Bruxism; is a frequent disorder called increased activity caused by strong jaw movements known as clenching or grinding teeth. (1)
The etiology of bruxism is multifactorial. It is thought to be a central nervous system phenomenon associated with stress and pain behavior. (2) Intense stress or depression, obsession, insomnia, all kinds of tension and jealousy experienced during the day are among the causes of teeth grinding. Inadequate nutrition, intestinal parasites, allergies, and endocrine disorders are systemic factors causing teeth grinding. If the intestines are full, stimuli from the stretched intestinal wall initiate digestive activity in the brain, intestinal contraction increases, digestive enzymes are secreted, gastric acid and saliva flow increases, and lastly, teeth grinding may occur as a result of contraction of the chewing muscles. It is possible to encounter the same problem as a result of brain traumas, several neurological disorders and also the side effects of some medications used. In addition to excessive consumption of alcohol and cigarettes, high or low-level fillings and prostheses, orthodontic disorders in teeth, early dental contacts also cause teeth grinding.
Generally used methods in evaluating bruxism; survey data from patients; signs of dental wear after clinical evaluation; the presence of clenching during sleep by relatives; electromyographic recording of the chewing muscles and polysomnography (sleep lab records). Excessive dental wear in the mouth is the most common symptom of bruxism. (3) In the clinical examination of patients with bruxism; abrasions in the tubercles of the molar teeth, incisions in the anterior teeth, fractures and abrasions, cracks and fractures on the facial surfaces can be observed. (4)
Bruxism is mostly seen between the ages of 20-40. (5) It is observed in 8-10 percent of adults and 8-38 percent of children.
When evaluated by gender, 80.3% of women feel that 50.8% of men feel their teeth clenched during the day or at night (p: 0.02), and 72.4% of women feel pain or fatigue in their jaws when they wake up in the morning (p: 0.01), 67.1% of women and 44.1% of men felt fatigued or strain in their facial muscles (p: 0.02). According to the results obtained, there is a statistically significant difference in the specified situations (p <0.05). (6)
In adults with teeth grinding and clenching problems, plaque treatment is most recommended. These plaques that hang at night; called the bite plate or splint. These plaques dissolve muscle spasm and minimize excessive forces coming and coming to the dental arch. Also, by giving a new position to the lower jaw, it relieves the problematic joint-muscle system. These plates are not used to treat bruxism, but to slow or prevent the progression of problems in the chewing system.
In the treatment of stress-induced habits, muscle relaxants, B vitamins, and psychological treatment are required in addition to these drugs. If necessary, antidepressant medication can be used with the support of a psychiatrist.
If the problem is of dental origin, this habit can be eliminated by correcting previously performed erroneous dental procedures, high or low fillings, and prostheses. With the orthodontic treatment, the clenching habit developed due to closing disorders can be corrected by bringing the teeth to the normal closing position. In advanced joint problems, surgical interventions can be performed on the joint capsule.
It has been reported that wear and breakage can be observed in composite resins in the presence of parafunctional habits such as bruxism. In such patients, composite resins with high wear and fracture resistance should be preferred. (7)
Most patients are aware of the clenching habit, but he is not aware that his sensitivity is related to this. Therefore, he does not attempt any treatment for bruxism. Researchers; reported that the rate of wear was associated with dentin sensitivity. (8)
If bruxism is not treated;
1-As a result of wear on the teeth, the vertical size decreases, and facial aesthetics deteriorate.
2-Pain in the teeth, jaw joints and muscles
3-Restriction of mouth opening in opening and closing movement
4- Jaw locking
6-The formation of deformations that require surgery in the following cases
7-It also poses a risk for breaking ceramic restorations. The presence of bruxism causes cracks or fractures in porcelain laminate veneers or the complete removal of the restoration.
1)Clark GT, Ram S. Four oral motor disorders: bruxism, dystonia, dyskinesia, and drug-induced dystonic extrapyramidal reactions. Dent Clin North Am. 2007;51(1):225-43.
2)Carlsson GE, Egermark I, Magnusson T. Predictors of Bruxism, Other oral parafunctions, and tooth wear over a 20-year follow up period. J Orofac Pain. 2003;17(1):50-7.
3)Özcan E., Sert S. [Evaluatıon of Relationships Between Severity of Dentin Sensitivity and Degree of Tooth Wear]. IU Dent J. 2010;44(2): 159-65
4)Bulut AC, Atsü S. [Contemporary Approaches of Bruxism Diagnosis and Treatment] KU Med School J. 2012;14(1):20-5
5)Pergamalian A, Rudy TE, Zaki HS, Greco CM. The association between wear facets, bruxism, and severity of facial pain in patients with temporomandibular disorders. J Prosthet Dent. 2003;90(2):194-200
6)Makbule TD , Zeynep GA , The Effect Of Bruxism On The Oral Restorations And Teeth, Necmettin Erbakan Üniversitesi Diş Hekimliği Fakültesi, Restoratif Diş Tedavisi ABD, Konya, 13 nov 2019
7)Osiewicz MA, Werner A, Roeters FJM, Kleverlaan CJ. Wear of direct resin composites and teeth: considerations for oral rehabilitation Wear of direct resin composites and teeth: considerations for oral rehabilitation. Eur J Oral Sci.2019;127(2): 156–61.