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Section Questions and Answers

Bruxism (Tooth Grinding) in Adults

"Habitual grinding and/or clenching teeth are forms of abnormal behaviour. Individuals may be aware of the habits during the day, but often they occur at night during sleep." - U.S. Surgeon General's Report

  1. What is bruxism?
  2. What are the signs and symptoms of bruxism?
  3. What causes bruxism?
  4. How is bruxism treated?
    How do nightguards help to treat bruxism?
  5. How does the dentist treat the attrition caused by bruxism?

 
1. What is bruxism?

  • Bruxism is the unconscious and involuntary habit of clenching or grinding teeth. This means that a person with bruxism is mostly unaware of, and unable to stop the habit.
    • It can take place at night when asleep or during the day.
    • As bruxism is related to stress, it is a fairly common problem.
    • Bruxism can affect the teeth, muscles, jaw joints (Temporomandibular joints), and the appearance of the face.

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2. What are the signs and symptoms of bruxism?

  • Excessive tooth wear caused by bruxism is not the same as normal tooth wear. These are the symptoms:
    • The teeth will be worn down, and become shorter. The dental term for this toothwear is attrition.
    • The teeth will become flattened, and the creamy/yellow dentine will be visible.
    • If bruxism is not treated, the teeth may be worn down to the level of the gums.
    • Teeth have a tendency to chip as a result of the grinding.
    • Tenderness and pain may be felt in the muscles and jaw joints on waking in the morning.
    • Eating may become painful because of restricted jaw movement.
    • Teeth can become sensitive, painful and loose, after they have been worn down or cracked by the grinding.
    • Extensive tooth wear can cause the jaws to close down too far, resulting in facial changes.
    • Unsightly creasing at the corners of the mouth will be evident.
    • Bruxism may also cause the development of prominent jaw muscles.
    • The sound of grinding teeth can disturb other people.

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Severe bruxism
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Moderate bruxism
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Normal toothwear
with ageing

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3. What causes bruxism?

  • The main causes of bruxism are stress, psychological problems, and medical conditions.
  • It may occur in people with cerebral palsy, or learning difficulties.

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4. How is bruxism treated?

  • Bruxism is treated psychologically, dentally and by medication.
    • The psychological and medical causes are dealt with by psychologists, psychiatrists and doctors.
    • Behaviour modification through relaxation training may be used to treat bruxism.
  • The dental treatment for bruxism is directed to preventing further damage to the teeth, and to the repair of the worn down teeth.
  • The preventive treatment is to use a nightguard.
    • Nightguards can lessen the effects of bruxism:
    • They cannot cure the bruxism as they do not treat the cause, but they can protect the teeth from further damage.
    • Nightguards prevent the upper and lower teeth from grinding against each other.
    • An acrylic nightguard or bite plate may also relieve the symptoms of jaw joint disorders caused by bruxism.
    • Nightguards are provided by the dentist:
    • Impressions are taken of the upper and lower teeth.
    • They are sent to the dental laboratory where the nightguard is made.
    • Nightguards are designed to cover the biting and chewing surfaces of the teeth in one of the jaws, usually the upper.
    • They can be made from a soft plastic or a hard acrylic material.
    • A mouthguard is often supplied with the cast from which it was made.

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Nightguard + cast
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Nightguard
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Nightguard in the mouth
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Acrylic bite plate

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5. How does the dentist treat the attrition caused by bruxism?

  • Where bruxism has resulted in severe attrition, the teeth will need to be restored:
    • Replacement crowns or onlays can be used to restore the worn down teeth.
    • These measures will restore the teeth to their normal size, and the jaws will regain their normal position.
    • The dimensions and appearance of the teeth and face can be aesthetically improved with dental restorations.

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Before
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After replacement crowns

See Toothwear

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