Causes and consequences of bruxism

bruxismo-donostia

Bruxism ​is the habit of grinding your upper and lower teeth​, causing wear. It is a neuromuscular pathology according to which, ​at times of stress​, and particularly at night while sleeping, the muscles you use to chew, and above all the masseter muscles, contract.

This can ​cause different movements resulting in wear​, in different directions, which varies widely from one  patient to another. ​Some people cause wear to their front teeth​, i.e. the incisors and canines, ​others to their rear molars​, and yet again others to all of their teeth.

The ​intensity of the wear ​also varies from case to case and, generally speaking, the older the patient, the greater  the wear. Some people clench their teeth strongly without moving them, meaning that they don’t suffer from wear  but rather from pain in their muscles and/or joints. These people are known as clenchers rather than bruxists.

Causes

Bruxism is something we do without realising it. A bruxist is a person who lets off stress by clenching and  grinding their teeth. Sometimes when a patient comes to the surgery, ​they haven’t realised that in fact they grind  and clench their teeth day and night​; however, when asked, they say that sometimes they waken with the  sensation of having clenched their teeth and with a slight feeling of pain in their jaw muscles. Often, ​their family  members or partners will have told them that they make a noise while sleeping​.  

The early signs of bruxism can often be detected in a routine dental check-up.

This is often the case with patients between 20 and 30 years of age who are showing early signs of grinding their teeth, and whose problem may become rather more serious as they grow older. This is a good time to start using a night guard to stop them from causing more wear to their teeth.

Children and teenagers too can suffer wear​, but we have to wait until they are at least 20 years of age to fit a  night guard, unless the problem is particularly exaggerated. Bruxism is closely related to ​nervous tension or  stress​.

Often a patient comes to the surgery because they ​have pain in the Temporomandibular Articulation (TMJ)​, the  articulation between the jaw and the skull. This joint is located in front of your ear, meaning that sometimes  patients are sent to us by an ENT specialist, given that the patient has gone to them thinking that they had  something wrong with their ears when in fact it is a ​TMJ disorder ​caused by clenching or grinding their teeth.

Such cases often coincide with complicated periods such as exams, changes at work or family concerns. At  other times, even if you are at an apparently relaxed and happy time of your life, your subconscious may prompt  you to grind your teeth.

Consequences

The symptoms depend on the intensity of the bruxism, but if allowed to develop, ​your teeth will wear away,  becoming flatter ​and coming closer to the nerve, making them ​sensitive ​to hot and cold, and sometimes painful  when eating

Flat teeth lose the ability to chew, reducing the height of your mouth and often making your chin stick out,  becoming more prominent. Dental wear can uncover the nerves of your teeth, causing ​infection​, meaning that we  sometimes have to proceed with a root canal treatment.

These teeth, having had their nerves removed, have a somewhat weaker structure and may break if you grind  them hard. It is therefore important to protect them with a ​night guard ​in order to distribute the pressure over all  of your teeth.

Grinding your teeth very hard can also ​loosen a piece of filling ​or tooth, or even a whole filling. If you have  crowns​, failure to protect them against bruxism, particularly when intense, could cause them to come loose,  meaning that they will have to be fixed back in place. Ceramic teeth are stronger than your natural enamel teeth,  meaning that grinding one against the other can cause a great deal of wear to the latter. Sometimes bruxism can  even cause a porcelain veneer to come off.

The importance of protecting your teeth from as early as possible, particularly in cases of intense bruxism, lies in  the fact that if you ​lose your own teeth, you are also likely to have problems with dentures or implants​.  Sometimes elderly people who grind their teeth and wear false teeth can cause the teeth to come away from their  dentures, or even crack or break the plate. In patients with implants, ​bruxism can lead to loosening of the screw holding the implant ​to the porcelain-fused-to-metal crown, which will have to be tightened again.

Relaxing head and neck massages and leading a more peaceful lifestyle improves the consequences of bruxism.

Preventing problems with a ​night guard​ is the key to avoiding future problems.