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Bruxomania

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sushantpatel_doc's picture
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Bruxomania is similar to Bruxism (involuntary ”nervous” grinding of the teeth while the patient is asleep) but occurs when a person is awake. Bruxomania can therefore be described as the involuntary ”nervous” grinding of the teeth while a patient is awake. It is thought bruxomania occurs as a way to relieve tension or stress and was first diagnosed as a medical condition in 1907.

Bruxomania: is it a new dance craze or an obsession for an up-and-coming rock group? What are the chances that you have it, and if you did, how would you know?
You could look in the mirror and bring your front teeth edge to edge, then slide them right to left, left to right and if they fit together at some point(s) like a puzzle, you probably have what is more commonly known as bruxism.
Teeth are not designed to fit into one another -- they're all supposed to have their own contour but when you are a true bruxism grinding case, they fit together like a puzzle.

Clenching and grinding is very cyclic and is most commonly related to stress in our lives."
Bruxism may also result from anxiety, suppressed anger or frustration, abnormal alignment of upper and lower teeth (malocclusion), complications of a disorder -- such as Parkinson's or Huntington's disease -- or as a side effect of some psychiatric medications and antidepressants.
Those people who have hyperactive or competitive personality types are more apt to have this malady.
Common in young children as a response to earache or teething pain as well as the growth and development of the jaw and teeth, bruxism usually disappears by adolescence.

Very often, even while awake, people are in a tight occlusion, meaning their upper and lower teeth are touching and that causes trauma to the TMJ (temporal mandibular joint) and that causes a tendency to have the bruxism.
So when someone has `TMJ' the joint is traumatized in some way, it's either popping, clicking, inflamed; there's a lot of pain involved with it.
Other signs and symptoms of bruxism may include teeth that are worn down, chipped, fractured or broken; teeth grinding loud enough to awaken your sleep partner; worn tooth enamel; increased tooth sensitivity; headache; jaw pain or tightness in your jaw muscle; earache; chronic facial pain; chewed tissue on the inside of your cheek and indentations on your tongue.
You really have to start with an accurate diagnosis because there are a whole lot of things going on in that area -- you have joints, you have blood vessels, you have nerves. Pain can be referred from other areas of the head or the neck so it's a tough diagnosis, to tell you the truth.
Always begin treatment with conservative measures, such as a soft diet, ibuprofen-type medicine for pain relief and warm, and moist heat on the painful area.
If the symptoms persist, then consider a splint appliance or occlusal guard. Worn in the mouth, typically at night only, what it does is put a little bit of space between the teeth so your muscles don't contract as hard.
Because grinding is in the unconscious muscle memory, the appliance won't stop the grinding.
It lessens the force of the grinding and distributes the load over the entire appliance so that one specific tooth or small area doesn't take all of the pressure.
When you are aware that you're clenching or grinding your teeth during the day, just put your tongue between your teeth and just kind of bite down lightly just as a reminder to yourself `OK I've got to stop this grinding habit just to try to interrupt it, to make yourself aware of what you're doing.
Because tooth contact any more than the time it takes to eat our daily meals is too much for the entire system, ask patients what habits they may have -- such as chewing gum, crunching on ice or eating chewy bagels.
It's just pointing out what seems to be the obvious because patients are into their routines and not really thinking that that chewy bagel is overtaxing the system or that chewing ice or gum all day long, again, is overtaxing the system.
Some patients chew on a pipe -- there are all sorts of things. If it's not food, don't be chewing on it. You really can't have your teeth together that much, especially if you're having a problem.

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sushantpatel_doc's picture
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Re: Bruxomania

effects of bruxism

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mithilamhapankar's picture
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Re: Bruxomania

If disagnosed early, finding and eliminating the original cause may cure bruxism. Later on, habitual bruxism can be treated by habit-modification.Treating associated factors can reduce or eliminate the behavior in cases where bruxism has not become habitual
Dental guards and splints
A dental guard or splint can reduce tooth abrasion. Dental guards are typically made of plastic and fit over some or all of upper and/or lower teeth. The guard protects the teeth from abrasion and can reduce muscle strain by allowing the upper and lower jaw to move easily with respect to each other. Treatment goals include: constraining the bruxing pattern to avoid damage to the temporomandibular joints; stabilizing the occlusion by minimizing gradual changes to the positions of the teeth, preventing tooth damage and revealing the extent and patterns of bruxism through examination of the markings on the splint's surface. A dental guard is typically worn during every night's sleep on a long-term basis. Dental guards do not cure the condition.A repositioning splint is designed to change the patient's occlusion, or bite
Another option is a NTI-tss (nociceptive trigeminal inhibitor) dental guard. Nociceptor nerves sense and respond to pressure. The trigeminal nerve supplies the face and mouth. The NTI appliance snaps onto the front teeth. Normally when the mouth is closed, the upper and lower front teeth overlap: The NTI prevents this overlap and translates the bite force from attempts to close the jaw normally into a forward twisting of the lower front teeth. The intent is for the brain to interpret the nerve sensations as undesirable, automatically and subconsciously reducing clenching force. Unfortunately, for patients who do not subconsciously clench less using an NTI devce, the NTI can lead to more severe damage from clenching. The NTI device must be fitted by a dentist.
The efficacy of such devices is debated. Some writers propose that irreversible complications can result from the long-term use of mouthguards and repositioning splints. Randomly controlled trials with these type devices generally show no benefit over other therapies. Clenching hard while wearing an NTI device may cause worse damage, because the NTI changes the forces on the teeth and the tempormandibular joint. NTI patients require ongoing monitoring by a dentist.
Damaged teeth can be repaired by replacing the worn natural crown of the tooth with prosthetic crowns. Materials used to make crowns vary; some are less prone to breaking than others and can last longer. Porcelain fused to metal crowns may be used in the anterior (front) of the mouth; in the posterior, full gold crowns are preferred. All-porcelain crowns are now becoming more and more common and work well for both anterior and posterior restorations. To protect the new crowns and dental implants, an occlusal guard should be fabricated to wear during sleep.

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