When “gritting your teeth” is not good (indeed it can be harmful) – Corriere.it

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Bruxism is a more common condition than people think, affecting women and men, children and adults. On average, two out of ten people suffer from it, which usually unknowingly tend to grinding and / or clenching teeth repetitively, during the day and / or night.

What is bruxism?

Il bruxismo a repetitive activity of the jaw muscles characterized by clenching or grinding of the teeth – he premises Roberto Broggi, specialist in gnathology at the Department of Dentistry of the Irccs San Raffaele Hospital in Milan -. It is generally divided into two types: sleep bruxism and wakefulness bruxism. The first occurs during the night rest with clenching and / or grinding of the teeth, often reported by the partner or detected by the interested party himself for the annoying sensation of stiffness of the facial muscles upon awakening. The bruxism of wakefulness, which is the most common, characterized, instead, by the pressure in the fixed position of the jaw: the clench is not relevant, but the teeth remain in contact more than necessary with a slight push. Bruxism in general is not in itself pathological. Often harmless muscle behavior, as can happen in children in whom it is frequently a natural phenomenon of central nervous system maturation.


How is it recognized?

Often the diagnosis of bruxism starts from a self-assessment of the patient which reports a series of annoyances to the doctor The next step collect its history e analyze the mouth and teeth to detect any signs, such as wear of the tooth surface or hypertrophy of the jaw muscles. In some cases, diagnostic investigations such as surface electromyography. Through a sort of portable instrument, the altered activity of the mandibular muscles during the day is assessed – explains Roberto Broggi -. Another investigation that can help highlight sleep bruxism, and also the presence of any sleep apnea, is the polysomnography.

What are the possible causes?

In most cases, bruxism the mirror of states of emotional tension, stress and worries. Not surprisingly, when a person goes through a difficult time, they are told “grit your teeth and move on”. Alongside the psychological component, exogenous factors may also play a role, such as smoking, alcohol, excessive caffeine intake as well as certain medications. In some cases it may be also linked to individual biological factors which lead to increased activation of the central nervous system. In the past it was believed that the basis of bruxism could be a mechanical problem, in particular an incorrect alignment of the two dental arches (malocclusion), however in recent years its role has been greatly reduced. Some studies suggest that bruxism could be a protective mechanism in sleep apnea sufferers. In fact, the increased activity of the masticatory muscles, causing a mandibular protrusion, would favor the opening of the airways. It also seems that it can counteract the acidity associated with gastroesophageal reflux, increasing saliva production.

And the dangers?

Bruxism often a phenomenon that does not create any discomfort, a sort of mechanical “reset” of the jaw muscles. However when persistent, frequent and intense can become a risk factor for tooth damage and other complications. The continuous rubbing can in fact favor the abrasion of the dental surfaces and over time a shortening of the teeth. Not only that, it can generate a soreness of the muscles of the face and overload the temporomandibular joint with limited mouth opening and joint noises. Furthermore, the continuous movements can damage the supporting tissues of the teeth and cause prosthetic-periodontal complications.

How can it be cured?

To reduce any discomfort and the risk of damaging the teeth, it is proposed the use of an occlusal plate or bite, a sort of mouthguard, possibly made to measure, which must be placed in the mouth before going to bed. In selected cases you can also use a sedative muscle relaxant drugs which act at the level of the central nervous system. But to solve the problem at the root, it is important to identify the triggers and take action on those. For example, when there is difficulty managing stress or emotional issues are present, relaxation techniques or psychological and behavioral strategies can help.

May 22, 2021 (change May 22, 2021 | 19:20)

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