What's the treatment for bruxism?
The goal of treatment is to prevent permanent damage to your teeth and reduce pain caused by bruxism. Treatment for bruxism varies depending on the cause. Ongoing management of bruxism is based on prevention of the abrasion of tooth surfaces by the wearing of an acrylic dental guard, created to the shape of the individual's upper teeth from a bite mould.
This requires trips to the dentist for measuring and fitting. Alongside this full width guard, smaller and alternative shapes can be obtained, some with proprietary names.
If a tense jaw is experienced during wakefulness, some sufferers find it helpful to gently press their jaws open with fingertip pressure, to relax the affected muscles much as one would treat a leg cramp, but in this case, it is important to take care not to overextend the jaw joint. Though, presently, there is no cure available for bruxers, it may be found beneficial to work at reducing stress and anxiety before bedtime, by a winding-down activity such as massage, meditation or reading, and eating early enough to ensure a fairly empty stomach at bedtime may also help.
To prevent damage to the teeth, mouth guards or appliances (splints) have been used since the 1930's to treat teeth grinding, clenching, and TMJ disorders. A splint may help protect the teeth from the pressure of clenching. It may also actually help reduce clenching behaviors, but some people find that it makes their clenching worse. In others, the symptoms go away as long as they use the splint, but pain returns when they stop or the splint loses its effectiveness over time.
There are many different types of splints. Some fit over the top of the teeth, some on the bottom. They may be designed to keep your jaw in a more relaxed position or provide some other function. If one type doesn't work, another may. For example, a splint called the NTI-tss fits over just the front teeth. The idea is to keep all of your back teeth (molars) completely separated, under the theory that most clenching is done on these back teeth. With the NTI, the only contact is between the splint and a bottom front tooth.
As a next phase after splint therapy, orthodontic adjustment of the bite pattern may be beneficial for some people. Surgery should be considered a last resort.
Finally, there have been numerous approaches to try to help people unlearn their clenching behaviors. These are more successful for daytime clenching, since nighttime clenching is cannot be consciously stopped. In some people, just relaxing and modifying daytime behavior is enough to reduce nighttime bruxism. Methods to directly modify nighttime clenching have not been well studied. They include various biofeedback devices, self hypnosis, and other alternative therapies. |