This psychosomatic phenomenon can be the result of stress, dysfunction of the nervous system or internal organs, dental abnormalities, unsuccessful prosthetics. Systematic seizures lead to abrasion, defects in tooth enamel, and cause sleep disorders. The doctor selects the tactics of treatment individually, based on the factors causing the disease.
It is necessary to distinguish night bruxism from the daily motor activity of the maxillofacial muscles – bruxiomania, which can be controlled. The causes of tooth decay in a dream are studied by several branches of medicine: neurology, psychology, and dentistry.
The credibility of the widespread belief that tooth grit 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.
Impaired functioning of the nervous system, its peripheral or central section. As a result, in addition to bruxism, motor and neurological pathologies such as tremor, epilepsy, Parkinson’s disease, enuresis, and sleep disorders develop.
An organic lesion of the trigeminal nerve, followed by the tonic tension of the facial muscles, can also cause uncontrollable strong compression of the jaws.
Bruxism in adults often develops on the background of a nervous overstrain. Sometimes it is called “the illness of businessmen,” since this category of people often experiences exorbitant psycho-emotional stress.
Systematic stress, affective states, emotional distress also cause night spasms of the chewing muscles.
From the point of view of dentists, there are two categories of disease-triggering factors:
- The first is anomaly or dysfunction of the teeth (their absence or excessive amount, incorrect bite), as well as inflammation or deformity of the temporomandibular joints.
- In the second group, the negative effects of treatment are combined: improperly installed fillings, bracket systems, poor-quality prosthetics.
According to the version of osteopaths, teeth creaking in a dream are attempts to restore the craniosacral rhythm or unlock the cranial sutures from the neuromuscular system.
Such disorders in adults appear due to diseases of the musculoskeletal system (spinal osteochondrosis in the cervical spine) or improperly installed dentures.
Other factors can cause paroxysms of the chewing muscles at night. The following probable causes of bruxism in patients of middle and older age categories are distinguished:
- the presence of malignant or benign neoplasms in the central nervous system;
- prolonged smoking, alcohol abuse;
- pathologies of the respiratory organs (bruxism can provoke adenoids, runny nose, nasal septum defects);
- immoderate 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 is also investigated – the direction of medicine, which studies the influence of personality traits on the development of somatic pathologies. Encephalograms of patients reveal abnormalities in the areas of the brain responsible for behavioral and emotional reactions. It is believed that people who are deprived of attention, who suffer from a guilt complex, are suspicious, envious, and also workaholics are gnashing their teeth in a dream.
Although the patient may wake up at night, he is unable to determine the cause of the awakening. Gnawing teeth are noticed by close people, especially if paroxysms happen regularly. Attacks are short-lived, lasting no more than 10 seconds. In parallel with the grinding, clicking, an increase in the pulse, a change in the respiratory rhythm (up to a short stop – apnea) can be observed.
Independently about the development of the disease can be judged by some indirect symptoms of bruxism. For example, painful sensations may appear in the morning with contraction of the masticatory muscles, facial myalgia. There are headaches and toothaches, dizziness.
Characteristic are also a feeling of fatigue, daytime sleepiness as a result of restless sleep. Episodic attacks do not adversely affect the condition of the dental apparatus or the whole organism. However, the systematic prolonged gnashing of teeth at night leads to negative consequences.
If pathological symptoms are rarely observed, without causing unpleasant painful sensations in the morning, there is no need to consult a doctor. Most likely, the cause is of a transient nature, so it does not need specialized treatment. Constant seizures lead to various, including remote, effects of bruxism.
Usually there are dental problems of the following plan:
- pathologically fast abrasion of enamel and dentin, leading to a decrease in crown height;
- cracks and chips on the hard surface of the tooth, up to a fracture of the neck or chipping a significant part;
- hyperesthesia – increased susceptibility to high and low temperatures, chemical and mechanical stimuli;
- is a consequence of bruxism and a wedge-shaped defect: in the neck part of the crown V-shaped grooves are formed;
- loss or partial chipping of fillings and restored parts of the tooth, damage to implants, failure of prostheses;
- injuries of adjacent tissues with the subsequent development of inflammatory processes (periodontitis and periodontal disease due to periodontal inflammation), teeth loosening, their prolapse.
In the long term, the night motor activity of the masticatory muscles leads to their hypertrophy, restriction of mobility of the lower jaw, dysfunction or damage to the temporomandibular joint (temporomandibular joints). Chronic pain in the temporomandibular joint, neck, shoulder joints.
Systematic damage to the mucous membranes of the oral cavity is fraught with fibromas, the formation of the dentate edge of the tongue, the occurrence of lichen edema, gingivitis. Under removable dentures can form non-healing ulcers, abrasions.
What doctor deals with the identification and treatment of bruxism? Specialists of different profiles are involved in diagnostics and therapy, since one can successfully get rid of night bruxism only by identifying its real cause.
Usually the first call for help occurs when the appearance of damage to the teeth. In this case, the dentist, on the basis of subjective complaints, examination of the oral cavity, makes a preliminary diagnosis.
In addition, objective studies are carried out with the help of special cap-brooks checkers. An overlay made on an individual impression after nighttime use is examined to identify occlusive obstacles and the degree of stress on different parts of the jaw.
Pathological motor activity of the masticatory muscles is also determined during the study of their bioelectric activity (electromyography) and polysomnography. A more thorough comprehensive survey requires determining the cause. At this stage, consultations of a neurologist, osteopath, psychologist, and other narrow specialists can be appointed.
After finding out the cause, the appropriate therapy is selected, sometimes including several techniques. Good results are given by psychotherapeutic trainings for relieving stress and tension, taking muscle relaxants, correcting bite. A positive effect is observed when using relaxing procedures, safe methods of treatment with folk remedies are allowed.
Since, in most cases, uncontrolled teeth grit is of psychogenic origin, psychotherapy sessions are the most common treatment method. Apply effective methods of cognitive-behavioral or BOS-therapy.
Self-control and relaxation techniques, auto-training are also effective. Showing counseling psychologist.
Drug treatment of bruxism is mainly aimed at eliminating the convulsive activity of the chewing apparatus musculature. Most commonly appointed:
- Sedative tablets are psychotropic, mainly benzodiazepine. Preparations of this group reduce the excitability of the nervous system without adversely affecting the body.
- Muscle relaxants are medicines that relax various types of musculature, including chewing. Treatment with drugs of this type is symptomatic, has contraindications.
- Preparations with a high content of calcium, magnesium, multivitamin complexes. Ascorbic acid and B-group vitamins are of particular importance.
Botulinum toxin injections, widely used in cosmetology, can be used to relax the muscles of the jaws. Botulinum toxin gives a relatively lasting and long lasting effect. Repeated administration procedures are required every six months.
When malformations of the dental apparatus become the cause of the disease, the main treatment is carried out by an orthodontist or an orthopedic dentist. To correct the bite is shown wearing braces, grinding, removal of supernumerary or replacement of missing teeth with implants. The same specialists eliminate defects in treatment or prosthetics, replacing improperly installed fillings and prostheses.
The use of silicone lining, made on an individual impression, is designed to protect the teeth from further destruction. It is not recommended to buy standard products in pharmacies, since wearing them can significantly aggravate the situation. Four types of caps are used: daytime during brooksiomania, nighttime during bruxism, fixing (on one or both jaws), as well as 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. Kappas are considered the most effective means of preventing the consequences of gnashing of teeth.
The care of the linings consists in regular washing and cleaning the outer surface with toothpaste. Also requires systematic replacement as wear.
According to indications, conservative treatment of bruxism is also carried out by physiotherapeutic methods. Showing a relaxing self-massage, regular warm baths in the evenings, setting warming compresses on the jaw area before bedtime.
When osteopathic etiology of the disease shows therapeutic massage, manual therapy, other procedures.
Traditional medicine recommends that during the day to use herbal infusions with a slight sedative effect (chamomile, for example). It is possible to use any potent drugs only with the permission of the 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 technique is ineffective and anti-scientific.
Prognosis and prevention
Practice shows the ineffectiveness of self-treatment, other attempts to cope with the disease without medical assistance. Over time, the problem is exacerbated, causing deterioration of the general condition, sleep disturbances, and dental pathologies.
When an adequate treatment is started early, it is possible to quickly enough cope with the manifestations and cause of the disease without negative consequences and complications.
Prevention of bruxism in adults consists of regular dental consultations, timely elimination of anomalies, and treatment of injuries. To avoid the development of pathology will help a healthy lifestyle, positively affecting the state of the nervous system. It is required to give up such bad habits as smoking, alcohol abuse.
Necessarily also need to treat neurological diseases. It is useful to use relaxation techniques, soothing auto-training, relaxing self-massage.