The Bruxism It is a disorder of the activity of the jaw muscles. It is characterized by a repetitive tightening or by grinding of the teeth that causes discomfort/muscle pain and dental damage.
In addition to the problems related to the dentition, there are several i physical disorders associated with bruxism. In particular, the tempor-mandibular joint disorder (TMD), Oroofacial pain, headache, tinnitus, postural disorders and disturbed breathing in sleep.
There are forms of primary and secondary disorder.
The primary bruxism It is divided into two types deemed clinically unrelated: bruxism during sleep and bruxism during the vigil.
The night bruxism (SLEEP BRUSSM – SB) is involuntary and is classified as a disorder of the sleep related movement. The daytime (Awake Bruxism-AB), on the contrary, is defined as the awareness of the tightening of the jaw and seems to be semi-evolutionary.
In adults under the age of 65, the prevalence of night bruxism It varies between 9.3% and 15.9% and gradually decreases with age. The prevalence of Day bruxism Instead, it is higher and varies between 10% and 31% in the general population and is more frequent in women.
Secondary bruxism has been observed as a side effect of the use of drugs and in some neurological and development disorders. In the future, it may be possible to further differentiate the forms of bruxism based on the underlying cause and clinical manifestations.
Causes of bruxism
To date it is believed that bruxism has anmultifactorial etiology which includes aspects of the function of the central nervous system (scarcely defined), genetic and behavioral factors.
Night bruxism can be a pathological variant of the normal physiological activity of various functions associated with sleep. Day bruxism is instead considered a paraphonal reaction to mental or physical stress.
Patients with night bruxism, in fact, present models of sleep excitement not observed in normal controls or in patients with daytime bruxism. However, also in night bruxism i stress factors And mood seem to play a role. Both conditions show autonomous and altered autonomous and neurochemical activation patterns.
Psychosocial aspects of bruxism
Numerous studies have interested in the relationship between bruxism, psychosocial factors, some traits of personality and psychological stress. These data highlight stable associations between bruxism and stressful lifestyles, between night bruxism and sensitivity to psychological stress, between experienced stress and tightening teeth during the day.
In addition, some studies associate traits of anxiety and neuroticism, as well as depressive symptoms to subjects suffering from bruxism.
Treatment of bruxism
Considering these short premises seems intuitive a multidisciplinary approach for the treatment of this condition. Clinical research, however, has no univocal answers in this regard.
There are many methods of treatment adopted today, at first the intraoral devices (such as the Bites). Following psychotropic drugs, physiotherapy, biofeedback and cognitive-behavioral psychotherapy.
In a recent study a Group behavioral cognitive protocol For night bruxism. In the protocol, learning meetings of problem-solving skills, progressive muscle relaxation and a training of pleasant activities were foreseen. The results are encouraging above all regarding the perception of pain and occlusive function.
Other studies introduce diaphragmatic breathing techniques and guided imagination to regulate anxious activation symptoms and facilitate relaxation.
There cognitive-behavioral therapyIn addition to providing these tools, it can help manage accessory conditions. For example, sleep problems and daily habits that can contribute to the increase in perceived stress.
In addition, some studies relate perceived stress, bruxism and coping strategies. The Maladactive coping strategiessuch as distraction, self -criticism, the use of substances, emotional avoidance are positively related to a tendency to night bruxism. The activation of the Massetere muscle during the day also increase.
The learning and consolidation of more functional coping strategies, such as acceptance, research of emotional support, humor and planning can help feel more resilient in the face of situations or stressful environments and facilitate a less tensive response also at the somatic level.
Bibliography
- Saczuk K1, Lapinska B1, Wilmont P1, Pawlak L1, Lukomska-Szymanska M2. Relationship between Sleep Bruxism, perceived stress, and coping strategies. Int J Environ Res Public Health. 2019 Sep; 16 (17): 3193.
- Santos Miotto Amorim C1, Firsoff EF, Vieira GF, Costa Jr, Marques Ap. Effectiveness of Two Physical Therapy Interventions, related to Dental Treatment in individuals with bruxism: Study Protocol of a Randomized Clinical Trial. Trials. 2014 Jan 7; 15: 8. DOI: 10.1186/1745-6215-15-8.
- Mesko Me, Hutton B., Skupien Ja, Sarkis-Evafre R., Moher D., Pereira-Cenci T. Therapies for Bruxism: A Systematic Review and Network Meta-analysis (Protocol). Syst. Rev. 2017; 6 (1): 4.
