Article of the Month -
The Bruxism Triad by Jeffrey S. Rouse, DDS. Inside Dentistry (www.insidedentistry.net)
- "Bruxism is defined as a diurnal and nocturnal parafunctional activity that includes clenching, bracing, gnashing, and grinding of teeth The estimates range from 5% to 95% of the population. Sleep bruxism is the grinding or clenching of teeth during sleep."
- "Tooth wear is described as the loss of the constitution of the tooth and is classified as being caused by attrition, abrasion, erosion, or a combination of these factors. Tooth wear is reported to cause tooth mobility, temperature hypersensitivity, and tooth fracture."
- Respiratory disturbances are categorize as snoring, with an incidence of 10% in children, and apnea, stopping breathing for 10 seconds.
- To be considered a sleep bruxer, one must have 4+ episodes per hour of sleep,25+ bruxing burst per hour, and at least one episode per night must make noise. It is higher in children and decreases with age. It occurs in 30% 5 to 6 yr old, 13% in 18 to 29 yr old, and down to 3% in patients 60+ yr old. Important to know that bruxism is unrelated to experienced and anticipated stress. It is believed as the patient ages, the airway improves, therefore bruxism decreases.
- GERD is a condition where the stomach contents leak into the esophagus. It affects ~40% of population. The acid content of the stomach may reach the oral cavity, this may be extremely destructive due to acid with pH of 1 to 2. The most common site for damage is the palatal surface of the maxillary molars.
- Personally, it is common to hear a child grind their teeth at night. Some times, the noise is so loud you can hear it across the room. We usually do the wait and see method on very young patients, as we read, they will "outgrow" the bruxing. On older patients, where there is wear on permanent teeth, we recommend some type of nite guard.
- Bruxing can cause dislodgement of restoration, fracture of teeth and other issues so it is always good to inform your dentist when this habit is present.
- It is a good idea to have the airway evaluated if a patient has bruxing and/or snoring.
- Always remember, the more information you provide your dentist the better diagnosis you will have.