Bruxism

The Bruxism (derived from Greek βρυγμός brygmos, male ' " gnashing of teeth " with a Latin ending) is the unconscious, mostly nocturnal, but also daytime running teeth grinding or clenching of the teeth, through the wear out the teeth, the periodontal ligaments overloaded and in addition the temporomandibular joint, the masticatory muscles, but other muscle groups that are hooked to the stabilization of the head may be damaged.

In this way, it can come up to severe pain syndromes and ear whistles ( tinnitus). Other common symptoms include dizziness, blurred vision and nausea. These pain syndromes are conducted in German literature as temporomandibular dysfunction ( CMD).

At night, feels the partner, similar to a snorer, often disturbed by the loud grinding of teeth.

Sleep -related bruxism ( bruxism ) belongs to the classification system for sleep ICSD - 2 to the sleep-related movement disorders and ICD-10 to other sleep disorders ( G47.8 ) or other somatoform disorders ( F45.8 ). It often occurs together with other sleep disorders such as sleepwalking.

• 3.1 Knirsch rail
• 3.2 biofeedback
• 3.3 Hypnotherapy

Cause

Scientific Bruxism is comparatively little attention. There are in the dental literature still too few studies to proclaim reliable findings. For example it is still not clear to what extent a genetic predisposition plays a role or whether the bruxism in principle is always a disease requiring treatment.

Risk Factors

Risk factors are according to studies and surveys, inter alia,

• Sleep disorders ( sleep apnea syndrome, snoring, daytime sleepiness )
• Chronic stress or anxiety
• Alcohol
• Caffeine
• Smoking
• Certain medications

Mechanical impact

Deviations of the occlusal position by 0.01 mm from the balanced tooth contact are perceived deviations of 0.1 mm can interfere with the masticatory apparatus to such an extent that it comes to bruxism. ( Kobayashi et al., 1988, double-blind study in a sleep laboratory ). Experimental tooth increases by 0.1 mm resulted in this series of experiments condensed phases of deep sleep, increased adrenaline distributions, prolonged apnea periods during sleep and after 14 days the masticatory muscles was ready traumatized that there was an increase in muscle tone.

The chewing force, which is normally in humans at the maximum of 0.4 to 0.45 kN, can be increased by a factor of 10. This can lead to serious damage.

Therapy

For therapy often helps already a guide for self-observation and education of the patient on the links and instructions for self-massage the tight muscles to relieve the symptoms somewhat. However, absent during sleep any control over the reflex activity of the masticatory system.

Might be helpful to the cooperation of the dentist with an appropriately educated physiotherapists continue. In certain cases, this can lead to a reduction of the tonus of the muscles of mastication.

Psychotherapy may be useful in the treatment of patients with bruxism.

The German Society of Dental, Oral and Maxillofacial Surgery ( DGZMK ) recommends to postpone any definitive surgery of the teeth in the presence of a Aufbissproblematik to remedy such problems.

Crunching rail

Dentists may, in conjunction with a suitably qualified dental technicians make a creaking rail ( splint ) to stop the wear on the teeth. Also any interfering contacts of the teeth can be balanced, which can also lead to relief.

Here, especially the extensive gnathology ( functional diagnosis ) by a qualified dentist with joint records ( axiography ) and secondary measures is essential.

The preparation of these rails provides extremely high demands on the qualifications of each dentist and dental technician. The routine training at the University Hospital of touches this aspect only.

We now know that the construction of the rail crunch is a highly complex task. If we do not succeed, articular ( joint between disk ) produce the sliding function of the Discus again with this track, failed treatment (U. Lotzmann, Marburg 2001). Depending on the type of malocclusion very different Aufbisskorrekturen or occlusive overlay may be required.

Biofeedback

In the field of biofeedback, there are various treatment trials. In one approach, the muscle tension is a probe on the masseter muscle measured and acoustically fed back to the patient, causing the patient to be aware of his actions. Thus, it is now possible to interrupt the Kauimpuls will. Will this training, the pulse can be perceived and possibly later stopped without audible sound over generalization.

Hypnotherapy

When trying a hypnotherapy treatment, a shift of muscle tension from the jaw is suggested in the manual, or an awakening at every gnashing of teeth until the habit is changed, or a spontaneous release of the tension in his sleep. These suggestions are strengthened post-hypnosis and checked out the reaction at a later interview.

Bruxism in Children

In children, bruxism may be perfectly normal. Children need before, during and after the change of teeth, the occlusion, so tweaking the proper bite between the upper and lower row of teeth, bite and grind handle, which, although accompanied by often violent crunch sounds, but often is not a cause for alarm. There is in American literature surveys, see a connection between " idiopathic " scoliosis when young and funktionsgestörtem masticatory system. However, bruxism in children can also be a sign of tension, anxiety, stress or overwork.

Definition of the scientific society DGZMK

The German Society of Dental, Oral and Maxillofacial Surgery ( DGZMK ) defined as bruxism parafunction ( grinding, pressing) with non-physiological effects on teeth, periodontium, masticatory muscles and / or temporomandibular joints.

History

The first publications on this subject date back to 1934, which is actually fundamental to this work published in 1991 as Harold yellow clinical management of head, neck and TMJ Pain and dysfunction.

The dental therapy trials of the 1970s, with extensive " gnathological rehabilitation " were not generally successful.