Bruxism
The term bruxism is defined as: “to grind the teeth, a clenching of the teeth, associated with forceful jaw movements, resulting in rubbing, gritting, or grinding together of the teeth, usually during sleep, believe it or not some people have had to get a dental implant due to this condition.”
Sleep Bruxism is a stereotyped movement disorder characterized by grinding or clenching of the teeth during sleep.? The disorder has also been identified as nocturnal bruxism, nocturnal tooth-grinding and nocturnal tooth-clenching.
What are the Symptoms?
The symptoms of Sleep Bruxism are tooth-grinding or tooth-clenching during sleep that may cause:
* abnormal wear of the teeth
* sounds associated with bruxism (It’s about as pleasant as fingernails on a chalkboard!)
* jaw muscle discomfort
It has been estimated that 95% of all Americans grind or clench their teeth. This is called bruxism. Bruxism can create pain and damage to dental structures, but the majority of Americans go undiagnosed. Bruxing can cause chronic facial pain and muscle fatigue and also wear down tooth enamel and most dental fillings. In some severe cases, natural teeth and restorations can be loosened by the bruxing. Chronic bruxing can cause trauma to the temporomandibular joint, causing inflammation, and leading to temporomandibular joint disease.
Signs and symptoms of bruxing should be dealt with. Many times people will wake with very sore and tired facial muscles. This should provide a clue to them that they brux, and they should have a dentist do a thorough examination to find the cause of their pain. Many people, once they are aware they are bruxing, will “catch” themselves clenching or grindis.
roughout the day.
More research is needed to determine the exact cause of bruxing, but it is thought that physical and emotional factors are involved. Stress or sleep disorders are probably contributors to bruxing during sleep. Bruxing is a very common reaction to stress during our waking hours. It is necessary to find ways to relax. Simple tips include placing reminder notes around the home or workplace, repeating phrases that help to relax, a warm, moist compress on the side of the face, warm baths, reducing caffeine. In some situations, relaxants and sedatives may be prescribed.
Since much bruxing may be attributed to an “abnormal bite”, custom-fitted mouthguards can be worn to prevent bruxing. An occlusal equilibration, which removes high spots and interferences on opposing tooth surfaces, may be necessary to treat the problem. More severe cases may require orthodontics or reconstruction of the tooth surfaces with onlays or crowns.
Bruxing is not the sole cause of TMJ pain dysfunction, and all “bruxers” do not manifest TMJ problems. A significant number of chronic bruxers do eventually show TMJ problems. If you feel you are bruxing and exhibiting symptoms, you should check with your dentist.
Pre-Disposing Factors:
a. Calcium and/or magnesium deficiency.
b. Primary misalignment of the jaw or misalignment secondary to TMJ dysfunction.
c. Intestinal parasites (pinworms)
d. Psychological stress.
e. Diets high in refined or processed foods.
f. Food or environmental sensitivity.
Dietary Suggestions:
a. Sip 2 to 3 oz. (1 mouthful) of distilled or filtered water every 30 minutes, while awake, daily (no well water or water containing fluoride or chlorine); more if you are perspiring.
b. Eliminate all hydrogenated fats and oils. The only oils you should use are fish oils, coconut oil and extra virgin olive oil.
c. Avoid refined carbohydrates, processed foods, alcohol, mucous producing foods such as dairy products, gluten containing grains and gelatin, and caffeine containing foods such as coffee, tea, cola and chocolate.
d. Increase raw foods and quality proteins.
NUTRITIONAL SUPPLEMENTS
Primary Nutrients:
1. BIO-MULTI PLUS – 1 tablet, 3 times daily after meals.
2. BIO-C PLUS 1000 ? 1 tablet, 3 times daily after meals.
3. M S M POWDER – 1/2 teaspoonful 2 to 4 times daily depending on the severity of symptoms. NOTE: Always take MSM with your Vitamin C.
4. BIOMEGA-3 ? 4 capsules, once daily after a meal.
Specific Nutrients: When symptoms or condition begins to subside, gradually, as needed, wean yourself from the Specific Nutrients & stay on the Primary Nutrients. If any symptoms re-occur resume taking Specific Nutrients.
5. CA/MG-ZYME ? 2 capsules, twice daily after breakfast and after dinner.
6. BROMELAIN PLUS CLA – 3 tablets, 3 times daily between meals on empty stomach and at bedtime.
7. V. H. P. – 1 capsule, twice daily after meals and 2 at bedtime.
8. 21ST CENTURY HOMEOPATHIC #5 – CHRONIC STRESS – 1 capful, daily at bedtime for 1 bottle.
Temporomandibular Joint Syndrome (TMJ)
TMJ dysfunction is caused by the malalignment of the teeth, jaws, and muscles. The symptoms of TMJ dysfunction vary, and include pain, clicking, or grating sounds when the mouth opens, and difficulty opening the mouth very wide.
TMJ dysfunction can occur for three reasons. First, the patient loses teeth through decay or trauma, or looses height of some teeth through BRUXISM (grinding) or age. Second, there are iatrogenic (treatment-induced) problems such as dental restorations that make the teeth either too high or too low. The third cause can be developmental problems. “In the last two hundred years, developmental abnormalities of the upper and/or lower jaw have become very common. This has been shown to be directly linked to the intake of processed foods, especially sugar and flour,” says Dr. Price. 22
The temporomandibular joint.
Because chewing is the primary mechanism necessary for supplying nutrients to the body, if the jaws or teeth are out of alignment, the entire cranium will distort in order to chew properly. The structural compensations necessary for this readjustment can be responsible for such varied symptoms as depression, loss of concentration, insomnia, headaches, neck pain, and low back pain?all caused by TMJ dysfunction.
TMJ dysfunction is diagnosed by observation of symmetry of facial features, midline shift of teeth, asymmetric wear of dental surfaces, asymmetry of jaw movement, tenderness over joints, and tenderness in associated muscles. It can also be diagnosed by x-rays, arthrograms (joint x-rays), MRI (magnetic resonance imaging), computerized motion studies, applied kinesiology testing, and electroacupuncture biofeedback.
Dr. Ravins believes balancing the jaw is essential to relieving TMJ dysfunction. Using computerized technology he can measure movements of the jaw and determine where irregularities lie. By using orthopedic appliances (similar to braces) worn in the mouth at night, he can realign the jaw and relieve the symptoms. Other dentists also use craniosacral therapy or cold laser therapy to help correct TMJ syndrome.
Reference
Price, W. A. Nutrition and Physical Degeneration. La Mesa, CA: The Price-Pottinger Nutrition Foundation, Inc., 1945, 1970.
EEG Biofeedback Training for Bruxism
Bruxism, or teeth grinding, is highly prevalent in our population, with perhaps 5% having symptoms so severe as to deserve treatment. It is highly correlated with Attention Deficit Hyperactivity Disorder (ADHD) in both adults and children. Among adults we observe it most in women with “Type A” personalities — aggressive and driving lifestyles. This may indicate no more than that such women are more likely to seek help for this condition.
Bruxism is also highly correlated with chronic pain in general, and with headache pain in particular. Both ADHD and chronic pain are in turn correlated with cortical underarousal, making it attractive to suppose that bruxism may also be regarded as an underarousal condition. The theory that bruxism is causally related to a purely dental phenomenon such as malocclusion is only sparsely supported. Certainly malocclusion can give rise to chronic bruxing. However, many cases of bruxism are manifestly not grounded in problems of malocclusion. Hence, a central nervous system hypothesis is coming to the fore:
“Noctural bruxism is a definitive example of masticatory muscle hyperactivity. Bruxism was long thought to result from occlusal disharmony, but a growing body of evidence suggests nocturnal bruxism to be a manifestation of an abnormally low arousal threshold during sleep.” (Parker, 1990)
An association of bruxism with underarousal is supported by observations of bruxing quite commonly during anesthesia. It is also associated with excessive doses of Prozac (R), an anti-depressant. This also supports the hypothesis of a disorder of arousal.
In most ADHD children, nocturnal bruxism is found to be remediated early in biofeedback training. In adults, the training appears to proceed in fairly predictable stages: An individual is usually much more aware of daytime clenching by around session six. Pain of nocturnal bruxing is usually remediated by session twenty. However, full remediation of the associated residual ADD usually takes longer.