Tooth Grinding (Sleep Bruxism) and sleep related movement disorders
Night-time clenching or tooth grinding is a common problem classified as Sleep Bruxism (SB), and is one of the sleep related movement disorders (ICDS-2).
Sleep Bruxism may be extremely damaging to the teeth and supporting structures as well as existing dental work. The etiology of Sleep Bruxism is not well understood but likely involves physiologic and behavioural factors.
Some risk factors include anxiety, psychological stress, obstructive sleep apnea, snoring, daytime sleepiness, alcohol consumption, caffeine intake, smoking and potentially genetic predisposition. Other risk factors include brain injury, psychiatric disorders and certain medications.
Rhythmic masticatory muscle rhythm (RMMA) is a brain-stem based, control of normal rhythmic empty jaw movement which may increase in SB which occurs mainly in Non REM sleep in the normal population and is associated with micro-arousals including autonomic nervous system (ANS) changes.
Missed Sleep Bruxism and its consequences abound due to a lack of understanding by both dentists and physicians.
- Do you or have been told that you grind your teeth at night.
- Do you have sore jaws, teeth or temporal headaches upon awakening.
- Referral may also uncover risk factors such as OSA or TMD.
This blog does not allow for a discussion on management here but a plan should include behavioural, medical and dental approaches and assessments. T
Tooth protection is frequently by certain types of dental appliance. Careful assessment must first be made however, as for example, a commonly made front tooth only dental appliance (NTI) is contra-indicated in TMJ internal joint derangement (which frequently remains undiagnosed) as is the one-piece night (SB) guard also contra-indicated when the patient has pre-existing OSA (also often remaining undiagnosed).
Without awareness and recognition, patients unnecessarily continue to suffer the consequences of Sleep Bruxism.
Ask about what options are available during your next booking. And remember, most insurance plans cover all or a portion of the medical solutions to OSA or SB.