Teeth Grinding (Bruxism): Worms Connection?

Bruxism

Bruxism is a parafunctional activity of the masticatory muscles that involves the rhythmic or non-rhythmic grinding, clenching, or gnashing of the teeth at any time of day.

It is a complex multifactorial condition that can be classified into two main types: awake bruxism and sleep bruxism.

Awake bruxism is characterized by clenching and grinding of teeth during the day, often associated with psychological or emotional stress.

Sleep bruxism, on the other hand, is a stereotyped movement disorder that occurs during sleep, and is often associated with sleep disruptions.

Reasons for bruxism(Teeth Grinding)

The exact causes of bruxism are not well understood but may include stress, anxiety, sleep disorders, and abnormal tooth alignment or jaw positioning. Certain medications and substances, such as caffeine and alcohol, may also contribute to teeth grinding.

Bruxism can be caused by a variety of factors, including grinding of teeth during sleep, high levels of stress, anger issues, and habits such as nail biting and tongue thrusting.

girl biting pen on regular basis does habit bruxism

Other contributing factors may include neck-cervical issues, nerve-related conditions, an imbalanced bite, chewing or eating on one side more than the other, genetic factors, the presence of wisdom teeth, and certain dental conditions.

Symptoms of Bruxism

The symptoms of bruxism can vary depending on the severity and frequency of the teeth grinding or clenching, as well as individual factors such as age and overall health. However, some common symptoms of bruxism may include:

1. Jaw pain or stiffness, especially in the morning

2. Headaches or migraines, especially in the temples or forehead

3. Tooth sensitivity, especially to hot or cold temperatures

4. Cracked, chipped, or worn-down teeth

5. Earaches or ringing in the ears (tinnitus)

6. Disrupted sleep or fatigue upon waking

7. Tension or pain in the neck or shoulders

8. Soreness or pain in the facial muscles

9. Cheek biting or tongue indentations

10. Changes in the appearance or alignment of the teeth

11. Toothache

If you are experiencing any of these symptoms, it is important to consult with the dentist or oral surgeon, or a TMJ expert for proper evaluation and management of bruxism.

Do you have headaches when you wake up? If the answer is yes then the Chances are higher that you have bruxism/ Teeth Grinding.

Evaluation for Bruxism

1. Clinical examination

During a clinical examination, the dentist will look for signs of tooth wear, such as flattened or chipped teeth, as well as signs of muscle tenderness or pain in the jaw or neck. The dentist may also ask the patient about their symptoms and habits, such as whether they experience jaw pain or headaches, or whether they grind their teeth during the day or at night.

2. Bite analysis

A bite analysis can be useful in diagnosing bruxism and identifying any occlusal issues that may be contributing to the condition. This may involve using various tools and techniques to analyze the patient's occlusion and identify any interferences or malocclusions that may be causing the patient to grind their teeth.

3. Electromyography (EMG)

EMG can be used to measure muscle activity in the jaw and to identify any patterns of muscle activity that may be associated with bruxism.

4. Imaging studies

In some cases, imaging studies such as x-rays or MRI scans may be used to evaluate the structures of the jaw and to identify any underlying conditions that may be contributing to bruxism.

Different Dental Check-up

1. Soft tissue evaluation

2. Checking jaw joint- @ pre auricular palpitation, @ lateral auditory meatus palpitation @ hearing the click sounds @checking for early contacts @ checking for functional and nonfunctional contacts @checking for edge to edge, lateral right protrusive, lateral left protrusive contacts @ use of Dawson hold techniques to find out early contacts, slide in the contact, maximum tooth contact @hyperactive muscle

3. Complete medical and dental history.

4. Impressions and Facebow transfer

5. Checking similar jaw joint movements in a semi-adjustable articulator.

6. Construct appliances accordingly.

Bruxism and Worms Connection-

There is no direct relationship between worms and bruxism or clenching habits. Worms have nothing to do with bruxism or vice versa. Instead, you must get a dental check-up and an Occlusal Night Gaurd.

Treatment for Bruxism

1. Occlusal appliances

Occlusal appliances, such as splints or night guards, can be effective in managing bruxism by protecting the teeth from further wear and reducing muscle activity in the jaw.

-Occlusal splints were effective in reducing tooth wear and muscle activity associated with sleep bruxism. Occlusal splints have the ability to redistribute forces during clenching and grinding and reduce muscle activity.

Although there are potential disadvantages of occlusal splints, such as discomfort or difficulty speaking or eating with the splint in place. But these issues may be temporary and can often be addressed with adjustments to the splint or patient education.

Soft splints: Soft splints are made of flexible, resilient materials that can help absorb the forces of bruxism and reduce muscle tension in the jaw. These appliances are typically worn during sleep and can be effective in managing mild to moderate cases of bruxism.

Hard splints: Hard splints, also known as occlusal guards or night guards, are made of rigid materials, such as acrylic, and are designed to fit over the teeth to protect them from further wear and damage. These appliances can be effective in managing more severe cases of bruxism and may be custom-made to fit the patient's individual bite.

Bite plates: Bite plates are similar to hard splints, but are typically designed to cover only a few teeth, rather than the entire arch. These appliances can be used to help correct minor occlusal issues, such as tooth or jaw misalignment, that may be contributing to bruxism.

Anterior deprogrammers: Anterior deprogrammers are appliances that are designed to prevent the back teeth from coming into contact during biting and chewing, which can help reduce muscle tension and force distribution in the jaw. These appliances can be useful in managing cases of bruxism that are related to occlusal issues.

Splint therapy should be accompanied by other forms of treatment, such as behavior modification and stress management, to address the underlying causes of bruxism.

2. Occlusal adjustment

Occlusal adjustment, which involves reshaping the teeth to improve their alignment and contact during biting and chewing, can be effective in managing bruxism in some cases. This approach requires careful evaluation and planning, and should only be performed by experienced dentists.

3. Muscle relaxation techniques

Muscle relaxation techniques, such as massage, stretching, or the use of heat or cold therapy, can be helpful in managing muscle tension and reducing the severity of bruxism.

Stress reduction techniques, such as meditation or yoga, may be helpful in managing underlying emotional factors that may be contributing to bruxism.

4. Medications

Certain medications, such as muscle relaxants or antidepressants, or antianxiety, may be helpful in managing bruxism in some cases.

5. Dental restorations

In cases where tooth wear has already occurred as a result of bruxism, dental restorations such as crowns, veneers, or fillings may be used to restore the damaged teeth and prevent further wear and damage.

6. Behavioural modification

Behavioural modification techniques can be used to help patients manage the emotional and behavioural factors that may be contributing to bruxism. These may include stress reduction techniques, relaxation training, and other strategies to help patients better manage their stress levels and improve their sleep habits.

Reference

"Functional Occlusion," Peter E. Dawson.
"Bruxism: Conceptual discussion and review" by Dube et al. published in the Journal of Oral Rehabilitation in 2020.
"Sleep Bruxism: Current Knowledge and contemporary management" by Okeson et al. was published in the Journal of the American Dental Association in 2016.
"Diagnosis and management of sleep bruxism in adults" by Lobbezoo et al. were published in the Journal of Oral Rehabilitation in 2018.
"The effect of occlusal splint on sleep bruxism: A systematic review and meta-analysis" by Li et al. published in the Journal of Oral Rehabilitation in 2020.
"Bruxism and temporomandibular disorders: A critical review" by Lobbezoo et al. published in the Journal of Oral Rehabilitation in 2015.

Author-

Dr. Abi Negi

Dentist

10 + years of experience

Certification in Practical Implantology

Certification in Rotary Endodontics

Associate Fellowship in Laser Dentistry Certification in Laser Treatments Diploma in Practical Occlusion and Restorative Dentistry Course Advanced occlusion appliance therapy, TMD Comprehensive Course in Veneers - Ceramic & Composite Aesthetic Certified - Europe, Germany WHO Health Program Certified Certification in Laser Dentistry Fellow of the Academy of General Education (FAGE) Member of the Indian Dental Association (IDA)