Why is bruxism dangerous in adults and how to get rid of it?

What is bruxism

Bruxism, or uncontrollable teeth grinding, most often occurs during sleep. According to dentists, the teeth of the upper and lower jaws at rest should not touch each other except for episodes of eating.

This also includes strong clenching of the jaws as a result of spasms of the masticatory muscles (clanchus), including during the day (bruxomania). If we can still somehow cope with daytime grinding or compression by controlling it (although not always), then at night our “controller” mind turns off.

With the harmful bruxing process, the effect on the teeth can be called destructive. They wear out and loosen faster, the enamel becomes thinner, sensitivity increases, the bite is disrupted, resulting in cracks and chips appearing on the teeth. Gums also suffer, there is a risk of inflammation and the service life of installed fillings, implants and dentures is reduced.

Often, a patient with bruxism will wake up with tightly clenched teeth and a feeling of pain in the jaw, teeth, or facial muscles. Morning headaches and dizziness, ringing in the ears, pain in various parts of the spine, daytime drowsiness and a feeling of lack of sleep are also likely.

How is the disease treated?

There are two main areas of treatment: protecting teeth and eliminating the cause of the disease itself.

To protect your teeth, your doctor may recommend wearing a mouth guard at night. If there are no malocclusions, one pair of mouth guards is made to be worn continuously while sleeping. Mouthguards made from individual tooth models accurately follow their shape and adhere very tightly. They cannot fly off during sleep; sleeping in them is completely safe.

Mouthguards protect teeth from contact and thereby relieve the symptoms of bruxism

If you have problems with your bite, you need to consult an orthodontist. After a complete examination, the doctor will be able to tell how long the treatment will last. In this case, you can also choose mouth guards (aligners), but you will need to wear them not at night, but all the time - up to 22 hours a day. Also, the aligners should be changed approximately once every 2 weeks for new ones with a new shape - this way they will correct the position of the teeth. Star Smile aligners are used to treat both adults and children.

Mouthguards are made of durable polymer material that does not damage teeth. Despite their small thickness (each mouthguard is less than 1 mm), they perfectly protect teeth from contact and prevent them from being damaged. And the closing of teeth in mouth guards is a little different in that there is space between the teeth, so you won’t be able to grind them anyway.

But braces are not recommended for patients with bruxism: there is a risk of damage to the system.

Another direction is to reduce the provoking psychological factor. It is possible to work with a psychologist to relieve stress, moderate physical activity, and normalize the daily routine. The fewer negative experiences, the easier it is to get rid of any “nervous” habit, and bruxism is no exception.

In severe cases, the disease can lead to inflammation of the temporomandibular joint, the appearance of crunching, clicking, and pain. Sometimes it becomes impossible to implement prosthetics. In this case, the treatment must be comprehensive, it is carried out by a dentist-gnathologist together with an orthodontist (if necessary).

A dentist-gnathologist deals with the diagnosis and treatment of all problems of the jaw apparatus.

It is easier to prevent the disease from developing to a serious stage. Even with slight signs of teeth grinding at night, it is better to consult a dentist and get advice on what to do to maintain dental health.

Main causes of bruxism

• osteopathic (due to malocclusion, postural disorders, birth trauma or diseases of the cervical spine);
• dental (as a result of violations of the structure and functions of the dental system);
• neurological (due to disturbances in the functioning of the central and peripheral nervous system);
• psychological (due to the emotional state of a person, various manifestations of psychosomatics).

Let us dwell on the last reason in more detail, since, according to researchers of bruxism, psychological components influence its formation up to 70%.

Symptoms of Bruxism

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A person with bruxism involuntarily grinds his teeth:

• If the cutting is observed during the day, it is called daytime bruxism,
• if at night, they speak, accordingly, about night bruxism.

Individuals suffering from bruxism often have problems relating to those with whom they sleep in the same bed or live in the same room because the symptoms prevent others from sleeping. Negative attitudes toward someone with bruxism create a vicious cycle, placing the person under even more stress, which only makes the symptoms worse.

Who is susceptible to bruxism

The disease is often considered characteristic of people who are overly busy and busy, and is attributed to great psycho-emotional stress and stress in everyday life. This is not always the case - even adequately busy people can suffer from bruxism.

According to a survey of those seeking psychological help and concerned about bruxism, such patients do feel tension during the day. However, the level of this tension is quite optimal and necessary for most often performing intellectual work. Many clients have an optimistic character, but there is still a tendency towards workaholism. Most often, grinding at night was found in closed and secretive people who strive to keep all experiences and emotions to themselves (both positive and negative).

Also, according to observations, bruxism manifests itself in people with a strong sexual constitution, who do not always manage to fully realize their sexual potential. Probably, the accumulated tension could become a trigger for the manifestation of bruxism, as a release of energy at night due to unsatisfied activity. Because on the lips, which are related to the dental system, there are a huge number of sensitive areas.

Another hypothesis is that teeth grinding and jaw clenching can accompany patient people who keep all their passions, tears, resentments, anger and irritation within themselves due to their nature or lack of ability to express negative emotions. Anxiety, the presence of neurosis, unresolved internal contradictions and complexes can also cause the development of bruxism. Hippocrates also believed that “confusion of the soul is the main cause of teeth grinding.”

Strong-willed people, trying to gather strength and overcome fears, are subject to strong jaw clenching. A highly developed instinct of self-preservation also plays an important role here. The clenching of the jaws and teeth resembles an element of struggle or a defensive reaction, proving that the person is still alive.

Thus, the reasons for the persistence of bruxism may vary depending, including on age .

• For children, these may be protest reactions to the prohibitions or behavior of adults, parental divorce, moving, changing kindergarten or school;
• in adolescents - rebellion, suppression of anger and the desire to escape from the care of elders, uncertainty with the choice of profession or incorrect self-determination.

Causes of teeth grinding

Today, most experts identify two main causes of teeth grinding [1]:

Stress, emotional exhaustion

Austrian gnathologist professor Rudolf Slavicek calls bruxism a “stress release valve” that helps relieve psycho-emotional tension [3]. Bruxism can be caused by:

• taking antidepressants, sleeping pills;
• abuse of alcohol, nicotine, caffeine, drugs;
• constant psycho-emotional tension, accumulated stress;
• depression, recent traumatic brain injury, Parkinson's disease and other mental disorders, neurological and psychosomatic diseases;
• sleep disorder;
• damage to motor neurons of the trigeminal nerve.

The secondary importance of occlusal disorders in the pathogenesis of bruxism has been proven.
As the main reason, a number of works emphasize the role of the central nervous system and psycho-emotional stress in the development of bruxism. There is evidence from the authors that an unstable psycho-emotional state is one of the triggers for the occurrence of bruxism. Magomedgadzhiev Sh. A., Department of Pathophysiology with a course of Clinical Pathophysiology, First St. Petersburg State Medical University named after. acad. I. P. Pavlova [3]

Occlusal disharmony

Occlusal disharmony is a violation of the contact (closing) of the teeth of the upper and lower jaw. May arise due to [4]:

• malocclusion;
• polyodontia - the presence of supernumerary teeth;
• partial edentia - the absence of several teeth;
• violations during dental prosthetics, installation of braces;
• pathologies of the temporomandibular joint and other causes.

Treatment and prevention

Dentistry suggests constantly wearing a mouthguard - a custom-made rubber structure that protects teeth from abrasion and loosening.

magnesium, calcium and B vitamins, light sedative and hypnotic infusions in order to calm the nervous system Before going to bed, you can apply a warm, damp towel to relieve tension, and undergo massage sessions of the chin and jaw system.

You should avoid eating foods that stimulate the nervous system (chocolate, coffee, strong tea, energy drinks, chewing gum).

Psychological and physiological ways to overcome bruxism

• You can learn autogenic training methods, breathing exercises, meditation, relaxation and stress relief.
• You should make a list of your favorite calming activities that allow you to relax and switch your attention from worries (to form a so-called “ bank of positive emotions ”). This could be long walks in nature, playing a suitable sport (swimming, running, cycling, yoga or qigong), taking warm relaxing baths with herbal decoctions, listening to music, chatting in a pleasant company, watching interesting films or programs, reading books, traveling to new places.

• A visit to a psychologist or psychotherapist will help the patient speak out, understand himself, internal conflicts, frequent mood swings, overcome depression and find spiritual harmony and balance.

Patients with bruxism are often torn between reason and emotions, between “want” and “should.” As a result, a person seems to eat and strive to destroy himself, grinding his teeth in his sleep when control over the psyche is weakened. Bruxism manifests itself as a destructive form of auto-aggression (aggression that has not found a way out). And the task of the psychologist is to recognize and bring out, work through and make conscious to the patient these suppressed elements of his psyche (including through the use of hypnotic techniques). Find acceptable options for expressing suppressed emotions, allow the patient to realize himself, turning aggression into a constructive direction.

Also, with the help of a psychologist, you can learn useful relaxation skills, for example, according to Jacobson . This technique consists of alternately working with different parts of the body - tensing and then relaxing the muscles, including the maxillofacial muscles.

In case of an excess of sexual energy, it will be useful to think about having a partner and regularly realizing your sexual potential, which in itself brings positive emotions and relaxes.

Treatment methods for bruxism

Comprehensive treatment of bruxism may include medication, psychotherapy, physical therapy, and dental methods. This approach demonstrates the greatest efficiency.

The doctor will develop a treatment plan based on the severity of the disorder. It is very important to identify the causes in order to select adequate therapy.

In the case of exposure to psychogenic factors, the basis of treatment is cognitive behavioral therapy: the patient’s mastery of relaxation and self-control methods, psychotherapeutic trainings, art therapy, etc.

Drug therapy is aimed at reducing convulsive muscle activity. The main groups of funds include:

• magnesium, calcium preparations;
• B vitamins;
• mild sedatives;
• sleeping pills, etc.

Treatment of bruxism with botulinum toxin is also classified as a medicinal method. Botulinum toxin injections block nerve impulses entering the muscles, which relieves the muscles from involuntary spasms. The effect of botulinum toxin preparations is not permanent - after several months the injections are repeated. It is important to understand that this is rather a way to combat the symptom. Injections do not help eliminate the causes of the disease.

In some cases, osteopathic treatment may be recommended: manual therapy, massage, warming up the muscles with compresses.

The dental approach involves the participation of different specialists: periodontist, dental therapist, orthopedist, orthodontist. In the absence of pathologies in the dental system, protective rubber or plastic mouth guards are made, which helps prevent the consequences of bruxism in adults. According to indications, the following activities can be carried out:

• selective grinding of teeth;
• correction of bite by wearing mouthguards, braces;
• restoration of the integrity of the dentition: prosthetics and implantation.

Correction of bite defects is possible only after the patient’s condition improves. The installation of fillings and veneers, and splinting of teeth may be postponed due to the high risk of damage to structures.

Why does a child grind his teeth in his sleep?

First, let's understand the mechanism of the process. It is based on involuntary movements of the masticatory muscles. In a dream, a child clenches his jaws, his teeth touch and rub against each other, making a characteristic sound.

Another question is what these movements are connected with. All the reasons why a child grinds his teeth in his sleep can be divided into four large groups:

• General: fatigue, stress, lack of vitamins and microelements. The baby simply does not have time to relax in his sleep, and daytime tension results in hypertonicity of the facial and chewing muscles.
• Dental: bite problems and other pathologies. Simply put, something in the mouth is uncomfortable and causes muscle contractions.
• Neurological: sleep disorders, apnea, epilepsy.
• Mental: Autism, ASD and other problems often cause bruxism in children, in addition to the more obvious symptoms.

Of course, it’s definitely not worth giving a child a serious diagnosis just because he grinds his teeth. But it won’t be superfluous to review your daily routine, diet and visit a doctor - for starters, the dentist.