Bruxism
Bruxism is one of the most common sleep disorders and occurs in most people at the same time in their lives. It is characterized by the grinding of the teeth and is typically accompanied by th clenching of the jaw. In most people , bruxism is mild enough to not be a health problem. While bruxism may be a diurnal or nocturnal activity, it is bruxism during sleep that causes the majority of health issues.
Signs & Symptoms
Most are not aware of their bruxism, and only 5% go on to develop symptoms, such as jaw pain and headaches, wich will require treatment. In many cases, a sleeping partner or patient will notice the bruxism before the person experiencing the problem becomes aware of it. Bruxism can result in abnormal wear patterns and fractures in teeth. Over time, dental damages will usually occur. Bruxism is the leading cause of occlusal trauma and a significant cause of tooth loss and gum recession.
Patients may present with a variety of symptoms, including: anxiety, stress, depression, earache, eating disorders, headache, insomnia, chewed tissue on the inside of their cheek, and or sore or painful jaw.
Diagnoses
Bruxism can sometimes be difficult to diagnose by visual evidence alone, as it is not the only cause of tooth wear. Over-vigorous brushing, abrasives in toothpaste and foods, and acidic soft drinks can also be contributing factors although each causes characteristic wear patterns that a trained professional can identify.
The most reliable way to diagnose bruxism is though EMG ( electromyographic) measurements. These measurements pick up electrical signals from the chewing muscles. This is the method used in sleep labs. EMG units pick up signals from facial muscles though wires connecting t=the unit to electrodes that are adhesively attached to the user’s face. TENS electrodes or ECG electrodes may be used.
Treatment
There is no single accepted cure for bruxism. However, treatments are available. Bruxism may be reduced or even eliminated when the associated factors, e.g. sleep disorders, are treated successfully. Other options include trigeminal inhibitor, biofeedback, botox, and dietary supplements.
Sleep Apnea and Bruxism
It was found that obstructive sleep apnea (OSA) was the highest risk factor for teeth grinding during sleep. One report evaluated the effect of continuous positive airway pressure (CPAP) on sleep bruxism in a patient with both polysomngraphic (PSG) recordings were carried out. The first showed 67 events of sounded tooth grindings, most of them appearing as an arousalresponce at the end of the apnea/hypopnea events in both the supine and lateral postures. During the CPAP titration night most breathing abnormalities were eliminated and a complete eradication of the teeth grinding events was observed. The results of this study both suggest that when sleep bruxism is related to apnea/hypopneas, the successful treatment of these breathing abnormalities may eliminate bruxism during sleep.
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