crowns / bridges) are stronger than natural teeth, so the grinding and / or clenching of teeth cause damages to the natural teeth that oppose them.You can see the major aesthetic and functional problem createdfor this patient. And rehabilitation is much more difficult and much more invasive and more expensive of course for the patient.
  Besides the problems with the length of the teeth, clenching / grinding teeth creates non-carious lesions.

 

These are called "abfractions",and they are loss of tooth in the area over the gum line,that weaken the tooth even more.  Naturally,if left untreated ,problems only grow.
  
"What can I do now Doctor? I am more stressed than before"

 


  The treatment for bruxism is a splint or mouthguard which the patient during sleep.

                                              


It looks like a bleaching tray,for home bleaching of the teeth,but more tough. So when the patient grinds or clenches his teeth, he grnds the mouthguard leaving the teeth intact.Also the mouthguard relaxes the muscles, because they are not in continuous strain.And with the mouthguard out body(and mind) gradually learns not to clench or grind the teeth.Naturally the mouthguard need adjusting, especially in the early visits, in order to distibute the stresses evenly on all the teeth.Te adjustment is done by the dentist.
Let us see photos with the mouthguard worn

                                                       




























  The red and black dots are from the articulation paper used to check for even stress distribution on all the teeth. The mouthguard is not forever; it may need redoing, if damaged by the bruxist patient.
  It might seem a little strange at first to wear it during the night and sleep with it but this feeling is the beginning of the treatment.It will seem inconvenient at first and during the first few days you may not be able to fall asleep easily, because there is a  feeling of a full mouth or because of  the increased saliva secretion, but you will get used to it.If you can accept your problem and understand that this is the only treatent, then you will show discipline
   Exercises of the jaw,can also be started as treatment for bruxism , but it is dangerous t blog about them.N ot because I'm afraid to share my knowledge, but due to the fact that if the wrong exercises to address the problem are implemented , the problem may get worse..Also some cases can be treated with anti-stress medication.
Hope I've you informed even more.

Sleep tight!



                                               

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