Grinding teeth
Synonyms
Medical: bruxism
introduction
Not only adults suffer from grinding their teeth, but this misconduct occurs even in young children, Parafunction called, on. Grinding teeth (Bruxism) often occurs during sleep and not only disturbs the rest of others in the same room at night, but also leads to teeth being abraded.
Grinding the milk teeth, on the other hand, is a completely natural process. But if normal occlusion, i.e. the mating of the chewing surfaces is achieved, teeth grinding should stop.
Read more on the topic: occlusion
causes
Crunch can have many different causes. The individual physical and mental state and the environment of the person affected also play a role. Even a simple filling or a new dental prosthesis such as a crown or bridge can cause a change in the bite position if the occlusion is poorly adjusted, creating a different position of the temporomandibular joint and muscles. The temporomandibular joint is only able to a certain extent to get used to another circumstance, which is, however, minor.
For example, if the filling is built up too high, the temporomandibular joint cannot adapt and attempts are made to reduce the interference by grinding. There is much more force on the tooth, which can cause discomfort. The muscles also try to get used to the new condition and become increasingly tense. If this misalignment is left as it is, the temporomandibular joint can also sustain lasting damage. The cartilage of the joint can become excessively stressed and wear out or tear. This allows the temporomandibular joint to jump out, as it no longer has any proper guidance. Stress can also trigger or increase bruxism, especially while sleeping.
The main cause in children, as in adults, can be psychological stress. This can be due to both domestic stressful situations and, in the case of small children, the situation in kindergarten. With older children, it can also be stressful situations at school, which are then processed with crunch during the night. In addition, misalignments of the teeth or the temporomandibular joint can also be the cause of teeth grinding. Especially when teeth have lost prematurely.
Read more on the topic: Causes of grinding teeth
stress
Stress has been shown to cause an increase in crunching. Especially at night, when the day's events are being processed, increased stress ensures that there is more pressing and crunching. When stressed, the hormone cortisol increases, which in the course of the day reaches its highest level in the evening. This is especially popular at night. When the person concerned wakes up the next morning, he feels severe discomfort in the mouth and jaw area, which also manifests itself as strong tension in the muscles.
Jaw cracking and headaches are also possible. In stressful life situations, those affected feel increased discomfort and impairments due to tension. Scientific studies have confirmed this fact.
Symptoms
Of course, the grinding of teeth as a symptom cannot be ignored. The dentist can see the effects of grinding teeth. The canine teeth are affected first, then the front teeth and finally the molars. Psychological changes in the child can also be noticeable.
Effects and Consequences
When teeth grinding and clenching, not only the teeth are affected, but also the masticatory muscles and the jaw joint. This can lead to tension in the masticatory muscles and changes in the temporomandibular joint. Broken canines are also caused by severe grinding and clenching of the teeth.
Read more on the topic: The consequences of grinding your teeth
Craniomandibular dysfunction, CMD for short, is the disease that results from excessive pressing and grinding. This term stands for a disharmony of the entire mouth, temporomandibular joint musculature apparatus.
Read more on the topic: Craniomandibular dysfunction
The teeth wear out faster through the pressing process and grinding facets are created on the teeth. Furthermore, the teeth are moved more by the excessive force and can loosen in the tooth socket. The teeth gradually become flatter, which ensures that the bite subsides. Furthermore, the muscles tense up due to the overload and can also tend to overstretch. Due to the lowering of the bite, the jaw joint is no longer in its normal position and can be prone to discomfort.
The guidance of the joint head can be impaired and manifest in jaw cracking and pain. If this change is not treated, the head of the temporomandibular joint can wear out more and lead to osteoarthritis. This joint wear causes a pathological joint guidance that damages the entire joint. This is also associated with very severe pain, which can also take on unbearable proportions. In the event of complaints, a dentist should be visited as soon as possible to initiate splint therapy so that an initial crunch does not develop into a CMD.
Read more on the topic: TMJ arthrosis
Toothache
Due to the increasing clenching and grinding, the teeth receive more stress and force than usual. More load is exerted on the surrounding tissue, the periodontium, which can irritate the tissue. This irritation causes discomfort. The patient experiences increased pain when chewing and eating.
A disordered opening of the mouth can also be favored by the incorrect loading of the teeth and the temporomandibular joint, which is characterized primarily by an unpleasant clicking noise. If the treatment is not carried out, the periodontium can be loosened by the overload and thereby also increase the degree of loosening of the teeth. This makes it easier for bacteria to penetrate the enlarged pockets and inflame them, which results in severe inflammation pain.
The burning pain is accompanied by the typical signs of inflammation such as swelling, redness and impaired function. Furthermore, due to the increasing muscle tension, radiating pain in the head, neck and back area is possible. Due to the anatomical proximity, the ear can also cause discomfort and express symptoms of tinnitus.
Read more on the topic: Causes of Toothache
a headache
It is possible that the complaints spread to other regions through grinding. The head region is particularly often affected. These headaches can have multiple effects. They can be stinging, oppressive, and only noticeable at certain times of the day. It is difficult for the doctor to find out whether the headache is caused by a dental problem.
migraine
Grinding your teeth can not only lead to headaches, migraines can also develop. The referred pain can trigger flare-ups and seizures in migraine patients and make them worse. The flare-ups can appear at shorter intervals with greater violence. Even in non-migraineurs, these symptoms can trigger symptoms of a migraine. If splint therapy is initiated in these patients, symptom relief occurs very quickly, and in many these symptoms disappear completely.
Read more on the topic: migraine
Tinnitus
Due to the muscle tension and hardening that often occurs, areas that are adjacent to or under the musculature can be blocked. The constant whistling sound of tinnitus that occurs suddenly can be caused by grinding teeth. The hardening of the muscles can constrict the ear and block structures. Furthermore, stress increases the risk of developing tinnitus and can even exacerbate symptoms. Once the splint therapy has been completed and the living conditions have calmed down, the symptoms usually disappear completely.
Read more on the topic: Tinnitus
Neck tension
The symptoms of tension in the muscles in the head and neck area are conceivable due to crunching, which is not limited to the facial muscles and the masticatory muscles. The anatomical proximity and the cooperation of the individual muscle groups can also cause tension in the neck muscles. These are particularly uncomfortable after getting up and restrict freedom of movement.
Any head movement can therefore lead to pain. The neck does not feel soft, and knots can usually also be felt. This tension can also be expressed as a hardening of the muscles. Massage or red light can relieve this tension so that the symptoms disappear. Nevertheless, splint therapy must be initiated in order to localize and heal the cause of the complaints.
Read more on the topic: Tension in the neck
Back pain
Pain from grinding teeth can radiate from the head over the neck area to the back and cause pain there. This primarily affects the upper part of the back, which is anatomically closest to the head. The tension in the masticatory muscles is related to tension in the neck muscles and these are accompanied by tension in the upper back. These can spread to the shoulder and manifest themselves in hardening. The muscles feel stiff and hurt when touched. Knot formation is also conceivable.
Read more on the topic: Back pain in the upper back
Grinding teeth at night
During sleep, the body shuts down and recovers. Especially during this time the activities of the day are processed while dreaming. It is not uncommon for people to grind, especially during this time. The person concerned gets up in the morning and feels increasing symptoms. Opening the mouth is not infrequently difficult. Before going to sleep, the stress hormone cortisol has its highest concentration. This level is broken down at night so that it reaches its lowest level in the morning. During the breakdown, the patient grinds more and more unnoticed.
When awake, crunching and pressing are prevented by inhibition mechanisms that are inactive at night. This particularly affects people with a stressful everyday life or people who are in a stressful life situation. It can be said with scientific evidence that stress greatly promotes night crunching and clenching.
Read more on the topic: Grinding teeth in sleep
Therapy grinding teeth
Nocturnal teeth grinding is a completely natural process up to the age of 3 years and therefore does not require therapy.
The therapy of teeth grinding in adults is wearing a grinding splint that is worn at night.
This at least avoids the harmful effects of teeth grinding on the teeth. This is often not possible with small children, as they do not easily tolerate wearing a nocturnal splint and, in addition, new splints would have to be made at shorter intervals because the jaw is constantly changing as it grows.
Only when the permanent teeth have erupted can a grinding splint be made and worn to treat teeth grinding.
This only prevents damage to the tooth enamel, but does not eliminate the actual cause. Only when the cause of this parafunction has been identified can a targeted therapy for grinding teeth provide a remedy. Until then you have to live with the condition. If the reason for the nocturnal teeth grinding is a misalignment of the teeth, for example that one tooth is higher than the others, the dentist can restore the normal position by grinding and thus eliminate the cause. Therefore, the dentist or orthodontist should always be consulted in order to initiate suitable therapy.
Read more on the topic: Therapy options for grinding teeth
rail
Splint therapy is a therapeutic approach to preventing teeth grinding. A plastic splint is made to prevent excessive stress on the teeth and the entire muscular and temporomandibular joint apparatus. This can be made for either the upper jaw or the lower jaw. By naming an impression at the dentist's, the dental technician can use the models to draw a custom-fit splint, which is then worn during the night. This splint prevents the teeth from coming together and can absorb and cushion the pressing. With the rail variants, you can choose between a soft plastic and a hard, solid plastic. It is also possible to combine a soft plastic on the inside and hard plastic on the outside. The therapy result is the same for all variants. The patient decides which variant he can best cope with. Wearing the splint prevents excessive tension on the muscles and relieves the jaw joint.
Read more on the topic: Occlusion splint
Exercises against grinding teeth
In addition to physiotherapy, there are a handful of exercises that the person affected can do supportively at home in order to avoid the crunch. One recommendation is to insert a cherry stone into the oral cavity and move it in a circular motion with the tongue. The stiffened muscles are relaxed and trained at the same time. This exercise should be done daily for half an hour to three quarters of an hour.
The affected person trains himself to avoid pressing unnoticed even in stressful situations. Chewing gum is not recommended, as the excessive chewing movement tends to encourage bruxism. Furthermore, the masticatory muscles can be loosened by external massage in order to prevent lump formation. The massage movement should be done rotating with a slight pressure, without it hurting.
Another form of exercise is the controlled maximum mouth opening, which should also take place once a day. The patient should open his mouth 10 to 20 times in a controlled manner up to the maximum position without causing him pain. After a few weeks, the exercise can be expanded so that you manually press against the lower jaw with your hand to create a slight resistance. The masticatory muscles are stretched and cramps can be released.
Relaxation exercises
In addition to the splint therapy, the dentist prescribes physiotherapy, which is intended to loosen the muscles and relieve tension. The physiotherapist massages the masticatory muscles and massages out knots. The patient can also do these massage exercises independently at home, but this exercise cannot replace physiotherapy.
Circular, lightly powerful massage exercises with both hands in the cheek region can have a positive effect on tension. Furthermore, the therapeutic approach of progressive muscle relaxation can be followed, in which all facial muscles are tensed for about 5 seconds, for example by crumpling. After 5 seconds of exercise, 20 seconds of relaxation follow. Care should be taken to ensure that the masticatory muscles are not tense.
Home remedies
Home remedies can temporarily relieve discomfort caused by grinding teeth, for example by cooling, but there is no home remedy that can reach the cause or even cure it.The literature advises taking supplements such as magnesium or calcium, but there is no evidence that any of the agents can help against bruxism.
homeopathy
Globules can be used in many ways and are a central therapeutic approach in homeopathy. Phytolacca D6 is the central globule, which is supposed to relieve cravings for crunching. Podophyllum D6 is used for teeth grinding in childhood, which is also used for teething problems.
Zincum metallicum D12 is the homeopathic remedy of choice for night-time teeth grinding. In general, there is nothing wrong with the supportive administration of globules in addition to splint therapy, provided it does not impair the success of the therapy. Consultation with the treating dentist should be made to clarify the dosage.
Grinding teeth in the baby
Babies can already have the phenomenon of crunching. Babies start to get to know their teeth and press them together at the age of 7 or 8 months. This is not pathological, but quite normal. The milk teeth slowly grow into their predetermined position and then fit onto their opposing teeth. At the latest when all teeth are there and the normal occlusion, the normal bite of the child has set, the grinding should have set. This state is reached at around 2 to 3 years.
Grinding teeth in the child
From the age of three, grinding is pathological and no longer an acclimatization phase, as in babies with deciduous teeth or later with mixed teeth. In children, stress often plays a major role, on the other hand there are also patients who crunch without an ascertainable cause. Unfortunately, in many cases, patients with symptoms of this kind in childhood also show similar symptoms in adulthood. So far, no scientific explanation can be found for the fact that adults tend to crunch more if they have already done so in childhood.
Furthermore, grinding can also occur in the phase of tooth change between the sixth and twelfth year of life, as the correct bite is only set and the definitive tooth position is fine-tuned. During this period, primarily between the ages of ten and twelve, when all remaining permanent teeth erupt, children can grind until the tooth surfaces of all upper and lower teeth fit together perfectly. During this period, grinding is not pathological. Outside of the eruption phases of milk teeth or permanent teeth, a dentist should be consulted in the event of grinding in order to treat these complaints.
Cost of a rail
The rail is usually completely free of charge, since the health insurance company pays the costs for the rail every 2 years. With private insurance, depending on the individual contract, it depends on whether and to what extent the costs for splint therapy are reimbursed. The laboratory costs for the rails are around 300-400 euros.
forecast
After eliminating the disruptive factors, the prognosis is good.
Summary
As with adults, nighttime can also occur with children Grinding teeth occur. In older children and adolescents, the causes are mostly in uncontrolled stress, which is discharged through grinding, or in misaligned teeth. In children up to 3 years of age, grinding is a completely natural process and is used to grind the erupting milk teeth. Therapy is not necessary. In older children and adolescents, the therapy consists in eliminating the stress factors or the positional anomalies of the teeth.
