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Bruxism: Grinding and Clenching

Definition:
Bruxism is the medical term used to describe the clenching and grinding of teeth. It may affect both children and adults and can be associated with a number of signs and symptoms. It is now understood that clenching and grinding are two separate entities that often co-exist.

Clinical Presentation:
Patients may complain of jaw pain, headaches, sensitive teeth, fractured teeth / fillings, increased jaw clicking or locking. On examination there is often evidence of excessive tooth wear, fractured restorations or teeth, temporomandibular joint tenderness, jaw muscle tenderness or well defined jaw muscles. Sufferers may complain of poor sleep quality. Bed partners may complain of poor sleep quality due to the loud noises generated during aggressive tooth grinding.

Aetiology:
Bruxism is thought to be mediated by a region of the brain that is directly influenced by external factors such as stress, certain medications, alcohol, caffeine, nicotine and various medical conditions.

Treatment:
The treatment of bruxism will depend on the clinical presentation. Aggressive night time clenching and grinding is managed with a jaw splint. Generally this is a hard acrylic device that covers all of the teeth either on the top or bottom jaw and will fit evenly against the teeth in the opposing jaw as outlined. If there is pronounced daytime clenching and grinding activity, it needs to be managed with behavioural modalities often incorporating jaw physiotherapy and relaxation strategies. For optimum results a structured and tailored programme needs to be designed for the patient to counteract both daytime and night time bruxism.

Splints:
There are various splint designs. These will not all have similar effects. Many jaw splints will aggravate TMJ problems, compromise the bite, and increase the intensity of clenching and grinding. Beware of the splint that does not cover all of your teeth.

 

 

Jaw Pain - TMJ - tmj, orofacial pain, tmj Ireland, jaw pain, bruxism, tooth grinding, dental splint, trigeminal neuralgia, neuropathic pain, facial pain, temporomandibular

Bruxism - Jaw Pain
Excessive tooth wear

Bruxism - Jaw Pain
Hard acrylic splint with extensive wear facets

Bruxism - Jaw Pain