Diagnosis and Treatment

2.1 Diagnosis Methods

1. Clinical Examination

• Dental Examination:

• • Process: The dentist evaluates the patient's teeth for signs of wear or damage consistent with grinding or clenching. This can include flattened tips, chipped edges, or tooth sensitivity.
  • Function: Helps determine the extent of dental damage and any potential need for corrective procedures.

• Jaw Evaluation:

• • Process: This involves assessing the jaw's range of motion, listening for clicking or popping sounds in the temporomandibular joint, and checking for areas of pain or tenderness.
  • Function: Identifies signs of temporomandibular joint disorders (TMD) which can be associated with bruxism.

2. Patient History

• Symptom Checklist:

• • Process: Patients are asked about common symptoms such as morning jaw soreness, headaches, disrupted sleep, or reports of grinding noises from a sleep partner. Take our QUIZ here
  • Function: Gives an insight into the frequency, timing, and severity of episodes.

• Lifestyle and Stress Evaluation:

• • Process: Gathering information on the patient's lifestyle, habits, and stress levels can provide context.
  • Function: Helps determine if stress could be a triggering factor and aids in guiding appropriate interventions.

3. Polysomnography (Sleep Study)

• Description: This is an overnight sleep study conducted in a lab setting.
• Process: Patients are hooked up to equipment that monitors various parameters, including brain waves, eye movements, heart rate, and muscle activity, including that of the jaw.
• Function: It can confirm the presence of nocturnal bruxism and rule out other sleep disorders, like sleep apnoea, which can sometimes coexist with bruxism.

4. Electromyographic Biofeedback

• Description: A technique that measures muscle activity.
• Process: Electrodes are placed over the jaw muscles to record their activity over a specified period.
• Function: Helps in assessing the frequency and force of jaw muscle contractions. This method can be particularly useful when evaluating awake bruxism.

5. Bite Strip Studies

• Description: Portable devices designed to measure the activity of jaw muscles.
• Process: Bite strips, equipped with sensors, are worn overnight to record instances of grinding or clenching.
• Function: Provides a non-invasive alternative to polysomnography, giving insights into the frequency and intensity of nocturnal bruxism episodes.

Typically patients will not have many of the investigations above. The first step is to diagnose Bruxism (take our Quiz Here)

2.2 Treatment Options

Bruxism, or the involuntary clenching, grinding, and gnashing of teeth, isn't just an occasional inconvenience for many. It's a real condition that can lead to significant dental and health issues if not addressed. The good news is that there are various treatment options available, each tailored to the root cause and severity of the condition. This guide sheds light on the available treatments for bruxism, paving the way for better dental health and overall well-being.

1. Dental Approaches

• Mouth Guards and Splints:

• • Description: These are protective devices worn over the teeth.
  • Function: They prevent the upper and lower teeth from coming into direct contact, reducing the damage caused by grinding.
  • Types: While over-the-counter guards are available, dentists often recommend custom-fitted ones for a more comfortable and effective fit. The goal of a mouth guard is to protect the teeth from damage. Many patients can find these uncomfortable and can increase the Grinding and Clenching effect

• Dental Correction:

• • Description: Procedures to address misalignment or damage.
  • Function: Correcting the alignment of teeth can reduce the instances of grinding in some patients. This might involve braces, reshaping the chewing surfaces, or even crowns.

2. Therapeutic Interventions

• Stress Management:

• • Description: Techniques to handle daily stressors.
  • Function: Since stress is a significant trigger for many with bruxism, methods like meditation, deep breathing, and progressive muscle relaxation can help manage the condition.

• Biofeedback Therapy:

• • Description: A technique that teaches control over muscle contraction.
  • Function: Patients learn how to control their jaw muscle activity using monitoring procedures and equipment.

• Behavioural Therapy:

• • Description: Counselling or therapies that address the behavioural aspects of grinding.
  • Function: Techniques such as habit-awareness training and habit-reversal techniques can be instrumental in addressing and curbing unconscious grinding.

3. Medications

While no drug directly treats bruxism, some can assist with its symptoms or potential causes:

• Muscle Relaxants:

• • Description: Medications that relax muscles.
  • Function: They can be prescribed for short-term use to prevent night time grinding. Tolerance and safety are long term issues, so useful in emergency situations, but not a long term strategy

• Botox Injections:

• • Description: Botox is injected into the jaw muscles.
  • Function: Botox offers significant relief and has a 95% success rate at the Bruxism Clinic. It works by relaxing the muscle for 4-5 months. Regular treatment required to maintain results

• Dose Adjustments:

• • Description: Reviewing and modifying current medications.
  • Function: If bruxism is a side effect of certain medications, a healthcare provider might change the dose or switch the patient to a different drug.

4. Lifestyle and Home Remedies

• Limiting Stimulants: Reducing or eliminating the consumption of caffeine and alcohol can help, especially before bedtime.
• Jaw Exercises: Certain exercises might help in strengthening jaw muscles and relieving discomfort.
• Mindfulness Practices: Simply being aware of the habit and actively keeping the teeth apart can sometimes reduce the frequency of grinding.

5. Surgery

In rare and severe cases where other treatments fail, and significant joint damage has occurred, surgery might be considered, especially for issues related to the temporomandibular joint.

Conclusion

Bruxism, while common, shouldn't be overlooked or minimized. Its potential impact on dental health and quality of life makes it essential to explore appropriate treatment options. Through a combination of dental solutions, therapeutic interventions, medications, and lifestyle changes, many can find relief and protect their oral health.