Bruxism in Adults and Children: Causes and Natural Solutions

Bruxism is a spasm of the masticatory muscles, which provokes spontaneous movement of the jaws and grinding of the teeth. Bruxism cannot be called a primary, independent pathology, the condition is always secondary. Most often, it is caused by certain mental or dental disorders. There is still no unified theory of the origin of the disorder. Therefore, the question of the nature of the disorder is open, research continues. Bruxism provokes many complications that require correction: from enamel wear to diseases of the temporomandibular joint. 

Treatment is carried out under the supervision of several specialists  a dentist , a neurologist , an otolaryngologist  and others. Depending on the nature of bruxism in a particular clinical case.

Causes of Bruxism

Teeth grinding is quite common. According to some estimates, the disorder develops in 40% of children under 12 years of age. In adults, the figure is at a consistently high level, about 10%, regardless of gender and age. Over time, the disorder does not go away, and therefore cannot be avoided without therapy. In order to carry out competent treatment, effectively eliminate the problem that arises, it is necessary to determine the primary cause. Otherwise, the result will be minimal. Many people have this condition, yet experts are still unsure about the causes of the disease. Different ideas exist about the cause of involuntary teeth grinding and teeth dislocation. 

Psychological theory. According to what the law says, bruxism is brought on by people feeling psycho-emotional stress. Showing In addition, stress and anxiety seem to cause the jaws and pusher organs to work harder during sleep. If people are angry, have painfully suppressed feelings or are always anxious, it can result in jaw muscles tensing involuntarily. That explains how some mental illnesses might present in someone. Those specifically blamed in the theory are:

When the body is under chronic stress, the central nervous system increases muscle tension and grand contractions without thinking about it.

many people with a lot of anxiety never fully relax their muscles while sleeping and deal with many tensions as a result.

Researchers assume that dental diseases play a major role. Incorrect occlusion of teeth and occlusal disorders are considered to be one of the causes of teeth grinding. When the position of your teeth is off and your bite isn’t balanced, the jaw muscles start to tighten on their own, causing you to grind your teeth at night. And sometimes disorders lead to movement of the jaw structures during the daytime, which is classified somewhat differently. But the essence remains the same.

Most often, within the framework of dental theory, bruxism is provoked by:

• incorrect bite, disturbances in the contact of the dental arches can provoke hyperactivity of the masticatory muscles;
• Dry socket and Aphthous Stomatitis may apper in bruxim .
• loss of teeth or improper prosthetics: misplaced teeth or unwell connected orthopedic structures can cause variations in the biomechanics of chewing;
• increased sensitivity of teeth: if they become hypersensitive due to microtraumas, there is a real possibility of developing pathology of gingivitis .

Neurological theory

 Bruxism may be related with dysfunction of the central or outlying anxious systems. Neurological causes are usually associated with dysfunction of muscle activity during sleep. Dysfunction of the dopaminergic scheme theaters a role.Studies show that bruxism may be connected to problems with the metabolism of dopamine, the neurotransmitter that controls movement. Episodes of bruxism are sometimes caused by disorders such as obstructive apnea and restless legs syndrome Fracture diseases and characteristic diagnoses also play a role. Attacks of teeth grinding develop against the background of Parkinson’s disease and Huntington’s chorea.

These are the main theories of the origin of the pathological condition. In adding to the overhead, there are other premises that enlighten the grounds of teeth grinding. There is a pharmacological theory. It notes that using antidepressants & psychostimulant drugs may increase the action of the masticatory muscles. Problems with hormone balance may also occur: for example, low melatonin or cortisol levels have been linked to bruxism.

The shape and structure of the teeth abscess and jaw are factors. Changes that happen during birth or later life to the jaw, temporomandibular joint and tight neck muscles can cause the disease. Also, if we believe our own research and numerous observations, teeth grindingis often found in patients with epilepsy, as part of the general motor activity during attacks.

Pathogenesis of the disorder

The pathogenesis of teeth grinding includes complex processes. The mechanisms are often interconnected. All of them, one way or another, lead to hyperactivity of the masticatory muscles, which forms the clinical picture of the disease, its basis. Pathogenetic mechanisms are a logical continuation of the immediate causes of the disorder. 

The main cause of neurological disorders is dysfunction of the central nervous system, which controls motor activity and regulation of muscle tone. 

There is another factor. The involuntary movement of the jaw in obstructive apnea or sleep fragmentation is a result of the brain’s attempts to get air into the lungs. They then develop into habits that become set and are considered a pathology.

Psycho-emotional anxiety is the very start of the sympathetic nervous system.

. This phenomenon affects the masticatory muscles. The phenomenon is especially pronounced during sleep, when control of consciousness is weakened.

Dental causes act as triggers that increase the manifestations of teeth grinding due to disruption of the biomechanics of the masticatory system. Incorrect occlusion of teeth causes redistribution of the load on individual areas of the masticatory muscles, which in turn leads to compensatory hyperactivity. Increases muscle tone and provokes nighttime clenching of teeth. 

In practice, teeth grinding is rarely associated with a single mechanism. More often, it is formed against the background of the interaction of several pathogenetic aspects or a whole set of them. And this makes reflex contraction, muscle squeezing difficult for therapy and no less difficult in terms of diagnosing the causes. 

Risk factors for the development of the disorder

Parafunctional disorder, teeth grinding often develops against the background of not only immediate causes, but also risk factors. They create an additional likelihood of developing the disorder. The following factors have an effect:. 

• bruxism is more often observed in children and young people; in children, teeth grinding is associated with the processes of growth and formation of the dental system, as well as with the peculiarities of nervous regulation; in adults, the accumulation of stress and the burden of chronic diseases plays a major role;
• insomnia: constant lack of sleep weakens the nervous system, increasing muscle tension;
• restless legs syndrome: increased motor activity at night can also affect the chewing muscles;
• sleep with sleep apnea leads to repeated interruptions in breathing and drops in blood oxygen which make it easier for involuntary movements;
• In families where bruxism is common, studies indicate that the disease is more likely, likely because of differences in the jaw, nervous system or patterns of behavior that run in families.professional characteristics, some professions are associated with an increased risk of developing bruxism due to constant stress or the need for concentrated work, most often uncontrolled muscle spasms of various forms are characteristic of creative people and managers;
• psychological personality traits: perfectionism, tendency to suppress one’s emotions, anxious personality type as the main factors;
• often drinking caffeine: such as coffee, tea or energy drinks can make you more likely to grind your teeth;

• alcohol brings poor sleep and negatively affects the neurological parts of grinding one’s teeth at night.
• Smoking causes nicotine to enter the nervous system which is hard for the body to relax from;
• some somatic diseases also have an effect;
• medications increase the risk: stimulants, psychotropic drugs, antidepressants, hormonal drugs and more. 

In most cases, risk factors for the development of unconscious chewing can be eliminated. Both with medical help and learned independently by changing habits and the way of living, etc.

Classification and types of disorder

Bruxism is classified by the time of manifestation, as well as by the stages of development of the conditional disease. 

Depending on the nature of the disorder, there are nocturnal, daytime bruxism and a mixed type of disorder. 

Nocturnal bruxism manifests itself mainly in sleep. It is considered by chapters of spontaneous gritting and crushing of teeth (sometimes one thing, sometimes a whole system of manifestations). Often the nocturnal form is accompanied by other sleep disorders, such as insomnia, obstructive apnea or restless legs syndrome. The disorder hints to noteworthy wear of teeth, microtrauma of the temporomandibular combined and discomfort in the masticatory muscles.

Daytime bruxism, also known as bruxomania, is slightly less common. Involuntary or semi-conscious clenching of teeth during the day is observed, usually without grinding. It is often associated with psycho-emotional stress, concentration or a negative habit. The condition rarely leads to significant wear of teeth, but can cause fatigue of the masticatory muscles and headaches. The disorder is easily corrected through conscious control and psychotherapeutic techniques.

The combined form is observed both during sleep and during the day. It can be painstaking the most simple form, since episodes of squeezing and grinding occur almost around the clock. Often, such a disorder leads to significant damage to the dental system, severe muscle tension and chronic pain. Treatment requires a comprehensive approach, dental, neurological and psychological correction are indicated.

Classification is carried out depending on the stage. Staging takes into account the nature of symptoms, severity of disorders and other points. Several phases of pathology development are distinguished.

At the initial stage, there are intermittent episodes of bruxism, which may be unnoticeable to the patient. With timely intervention (for example, eliminating stress), the disease can be completely eliminated without consequences for the person.

Then the compensated stage develops. Bruxism episodes become more regular, but the body is still able to partially compensate for the consequences. At this stage intervention is important to prevent the progression of the disease. It fixes not go missing on its own. Even if the patient notices changes, symptoms, he cannot do anything in most cases. 

A subcompensated stage is formed. The occurrence and strength of bruxism events increase, the body’s compensatory mechanisms weaken. Without treatment, the disease progresses to decompensation. The main symptoms intensify, the likelihood of one or more complications increases. 

Finally, the decompensated stage occurs. Complete exhaustion of the body’s compensatory mechanisms, significant structural and functional damage to the dental system. Long period and complex treatment is required. Otherwise, the course of the pathology becomes unpredictable, and the prognosis is negative.

Symptoms of bruxism

The clinical picture depends on the form and stage of the disorder. But in general, the indications of the complaint are as shadows:

• visible wear of teeth: one of the most noticeable manifestations . The enamel becomes thinner due to wear the teeth become shorter and their surface becomes smooth and flat
• enlarged tooth compassion: due to loss of varnish, teeth may react excruciatingly to cold, hot, sweet or acid;
• Tooth abscess
• the appearance of cracks and chips: especially often on the chewing surface and front teeth;
• damage to fillings and orthopedic structures: bruxism can destroy fillings, crowns, bridges and dentures, which is also visible to the naked eye;
• toothache of changing intensity: may be the result of overwork or microtrauma;
• discomfort and tension in the masticatory strengths: often felt as a dull or pressing ache especially in the morning after nocturnal bruxism
• jaw fatigue: feeling feeble or powerless to open your entrance fully after awakening up
• muscle spasms: intermittent cramps or a feeling of tension in the jaw and temples;
• clicking or crunching in the joint: clicking, strange sounds – the result of joint degeneration, the disturbances intensify when opening the mouth;
• pain in the joint area;
• limited jaw movement: difficulty initial the mouth or a feeling of being fixed
• headaches: most often localized in the temporal region and associated with muscle strain;
• Sleep problems: with insomnia shallow sleep, frequent awakenings
• fatigue and irritability: associated with poor sleep quality and chronic pain
• deformation of facial contours
• Sound manifestations: grinding of teeth during sleep which is often noticed by loved ones patients do not pay attention to the fact that they grind their teeth.

Psycho-emotional symptoms are encountered. Increased anxiety:, emotional instability. Relief of symptoms with regular clenching of teeth without treatment of the primary cause is ineffective. The primary disorder must be treated and eliminated. Only in this case is it possible to reliably get rid of the symptoms.

Complications of the disorder

Complications of bruxism in adults and children develop against the background of a long-term course of the pathological condition. Among them:

• tooth wear: severe abrasion of enamel leads to shortening of teeth, increased sensitivity and significantly increases the risk of caries;
• cracks and chips: damage to teeth, fillings, crowns and other orthopedic structures, which have already been mentioned earlier;
• TMJ dysfunction: not only limited mobility, but also significant risks of arthritis, arthrosis and destruction of the jaw joints;
• chronic and severe sleep disorders;
• malocclusion;
• aesthetic problems: deterioration of the appearance of teeth and jaw, change in the oval and contour of the face due to changes in the nature of the bite;
• Psycho emotional consequences: Irritability, anxiety due to chronic pain and fatigue.

Please note!

The most difficult consequences of bruxism in children. In younger patients, the sickness clues to a desecration of the development of the jaw, bone flesh, bite incongruities and other snags. Consultation with a dentist, gnathologist is indicated. And without delay, since without sufficient treatment, bruxism is guaranteed to lead to complications. The only question is how complex and pronounced.

Diagnosis of bruxism

Bruxism diagnostics is a complex process. The foundation for judgment is the patient’s criticisms, documentation of typical cyphers of the ailment and authorization of unnecessary activity of the masticatory muscles.

The patient may complain of teeth grinding, noticed by relatives, or of characteristic symptoms. Among them are jaw pain, headaches, facial muscle fatigue, etc. It is important to clarify at what time of day the symptoms appear. The presence of risk factors plays a role.

A clinical examination includes an assessment of the condition of the teeth, gums, temporomandibular joint and masticatory muscles. The most typical signs of bruxism include wear of tooth enamel, chips, cracks, as well as hypertonicity and soreness of the masticatory muscles. The functional state of the TMJ is assessed.

Extra methods can provision the judgment and show the grade of the disorder.

• Polysomnography is a sleep study that makes it possible to record episodes of involuntary muscle activity during nighttime rest;
• Electromyography  : to measure the activity of the chewing muscles especially during sleep.

Additionally  an assessment of the occlusion of the teeth and the condition of the orthopedic structures is carried out. Often, an examination is required not only from a dentist-therapist, but also from other doctors: a neurologist, orthopedist, orthodontist, otolaryngologist, and others.

Treatment of bruxism

Bruxism should be accomplished in both adults and children using a comprehensive approach. Bruxism can be treated differently depending on its form, how far along it is and details about the patient.

Surgical correction of the main problem is essential. Treatment for bruxism works best if we recognize and remove what is causing the problem.

• correction of dental occlusion, treatment of temporomandibular joint diseases, replacement of damaged fillings and orthopedic structures are indicated;
• chronic stress, anxiety and depression need to be addressed through psychotherapy and/or medication;
• Treatment of concomitant neurological disorders such as Parkinson’s disease or sleep disorders is carried out.

Important!

Correction of the primary disorder solves two problems at once. It eliminates symptoms and also helps prevent the development of a repeated disorder, new episodes of bruxism. This is the basis of therapy. Everything else is secondary.

Wearing occlusion caps is indicated as a primary symptomatic measure. The use of special dental caps is considered the main method of protecting teeth from wear. A cap for bruxism evenly distributes the load on the teeth, prevents their contact, active friction and reduces the risk of injury. It also helps to decrease the munching strengths. There are hard and soft caps. Night and day. These are plastic or silicone pads. Products made of medical silicone are used more often. 

Since there are often psychological reasons, psychotherapy and cognitive-behavioral correction are indicated. Knowledge  relaxation techniques. To increase control over your emotional state. 

Drug therapy is possible. Drugs are used to relieve symptoms and relieve muscle tension. Muscle relaxants relax the chewing muscles and reduce hypertonicity. Antidepressants help with psychoemotional disorders associated with bruxism.

Botox helps well against bruxism. Botulin toxin is injected directly into the muscles of chewing. The use of botulinum preparations effectively reduces muscle hyperactivity and relieves pain. The rehearsal of presenting this grounding is linked with muscle reduction and relief of extra tension, muscle shudder. Botulinum therapy is actively used as a symptomatic measure.

Physiotherapy and massage may be performed. Other symptomatic measures and lifestyle changes are indicated. Don’t consume caffeine, alcohol or smoke on a regular basis. Build a good sleeping pattern and a peaceful place where you can relax easily. Learn how to consciously relax the jaw during the day. Eat soft foods for jaw pain.

In rare and severe cases, when other methods are ineffective, the disorder is accompanied by a pronounced course, surgical intervention may be required. But it is not carried out to eliminate bruxism, but to correct changes in the temporomandibular joint or the entire dental system. Dangerous complications.

Prognosis and prevention of the disorder

How bruxism is treated relies on early and complete diagnosis. In the early stages, the disease is well treated, and most symptoms can be eliminated. In advanced forms, complications may develop. Yet, proper treatment and frequent visits to specialists decrease the chances of cancer growing. Special correction gives good results.

To prevent bruxism, you should use measures to lower the risk and control the complications if the condition is already present. An example of these measures is:

• stress level control;

• keeping to a regular sleep and rest timetable
• .regular dental check-ups;
• limiting consumption of caffeine and alcohol;
• quitting smoking;

• use of individual mouth guards to protect teeth at the first signs of bruxism.

If there are major manifestations of the disease, you need to see a doctor.

Answers to questions

How to get rid of bruxism?

Brusim, jaw clenching and teeth grinding can be eliminated by correcting the primary cause. Incorrectly fitted dentures, dental, nervous diseases, nervous tension and psychological culprits. Everything is strictly individual. These are always special cases. You need to know what causes the disorder. There are no universal recipes. 

Which doctor should you get if you doubtful you have bruxism?

If a person often clenches the jaw muscles, there is increased constant tension in the area of ​​the chewing muscles, stiffness, a dentist consultation is indicated. If necessary, he will refer to other doctors. An orthopedist, orthodontist, therapist, osteopath, depending on the nature of the restrictions. The doctor will complete diagnostics and suggest the wanted action. 

How long does the treatment take?

It is hard to say deprived of significant the details of a exact clinical situation. On average, from several months to a year, in difficult cases. If we are talking about complete recovery and restoration. In case of complications, the periodontits increases.