The bruxism is a disorder of the jaw muscles. It is characterized by repetitive clamping or grinding of the teeth which causes muscle discomfort / pain and damage to the teeth.
In addition to the problems related to teeth, there are several physical ailments associated with bruxism . In particular, temporomandibular joint disorder (TMD), orofacial pain, headache , tinnitus, postural disturbances and disturbed breathing in sleep.
There are primary and secondary forms of the disorder.
The primary bruxism is divided into two types considered clinically unrelated: bruxism bruxism during sleep and while awake.
The nocturnal bruxism (Sleep Bruxism – SB) is involuntary and is classified as a movement disorder related to sleep. Daytime bruxism (Awake Bruxism – AB), in contrast, is defined as awareness of jaw clenching and appears to be semi-voluntary.
In adults under the age of 65, the prevalence of nocturnal bruxism varies between 9.3% and 15.9% and gradually decreases with age. The prevalence of daytime bruxism is instead 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 drug use and in some neurological and developmental 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
Bruxism is currently believed to have a multifactorial etiology that includes (poorly defined) aspects of central nervous system function, genetic and behavioral factors.
Night bruxism can be a pathological variant of the normal physiological activity of various functions associated with sleep. Daytime bruxism, on the other hand, is considered a parafunctional reaction to mental or physical stress.
In fact, patients with nocturnal bruxism have sleep arousal patterns not observed in normal controls or in patients with daytime bruxism. However, stress and mood factors also seem to play a role in nocturnal bruxism . Both conditions show altered autonomic and neurochemical sympathetic activation patterns.
Psychosocial aspects of bruxism
Numerous studies have investigated the relationship between bruxism, psychosocial factors, certain personality traits and psychological stress . These data highlight stable associations between bruxism and stressful lifestyles, between nocturnal bruxism and sensitivity to psychological stress, between experienced stress and teeth clenching during the day.
Furthermore, some studies associate traits of anxiety and neuroticism, as well as depressive symptoms, to subjects suffering from bruxism.
Bruxism cure
Considering these brief premises, a multidisciplinary approach for the treatment of this condition seems intuitive . However, clinical research has no clear-cut answers in this regard.
There are many treatment methods adopted to date, primarily intraoral devices (such as bites). Followed by psychotropic drugs , physiotherapy, biofeedback and cognitive-behavioral psychotherapy .
A group cognitive behavioral protocol for nocturnal bruxism was tested in a recent study . The protocol included learning sessions of problem-solving skills, progressive muscle relaxation and training of pleasant activities. The results are encouraging especially with regard to pain perception and occlusive function.
Other studies introduce diaphragmatic breathing techniques and guided imagery to regulate anxiety activation symptoms and facilitate relaxation.
The cognitive-behavioral therapy , in addition to providing these tools can help you manage the ancillary conditions. For example, sleep problems and daily habits that can contribute to the increase in perceived stress.
Furthermore, some studies link perceived stress, bruxism and coping strategies. The coping maladaptive strategies such as distraction, autocriticismo, substance use, emotional avoidance is positively correlated with a tendency to nocturnal bruxism. They also increase the activation of the masseter muscle during the day.
Learning and consolidating more functional coping strategies, such as acceptance, seeking emotional support, humor, and planning can help you feel more resilient in the face of stressful situations or environments and facilitate a less stressful response too. on the somatic level.
