Fast paced lifestyles come with a range of stressors. This constant state of stress has given rise to several compulsive habits like nail biting, compulsive hair-pulling or tearing (trichotillomania) and eye blinking (blepharospasm).   Among the range of habits that have developed with today’s lifestyle, those that negatively affect oral structures are particularly detrimental. Bruxing, or compulsive grinding and clenching of teeth is one such parafunctional habit that is very rampant.  Mentioned below are some of physiological and psychological factors that contribute to this habit, and we will attempt to shed some light on some of them.  

WHAT IS BRUXING? 

Compulsively grinding your teeth together is known as Bruxing. 

Bruxing occurs in 2 types, namely, static bruxing, when a person just clenches the teeth together with force. Secondly, dynamic bruxing occurs when the person actively and aggressively grinds and mows their teeth.  

Apart from the psychological factors that usually precipitate the condition, discrepancies, and interferences in the occlusion (the teeth meeting together) can also give rise to Bruxing. 

Bruxing particularly stresses a group of muscles that contribute towards chewing food, the muscles of mastication.  In a state of rest, the teeth are separated from each other by a few millimeters. This space is called the Freeway space, permitting muscles to be at rest. In a bruxing situation, the teeth are constantly in contact and grinding against each other, even when food is not being chewed. This in turn results in a constant firing of the muscles of mastication giving rise to continuous conflict between teeth and muscles. Here the muscles will always win.

The habit might have different repercussions. For some, it may not cause any signs or symptoms, apart from wear and tear changes in the teeth, or evidence of a hyperactive musculature, evident only to a professional. Unfortunately, for some, the consequences can be devastating and life altering.  In any habit that harms oral structures, there are signs initially, and eventually symptoms. Signs of bruxism would be wear of the existing teeth (flattening of the teeth, erosion on the neck of the teeth) causing mild to severe teeth sensitivity. Further, as acid reflux contributes to severe teeth erosion, GERD (gastro-oesophagul reflux disease) aggravates the damage caused by bruxing.  Muscle hypertrophy, or increase in muscle bulk, results from grinding, since the muscles are in constant function. This is the equivalent of your weight-training to be a bodybuilder, 24x7. 

Failing restorations, chipped fillings, bridges breaking or chipping are common signs of bruxing. Unchecked bruxism eventually leads to severe symptoms and life altering changes. Constant grinding causes acute muscle fatigue, disturbed sleep patterns or sleep apnea, cracked teeth syndrome (an acutely painful condition), neck stiffness, Tinnitus (ringing in the ear) TMJ syndrome, MPDS, and migraine mimicking headaches just to name a few.                                                                                                                                                  

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WHATS THE SOLUTION? 

Treatment of a bruxing problem is a multi-modal, and often multi-specialty approach. For mild to moderate cases, treatment can range from something as simple as wearing a barrier device or a muscle deprogramming device. This need to be fabricated by a professional, and not purchased over the counter. A professional can evaluate bite interference and correct it using tested methods used by a dental surgeon, orthodontist, and a prosthodontist. The cascading effects on the TMJ need to be evaluated by clinical evaluation, X-ray’s, and/or MRI’s.

Severe bruxism and its spillover need to be approached from a neuropsychologist angle, along with musculoskeletal evaluation. A team of TMJ specialist, dental surgeon, physiotherapist, orthodontist, and a maxillofacial surgeon, in case corrective changes are necessary in a degenerated joint, are required to address the problem.

CONCLUSION:

Surprisingly, almost 70-80% of the population grind their teeth, intentionally or inadvertently. Acceptance and systematic assessment and treatment is the only option to prevent the fall out of this rampant habit. -

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