What are the complications of tooth grinding at night and how is it managed?
Hello, What are the complications of tooth grinding at night and how is it managed? Please leave your comments on this. Do I need medical advice?
@jack bruxism is defined as a sleep-related movement disorder. The Glossary of Prosthodontic Terms (GPT-8) defines bruxism as parafunctional tooth grinding habit consisting of involuntary rhythmic or spasmodic nonfunctional gnashing, grinding, or clenching of teeth. Chronic bruxism, based on published reports, can cause mild-to-severe tooth wear, tooth cusp fracture, attached gingival recession, tooth mobility, fractured restorations, masticatory muscle pain, and temporomandibular disorders. Additionally, the literature includes other possible effects such as jaw opening limitation, temporal headache, ear symptoms (eg, plugging, tinnitus, subjective hearing loss), migraines, neck pain, insomnia, and depression. In a retrospective analysis of parent report surveys, Insana and colleagues found a high prevalence of sleep-bruxism among preschool children (36.8%). In addition, in a subset of preschoolers who received additional behavioral and neurocognitive assessments, bruxism was also associated with increased internalizing behaviors and increased health problems, which in turn were associated with decreased neurocognition. The researchers concluded that pediatric sleep-bruxism may serve as a warning sign for possible adverse health conditions, and the need for early intervention. Effective management of bruxism relies on the recognition of potential causative factors associated with the condition. For example, since daytime or diurnal bruxism may be confounded by factors such as stress, distress, and other psychosocial parameters, considering interventions such as habit modification, relaxation therapy, biofeedback, or counseling may be appropriate. In the patient with sleep bruxism (which does not appear to be impacted by psychological or psychosocial factors), appropriate intervention might include appliance therapy and medication. In patients with medication or drug-induced bruxism, medication withdrawal or a change of medication type to one less likely to cause bruxism should be considered. If street drugs are involved, intervention should include drug and perhaps psychological counseling. The health care provider attempting to manage bruxism should understand that nocturnal or sleep bruxism is not going to be cured by intervention. And the behavior is likely to decrease with age. Daytime bruxism can sometimes be effectively eliminated via intervention, suggesting a cure, but recrudescence of the condition is common.