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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. 

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.  Only a trained professional can tell the difference between bruxing wear and wear caused by overly aggressive brushing, acidic soft drinks, and abrasive foods.

A BiteStrip® is an economical device used to diagnose bruxism at home.  The device itself is a small electromyography which senses and monitors any activity in the jaw muscles during sleep.  The frequency and severity of the condition can then be assessed and the best treatment plan can be formulated.

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 and deep pockets, where bacteria can colonize and destroy the supporting bone.  
  • 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. 
  • NTI-tss device – This device is fitted by a health professional and only covers the front teeth.  The goal of the NTI-tss is to prevent the grinding of the rear molars by limiting the contraction of the temporalis muscle.
  • Botox® – Botox® can be injected into the muscles to relax and weaken them.  Botox® is an excellent treatment for bruxism because it weakens the muscles enough to prevent grinding but not enough to interfere with everyday functions like chewing and speaking. 

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.

Testimonials.

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Testimonials

I am 42 years old. All of my life I was self conscious about my smile
because of the dark tetracycline stain on my teeth. When I was 37 I
decided to do something about it. I had braces for four years to prepare
me for orthognathic surgery. My maxillofacial surgeon moved my jaw
forward so my overbite would be corrected. After that healed, the braces
came off and I went to see Dr. Stewart. She said I was a perfect
candidate for porcelain veneers. After talking with her and seeing her
portfolio, she installed them.

Almost over night I went from not smiling at all to grinning like a
fool. I can tell you the exact moment I knew I had made the right
decision to do what I had done. About a month after Dr. Stewart had
finished with me, a complete stranger said, "You have a nice smile." It
was the first time in my life I had ever heard those words...ever. My
limited vocabulary prevents me from describing what those words meant to
me but my whole world was changed.

I am 42 years old and I have a nice smile. Would I do it all again?
Absolutely! Do I have any regrets? Absolutely not!

Thanks Dr. Stewart!


Stephen...with a PH!

"Whenever people complain about their dentist or say they haven't been for a checkup in years, I tell them about Dr. Nancy Stewart and her great team. They're all friendly and professional, and the work they do is top-notch. For the past nine years, they have done both 'yearly maintenance' and cosmetic procedures on my teeth, and I get regular compliments on my smile! Leave your excuses at home and go see Dr. Nancy."

Kate Y. February 2007

"Dr. Stewart may be the only dentist I have never been afraid to go to.
Everyone on her staff is informative, friendly and professional, and so is
she. Check out the photo board on your way out, too - she's the only dentist
I've ever met who gets flossing photos from her patients' vacations!"

J. Handler

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