BRUXISIM

Habitual grinding of teeth when the individual is not chewing or swallowing. Also used to indicate nonfunctional contact of teeth which may include clenching, gnashing, grinding and tapping of teeth.

Bruxism during daytime is commonly a semivoluntary ‘clenching’ activity and is also known as ‘Awake Bruxism’ (AB) or Diurnal Bruxism (DB). Diurnal Bruxism is the subconscious grinding of teeth usually during the day associated with movements such as chewing pencils, nails, cheeks & lips

Bruxism during sleep is subconscious grinding of teeth during night time characterized by rhythmic patterns of masseter. Also known as Nocturnal Bruxism or Sleep Bruxism.

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OCCURRENCE

Common in infants

• Eruption of first primary tooth
• More prevalent in mixed dentition

Common during sleep

• Transition from deeper stages to lighter
• REM stage

ETIOLOGY

Local Factors

• Reaction to an occlusal interference
• High restoration, irritating dental condition

CNS

• Cortical lesions,
• Cerebral palsy,
• Mental retardation

Systemic

• GI disturbances leading to Chronic Abdominal distress
• Nutritional deficiencies - Mg deficiency
• Allergies - Food
• Endocrine disorders

Psychological theory

• Associated with feeling of anger, aggregation
• Stress
• Emotional status – inability to express the emotion

Other causes

• Genetics
• Enthusiastic student, compulsive overachiever
• Competitive sports

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TREATMENT

Reduction of increased muscle tone

• TMJ appliance- Prefabricated intra oral appliance for TMJ disorder
• Restorative - Severe abrasion - Pulp therapy, Stainless steel crown

Psychotherapy

• Counseling the child helps in tension relief & also creating habit awareness.
• Relaxing training-Tensing and relaxing exercise, Voluntary relaxation, Hypnosis, Behavior Conditioning
• Biofeedback -Positive feedback for Learning of tension reduction.

Drugs

• Vapocoolants – Ethyl chloride for pain -TMJ
• Local anesthetics
• Tranquilizers, sedatives, muscle relaxants
• Diazepam – Anxiety and alteration of sleep arousal
• Tricyclic antidepressants- Reduce REM

Others

• Electrical method-Electro galvanic stimulation
• Muscle relaxation-Acupuncture
• Orthodontic correction

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