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Making bruxism less painful

For many Atlantic Canadians, life is a grind. Literally. Bruxism, the clenching and grinding of teeth when not eating, can be a serious and lifelong condition.

Actually bruxism is two conditions, awake bruxism and sleep bruxism, notes Dr. Brian Barrett, a dentist and executive director of the Dental Association of Prince Edward Island in Charlottetown. Awake bruxism involves grinding and clenching, but usually more of the latter, while sleep bruxism can also include holding or thrusting out the lower jaw.

“Daytime bruxism effects up to 31 per cent of the population while roughly 13 per cent of people experience sleep bruxism,” says Dr. Barrett.

Often the first sign of bruxism is auditory. “Your dentist often discovers the habit by asking you about whether you are aware or have been told by a partner that you grind your teeth while sleeping. Even children have bruxism and any parent hearing this noise from the child’s bedroom can be alarmed because it is quite something – like fingernails on a blackboard,” says Dr. Barrett.

A huge amount of pressure can be put on teeth and their supporting structures when a person clenches or grinds, he adds. “This, over time can lead to cracked or chipped enamel and loosened teeth. Teeth that are irritated by excess pressure will often become sensitized to hot and cold, but once protected from the bruxism this should subside.”

At one time, sleep bruxism was believed to be related to a person’s bite or their stress level as well as depression and anxiety, but research does not support this, says Dr. Barrett.

However, he notes, stress or extreme concentration can trigger a daytime bruxism habit in some people. “Individuals may clench their teeth while performing certain tasks through the day like driving or focusing on the computer screen. After a while the muscles in their cheeks begin to tire and get sore.”

If stress or over-attentiveness is the cause of daytime bruxism, the problem usually goes away when these issues are addressed.

Recent studies have discovered that sleep bruxism is a rhythmic muscle movement like restless leg syndrome that occurs as a result of stimulation of certain centers in the brain during sleep. “The muscles for chewing are activated, as are those that open and close the jaws,” says Dr. Barrett. “These muscle movements occur as often as 15 times an hour.”

Bruxism can be hard to diagnose. While wear and tear on the teeth may be an indication, there are other reasons why this could happen. Your dentist will monitor your mouth including any irregular wear on the surfaces of your teeth.

There is no proven therapy for sleep bruxism, and most treatments, including bite planes, are often used to address any harmful side-effects such as increased tooth wear. Bite planes cover the teeth in an effort to protect them from such wear. “They will also tend to prevent any muscle soreness that can occur from prolonged clenching, but in many cases once the muscles become tender the clenching stops because it hurts to do so,” says Dr. Barrett. “This is protecting the painful muscle tissues against further damage and allowing for time to heal.”

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