Bruxism BY AHMAD YOUNES PROFESSOR OF THORACIC MEDICINE Mansoura Faculty of Medicine

1. BruxismBYAHMAD YOUNESPROFESSOR OF THORACIC MEDICINEMansoura Faculty of Medicine

2. What is bruxism? • Bruxism is unconscious, excessive grinding, rubbing clenching of teeth during non-functional movements of the masticatory system. • This condition affects both kids and adults. • Some people with bruxism unconsciously clench their teeth together during the day, often when they feel anxious or tense.-called as bruxomania • Most kids who have bruxism — and some adults with the condition — grind their teeth during sleep, usually in the early part of the night. This is called sleep bruxism.

3. Bruxism can be classified as: • Day Time Bruxism/ Diurnal bruxism /Bruxomania: conscious or subconscious grinding of teeth usually during the day. It can occur along with parafunctional habits such as chewing pencils, lips, cheeks, nails. This type of bruxism is usually silent except in patients with an organic brain disease. • Night time bruxism/ Nocturnal bruxism: Subconscious grinding of teeth characterized by rhythmic patterns of masseter EMG activity.

4. SLEEP-RELATED MOVEMENT DISORDERS • Restless Leg Syndrome • Periodic Limb Movement Disorder • Sleep Related Leg Cramps • Sleep Related Bruxism • Sleep Related Rhythmic Movement Disorder • Sleep Related Movement Disorder Due to Drug or Substance • Sleep Related Movement Disorder Due to a Medical Disorder

7. Sleep Related Bruxism • Jaw contraction occur in 2 forms A- Sustaned (tonic) jaw contractions . B- Series of repetitive breif (phasic) contractions termed rhythmic masticatory muscle activity (RMMA). • Additional masseter electrodes may be placed at the discretion of the clinician .

8. Sleep Related Bruxism • Brief (phasic) or sustained (tonic) elevation of chin EMG activity that are at least double the amplitude of background EMG. • Brief elevation of EMG activity are 0.25-2 seconds in durations and at least 3 such elevations occurred in a regular sequence. • Sustained elevations of chin EMG if duration more than 2 seconds . • A period of at least 3 seconds of stable background chin EMG must occur before new bruxism can be scored. • Bruxism can be scored reliably by audion combination with PSG by at least 2 audible tooth grinding episodes/night in absence of epilepsy.

13. Fractures of teeth and Occlusal wear facets on teeth

14. ETIOLOGY • Psychological and emotional stresses.e.g.:- anxiety, anger, frustration . • Occlusal interference or discrepancy. • Pericoronitis and periodontal pain is said to trigger bruxism in some individuals. • Using caffeine, tobacco, cocaine or amphetamines seems to increase the risk of bruxism

16. Sleep Related Bruxism • Many cases of bruxism go undetected with no ill effects, while others cause headaches or earaches. • Usually, it’s more bothersome to other family members because of the grinding sound. • In some circumstances, nighttime grinding and clenching can wear down tooth enamel, chip teeth, increase temperature sensitivity, and cause severe facial pain and jaw problems, such as temporomandibular joint disease (TMJ). • Most kids who grind, do not have TMJ problems unless their grinding and clenching happen a lot.

17. Sleep Related Bruxism • Bruxism occurs in up to 30 percent of children, often around the ages of 5 and 6. • It's particularly common in children with cerebral palsy or severe mental retardation. • But most children outgrow bruxism before they get their adult teeth.

19. Teeth Grinding Symptoms • Teeth grinding or clenching, which may be loud enough to wake your sleep partner • Teeth that are worn down, flattened or chipped • Worn tooth enamel, exposing the inside of your tooth, Increased tooth sensitivity. • Jaw pain or tightness in your jaw muscles

20. Teeth Grinding Symptoms • Earache — because of violent jaw muscle contractions, not a problem with your ear • Dull morning headache • Chronic facial pain • Chewed tissue on the inside of your cheek

21. Teeth Grinding Effects • Loosening of teeth from the gums • Losing of teeth • Fracturing of teeth • Wearing away of teeth enamel • Receding gums • Aching jaws • Recurring headaches • Tooth pain • Developing jaw joint disorders One study found that while the average person's tooth enamel erodes by about 0.3 millimeters every decade, teeth grinders can wear away 0.2 millimeters in just a couple of years.

23. Treatments for teeth grinding symptoms • Using a warm, wet wash cloth on the jaw • Massaging jaw muscles, the neck, and face to relieve tension on trigger points • Getting physical therapy • Doing exercises to relax the jaw • Visiting a chiropractor • Using muscle relaxants to relax the jaw

24. Treatments for teeth grinding symptoms • Reducing stress • Drinking more water • Getting more sleep • Not chewing gum or on other objects • Consciously relaxing the face and jaw throughout the day • Buying a teeth grinding mouth guard • Avoiding alcohol, which increases the urge to clench the teeth • Avoiding caffeine, which can make you jumpy and tense

27. Treatments for teeth grinding symptoms • Mouth guard or protective dental appliance (splint) to prevent damage to your teeth. Dentist can make a custom mouth guard to fit mouth. • Over-the-counter mouth guards are available and they're less expensive than custom guards, but they generally don't fit well and can dislodge during bruxing

28. Treatments for teeth grinding symptoms • If bruxism seems to stem from dental problems, dentist may also correct misaligned teeth. • In severe cases — when tooth wear has led to sensitivity or the inability to chew properly — your dentist may need to use overlays or crowns to entirely reshape the chewing surfaces of your teeth.