Does a loved one grind his teeth in a dream? This is bruxism in adults – uncontrolled motor activity of the masticatory muscles, accompanied by clenching of the jaws with a characteristic sound.
Bruxism in adults as a psychosomatic phenomenon can be a consequence of stress, dysfunction of the nervous system or internal organs, dental anomalies, and unsuccessful prosthetics. Systematic seizures lead to abrasion, defects in tooth enamel, and cause sleep disorders. The doctor selects the treatment tactics individually, based on the factors that caused the disease.
It is necessary to distinguish nocturnal bruxism from daytime motor activity of the maxillofacial muscles – bruxiomania , which can be controlled. The causes of squeaking teeth in a dream are studied by several branches of medicine: neurology, psychology, dentistry.
The credibility of the widespread belief that gnashing of teeth is a consequence of helminthic invasion is in doubt. There is a theory that parasites can indirectly cause paroxysms of the masticatory muscles, since their presence in the body provokes a deficiency of B-group vitamins. Different clinical disciplines put forward the following versions of the etiology and pathogenesis of bruxism .
Violation of the functioning of the nervous system, its peripheral or central division. As a result, in addition to bruxism , motor and neurological pathologies such as tremor, epilepsy, Parkinson’s disease, enuresis , and sleep disorders develop .
Organic damage to the trigeminal nerve with subsequent tonic tension of the facial muscles can also cause uncontrolled strong compression of the jaws.
Bruxism in adults often develops against a background of nervous overstrain. Sometimes it is called “the disease of businessmen”, since this category of people often experiences exorbitant psycho-emotional stress.
Systematic stress, affective states, emotional distress also cause nocturnal spasms of the chewing muscles.
From the point of view of dentists, there are two categories of disease-provoking factors:
- The first is anomalies or dysfunction of the teeth (their absence or excessive number, malocclusion), as well as inflammation or deformation of the temporomandibular joints.
- The second group combines the negative consequences of treatment: incorrectly installed fillings, braces , poor-quality prosthetics.
According to osteopaths, teeth grinding in sleep is an attempt to restore the craniosacral rhythm or to unblock the cranial sutures from the neuromuscular system.
Such disorders in adults appear due to diseases of the musculoskeletal system (osteochondrosis of the spine in the cervical spine) or improperly installed dentures.
Other factors can also cause paroxysms of the masticatory muscles at night. There are the following probable causes of bruxism in middle and older patients:
- the presence of malignant or benign neoplasms in the central nervous system;
- prolonged smoking, alcohol abuse;
- pathology of the respiratory organs ( bruxism can be provoked by adenoids, runny nose, defects of the nasal septum);
- excessive consumption of coffee, strong tea, other tonic drinks;
- overeating, especially before bedtime;
- taking medications that stimulate the nervous system and muscle tone.
The phenomenon of bruxism in psychosomatics , a branch of medicine that studies the influence of personality traits on the development of somatic pathologies, is also being investigated . Encephalograms of patients reveal abnormalities in areas of the brain responsible for behavioral and emotional responses. It is generally accepted that people who are deprived of attention, suffering from a guilt complex, suspicious, envious, and also workaholics grit their teeth in a dream .
Despite the fact that the patient can wake up at night, he is not able to determine the reason for the awakening. Close people notice teeth grinding, especially if paroxysms happen regularly. The attacks are short-lived, lasting no more than 10 seconds. In parallel with grinding, clicking, an increase in pulse rate, a change in the respiratory rhythm (up to a short stop – apnea) can be observed.
Independently, the development of the disease can be judged by some indirect symptoms of bruxism . For example, in the morning, painful sensations may appear when the chewing muscles contract, facial myalgia. Headaches and toothaches, dizziness are noted.
Feeling tired, daytime sleepiness as a result of restless sleep is also characteristic . Episodic attacks do not negatively affect the condition of the dental apparatus or the whole organism. However, systematic prolonged grinding of teeth at night leads to negative consequences.
If pathological symptoms are rare, without causing unpleasant painful sensations in the morning, you do not need to see a doctor. Most likely, the reason is transient, so it does not need specialized treatment. Constant attacks lead to various, including long-term consequences of bruxism .
Usually there are dental problems of the following plan:
- pathologically fast abrasion of enamel and dentin, leading to a decrease in the height of the crown;
- cracks and chips on the hard surface of the tooth, up to a fracture of the neck or splitting off a significant part;
- hyperesthesia – increased susceptibility to high and low temperatures, chemical and mechanical stimuli;
- it is a consequence of bruxism and a wedge-shaped defect: in the cervical part of the crown, V-shaped notches are formed;
- loss or partial chips of fillings and restored parts of the tooth, damage to implants , breakage of dentures;
- trauma to adjacent tissues with the subsequent development of inflammatory processes (periodontitis and periodontal disease as a consequence of periodontal inflammation), loosening of the teeth, their loss.
In the long term, nocturnal motor activity of the masticatory muscles leads to their hypertrophy, limitation of the mobility of the lower jaw, dysfunction or damage to the TMJ (temporomandibular joints). Chronic pain appears in the TMJ, neck, shoulder joints.
Systematic damage to the mucous membranes of the oral cavity is fraught with fibromas, the formation of a serrated edge of the tongue, the appearance of lichen lichen, gingivitis. Non-healing ulcers and abrasions can form under removable dentures.
What kind of doctor is involved in identifying and treating bruxism ? For diagnostics and therapy, specialists of different profiles are involved, since it is possible to successfully get rid of nocturnal bruxism only by identifying its real cause.
Usually, the first call for help occurs when teeth are damaged. In this case, the dentist, based on subjective complaints, examination of the oral cavity, makes a preliminary diagnosis.
Additionally, objective studies are carried out using special mouth guards – brooks checkers . The patch made from an individual impression after night use is examined to identify occlusal obstacles, the degree of load on different parts of the jaw.
Pathological motor activity of the masticatory muscles is also determined during the study of their bioelectric activity (electromyography), polysomnography . A more thorough comprehensive examination requires determining the cause. At this stage, consultations of a neurologist, osteopath, psychologist, and other highly specialized specialists can be appointed.
After finding out the reason, the appropriate therapy is selected, sometimes including several methods. A good result is given by psychotherapeutic trainings to relieve stress and tension, taking muscle relaxants , and correcting bite. A positive effect is observed when using relaxing procedures, safe methods of treatment with folk remedies are allowed.
Since most uncontrolled teeth grinding is of psychogenic origin, psychotherapy is the most common treatment. Effective methods of cognitive- behavioral or biofeedback therapy are used.
Self-control and relaxation techniques, auto-training are also effective. Psychologist’s consultations are shown.
Drug treatment of bruxism is aimed mainly at eliminating the convulsive activity of the muscles of the masticatory apparatus. Most often assigned:
- Sedative tablets are psychotropic drugs , mainly benzodiazepines . Drugs in this group reduce the excitability of the nervous system without having a negative effect on the body.
- Muscle relaxants are medicines that relax different types of muscles, including the chewing muscles. Treatment with medicines of this type is symptomatic and has contraindications.
- Preparations with a high content of calcium, magnesium, multivitamin complexes. Ascorbic acid and B-group vitamins are of particular importance.
In order to relax the muscles of the jaws, injections of botulinum toxin , which is widely used in cosmetology, can be used . Botulinum toxin has a relatively stable and long-lasting effect. Re-introduction procedures are required every six months.
When the cause of the disease is anomalies in the development of the dental apparatus, the main treatment is carried out by an orthodontist or orthopedic dentist. To correct the occlusion, it is shown wearing braces , grinding, removing supernumerary teeth or replacing missing teeth with implants . The same specialists eliminate defects in treatment or prosthetics by replacing incorrectly installed fillings and prostheses.
The use of custom-made silicone onlays is designed to protect the teeth from further decay. It is not recommended to purchase standard products from pharmacies, since wearing them can significantly aggravate the situation. 4 types of mouthguards are used: day for bruxiomania , night for bruxism , fixing (on one or both jaws), and also resonating.
The latter option is indicated for the most severe forms of the disease, when there is a high risk of significant damage to the teeth or displacement of the head of the temporomandibular joint. Such a device reduces the intensity of muscle spasm. Mouthguards are considered the most effective means of preventing the effects of teeth grinding.
Care of pads consists in regular rinsing, cleaning the outer surface with toothpaste. It also requires systematic replacement as it wears out.
According to indications, conservative treatment of bruxism is also carried out using physiotherapeutic methods. Relaxing self-massage, regular warm baths in the evenings, setting of warming compresses on the jaw area before going to bed are shown.
With osteopathic etiology of the disease, therapeutic massage, manual therapy, and other procedures are indicated.
Traditional medicine recommends using herbal infusions with a slight sedative effect (chamomile, for example) throughout the day . You can use any potent drugs only with the permission of a doctor.
Sometimes applied kinesiology is used – a type of chiropractic that declares the relationship of muscle tone with the state of internal organs. From the point of view of official science, the method is ineffective and unscientific.
Forecast and prevention
Practice testifies to the ineffectiveness of self-medication, other attempts to cope with the disease without medical help. Over time, the problem is aggravated, causing a deterioration in general condition, sleep disturbances, and dental pathologies.
When adequate treatment is started early, it is possible to quickly cope with the manifestations and causes of the disease without negative consequences and complications.
Prevention of bruxism in adults consists in regular consultations with a dentist, timely elimination of anomalies, and treatment of injuries. A healthy lifestyle, which has a positive effect on the state of the nervous system, will help to avoid the development of pathology. It is required to give up such bad habits as smoking, alcohol abuse.
Neurological diseases must also be treated. It is useful to use relaxation techniques, soothing auto-trainings, relaxing self-massage.