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Andrew Sullivan, DDS & Joel Pascuzzi, DMD, LLC
Specializing in Periodontics
Oral Medicine and Implant Surgery
Call: (201) 437-9098

Bruxism

Bruxism refers to an oral parafunctional activity that occurs in most humans at some point in their lives.  Grinding of the teeth and clenching of the jaw are the two main characteristics of this condition, which can occur during the day or at night and most patients are unaware that they are doing this.

Bruxism is one of the most common known sleep disorders and causes most of its damage during sleeping hours.  The clenching and grinding which accompanies bruxism is symptomatic of a malfunctioning chewing reflex, which is turned off in non-sufferers when sleeping.  For sufferers, deep sleep or even naps cause the reflex nerve control center in the brain to turn off and the reflex pathways to become active.

Typically, the incisors and canines (front 6 upper and lower teeth) of opposing arches grind against each other laterally.  This side to side action puts undue strain on the medial pterygoid muscles and the temporomandibular joints.  Earache, depression, headaches, eating disorders, and anxiety are among the most common symptoms of bruxism; these symptoms also accompany health issues such as chronic stress, Alzheimer’s disease, and alcohol abuse.

Bruxism is frequently misdiagnosed or not diagnosed at all, because it is only one of several potential causes of tooth wear and most patients are unaware that they are doing this.  Only a trained professional can tell the difference between bruxing wear and wear caused by overly aggressive brushing, acidic soft drinks, and abrasive foods.

Reasons for the treatment of bruxism

Here are some of the main reasons why bruxism should be promptly treated:

  • Gum recession and tooth loss – Bruxism is one of the leading causes of gum recession and tooth loss. It damages the soft tissue directly and leads to loose teeth.
  • Occlusal trauma – The abnormal wear patterns on the occlusal (chewing) surfaces can lead to fractures in the teeth, which may require restorative treatment.
  • Arthritis – In severe and chronic cases, bruxing can eventually lead to painful arthritis in the temporomandibular (TMJ) joints (the joints that allow the jaw to open smoothly).
  • Myofascial pain – The grinding associated with bruxism can eventually shorten and blunt the teeth.  This can lead to debilitating headaches and muscle pain in the myofascial region.
Treatment options for bruxism

There is no single cure for bruxism, though a variety of helpful devices and tools are available.  Here are some common ways in which bruxism is treated:

  • Mouthguards – An acrylic mouthguard can be designed from tooth impressions to minimize the abrasive action of tooth surfaces during normal sleep.  Mouthguards should be worn on a long-term basis to help to stabilize the occlusion, as well as prevent damage to teeth and to the temporomandibular joint. 
  • Occlusal Adjustment - At times there may be an occlusal prematurity, which means that a tooth or a group of teeth occlude first before the majority of the teeth occlude when closing the jaw. After muscles are relaxed, the prematurity can be located and removed by selective grinding a tooth or a group of teeth. 
  • Other methods of treatment include relaxation exercises, stress management education, and biofeedback mechanisms.  When the bruxing is under control, there are a variety of dental procedures such as crowns, gum grafts, and crown lengthening that can restore a pleasant aesthetic appearance to the smile.

If you have questions or concerns about bruxism, please contact our office.