(Teeth Grinding)
Definition and consequences
neurotransmitters, such as dopamine, is less clear Prepared for the CSS by:
than originally suggested. Antidepressants such as Gilles Lavigne, DMD,MSc, FRCD(c)
Sleep Bruxism (SB) has been described as the serotonin selective reuptake inhibitors or SSRIs (e.g. gnashing or grinding of the teeth during sleep. It is Prozac, Paxil, Zoloft) are known to exacerbate Professor of Dentistry and Psychiatry,
l'Universite de Montreal
consequences of SB are tooth destruction, In the past, dental occlusion (bad tooth contact) was (temporomandibular joint, TMJ) pain, plus disruption seen as a major factor in SB. Now, its role is less of family sleep by the strident noise induced by tooth prominent in the literature and is more related to Although no genetic marker has been found, in monozygotic twins SB is highly prevalent. Moreover, Prevalence
SB persists in 86% of twins in adulthood in comparison to 35% in non-twins. SB is reported by 8% of the adult population and close to 14% of children have been reported by their parents to grind their teeth a few times per week. A clear decline of SB is noted with age. In teenagers Management
the prevalence is 8% declining to 3% in those persons 60 years of age and older. Following the exclusion of medical problems the management of SB includes behavioral-cognitive strategies (e.g., relaxation), physiotherapy and oral splint (hard acrylic or soft rubber device) to prevent Recognition and diagnosis
tooth damage. Among advice given to patients, we also recommend: The diagnosis is based on a history of hearing tooth grinding by a family member or friend, the presence of tooth wear/damage, orofacial-joint pain and/or fatigue upon awakening, increased jaw muscle size (hypertrophy). A final diagnosis for severe and persistent cases is possible only through an overnight •Avoid sleeping on your back (supine position) sleep study (polysomnography) with a video recording since SB has to be distinguished from rapid •No noise or computer or TV in the bedroom muscle twitches in the jaw area (oromandibular myoclonies), tooth tapping, grunting, sleep talking, snoring, etc. Home audio-video recording is an alternative to identify the presence or absence of grinding sounds. In this situation a standard video Robaxacet, Tylenol Muscle or Flexeril (prescription recording at low speed is used along with a black required) could be administered at bedtime to decrease muscle pain and increase relaxation during periods of intense SB. In more severe cases, we use Rivotril (Clonazepam: prescription required) on a short-term basis. Botox injections, a muscle contraction blocker, have been used with some SB Causes and pathophysiology
patients but the lack of controlled studies reduces our enthusiasm for it’s use as a safe and effective The suggested causes of SB includes anxiety, very brief, intense awakenings from sleep, sensitivity to brain chemicals (neurotransmitters such as dopamine If teeth of SB patients are sensitive to cold, and serotonin) but so far very little comprehensive application of Gel Kam (available at the drug store) explanation is available. Anxiety is seen as a trigger


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