Bruxism
From Holoprosencephaly
Bruxism
Bruxism is grinding, gnashing or clenching of the teeth. Bruxism entails forceful contact between the biting surfaces of the upper and lower teeth an may often cause loud, unpleasant sounds. Bruxism may occur throughout the day. Bruxism can be mild and occasional or frequent and forceful.
Bruxism often exerts remarkably powerful forces on the teeth, gums, and joints. Some experts believe that these forces are three times the forces generated during chewing while others believe it may be as high as ten times - powerful enough to crack a walnut. (Castaneda, 1992)
Why are these forces so high?
First the clenching/ grinding activity is not under control of the concious, rational brain, which might have moderated or prevented the act from occurring. Second, when a child eats, the chewing force is applied in part to the food, not the teeth; but when a child clenches or grinds his/her teeth, the entire force is applied directly to the teeth.
What are the Symptoms?
The symptoms of bruxism are tooth grinding or tooth-clenching that may cause abnormal wear of the teeth, unpleasant sounds, and jaw discomfort.
Some children have episodes that occur infrequently and have no evidence of dental injury or impairment of psychosocial functioning. Yet others have daily episodes with evidence of dental attrition (wearing of the teeth), tempomandibular (jaw) disorders, other physical injury or impairment of psychosocial functioning.
While not a life-threatening condition, chronic bruxism can lead to many of the fore'mentioned problems. Long term bruxism may lead to sensitive teeth, worn out, fractured, or loose teeth. Grinding and clenching break down the enamel reducing the anatomy of the teeth. The back teeth (molars) lose their cusps and natural contours, appearing instead flat. When anterior teeth are affected, their biting surfaces can be damaged.
What causes bruxism? How is it treated?
According to the American Academy of Pediatric Dentistry the causes of bruxism seem to be multiple factors (such as emotional stress, neurologic disabilities, traumatic brain injury,deviations of the way teeth allign, oral muscle concerns etc.) with the methods to manage this condition ranging from patient/parent education, bite guards, and psychological techniques to medications.
It must be emphasized that no absolute treatment for bruxism is yet available. The bulk of researched modes of management for bruxism seem to be directed toward healthy adults and young adults with few reports in medical/dental literature relative to treating bruxism in children. In most instances, a variety of approaches may be attempted, sequentially or simultaneously, and in the end may-or may not-deter or eliminate this habit.
Your child's dentist may recommend a mouthguard that fits over your childs lower set of teeth and prevents the two sets of teeth from grinding against each other. Since the device is removable, prior to placement there should be some discussion on how the child will manage the appliance if it dislodged within the mouth.
Reports indicate that in some cases bruxism may vanish spontaneously. In others, grinding and clenching may occur so seldom, or are so weak, as to hardly justify any action at all. In our clinic experience, much of the time bruxism seems to lessen as the child transitions from baby or primary teeth to their adult permanent teeth. Families have reported some intervals of increased tooth grinding as the child has adult molars erupting or coming in-this can occur at age 6 and again at age 12 as the second permanent molars erupt.
Unfortunately, while definitive assistance is so limited, we do recommend continued support and care from the dentist treating your child to determine if any additional steps need to be taken to minimize possible discomfort. And, ongoing involvement of the medical team to rule out any other causative factors for the grinding.(eg,earache,ets).
Joni R. Hopps, BS, RHD, MS
Manager, Dental Clinic at the Carter Center at Texas Scottish Rite Hospital in Dallas, Texas
You may also find these external links beneficial:
• http://www.scdonline.org --- Special Care Dentistry Association
• http://www.eservices.aapd.org ---Am. Academy Pediatric Dentistry
• http://www.scgrotto.com Grottoes of North America ---This is a masonic organization providing free dental care for disabled children.
