Bruxism is best defined as the involuntary, unconscious, and excessive grinding, tapping, or clenching of teeth. Estimates of the prevalence of bruxism range from 5-20% of the US population.
Potential Symptoms and Consequences of Bruxism
The bruxism habit is not life-threatening in any way. In its initial stages, because bruxism only involves minor symptoms and inconveniences, it is often ignored by both patients and clinicians. At a certain point, however, the symptoms begin to noticeably affect one’s quality of life. It is typically at this point that a patient starts looking for a cure. This delay is unfortunate, for by then the habit is ingrained and has already brought about irreversible losses, as seen in the following symptoms and consequences:
I. Sensitive, worn-out, decayed, fractured, loose, or missing teeth (McGuire and Nunn, 1996).
xxImage to the right: A normal complement of adult teeth (source: internet)
Breakdown of Tooth Enamel:
Grinding or clenching break down the enamel, sometimes, in long-term bruxers, reducing teeth to stumps. Instead of a white enamel cover, one often sees the more yellowish and softer dentin. The back teeth of some chronic bruxers often lose their cusps and natural contours, appearing instead flat, as if they had been worked over with a file or sandpaper. When anterior teeth are affected, their biting surfaces are damaged. As well, the absence of enamel makes it easier for bacteria to penetrate the softer part of the teeth and produce cavities. With time, the condition may lead to bridges, crowns, root canals, implants, partial dentures, and even complete dentures.
Tooth Restoration/Implants Required In Some Chronic Cases:
As long as bruxism continues, the situation keeps getting worse. Thus, “by 40 or 50 years of age, most bruxers . . . have worn their teeth to the degree that extensive tooth restorations must be performed” (Christensen, 1999). For example, implant complications are more likely in people who habitually clench or grind their teeth (Perl, 1994, Nishimura et al., 1997). In one study, more than 75% of observed implant fractures occurred in patients with signs and histories of chronic bruxism. Hence, in cases of untreatable severe bruxism, the use of implants is strongly counterindicated (Rangert et al., 1995.; reviewed by Nishimura et al., 1997).