Diagnosis of bruxism or teeth grinding

The local origin or gnashing of teeth is due to periodontal disease and periodontal pockets and occlusal disharmony: with the teeth worn away by contact and the damaging “knocks” which are repeated tooth contacts being made on surfaces of the teeth.

Emotional strain is the most common cause of bruxism, stress, in a child and adult, or states of anxiety attacks and deep rooted stress. The bruxism is often not noticed by patients and the dentist is the first to detect it and observe the excessive wear on the teeth (facets) in functional areas and moderate erosion in areas that are not functional, widening areas and occlusal reduction the vertical dimension of the face, sometimes family members are put on alert because of the patient becomes quiet and the grinding noise becomes a nuisance.

Initially the patients “play” with the tooth contact without force or contraction, but under a state of emotional stress produces a greater pressure surpassing the threshold of the periodontal receptors of pressure and the patient is no longer conscious and muscles and not relaxed.

It is difficult to obtain a diagnosis without questioning a witness if the patient is unaware of the problem and seeking help from relatives to verify the situation, they are required to sleep during the helper’s attempt to open his mouth taking the index finger and thumb and try to separate the teeth, in normal resting mouth they will open successfully, in the opposite case, a state of tension, it will become difficult to separate them.

According to their aggressiveness and the establishment in the patient, better diagnosis and treatment can be classified as habits (bruxism in any form, finger sucking, lip or cheek and onicofagia) as follows:

* Grade I The presentation is not aggressive, their reproduction is for a short period of time, sometimes an occasional, though the patient may be unconscious, is reversible and that appears and disappears by itself, can disappear when the subject makes it conscious, may be subject to local factors within the mouth, which when detected and removed promptly allow the prevention and elimination of it. Anxiety may be absent in the patient.

Grade II *  The anxiety level is already present, the reproduction is subject to the enabling factors, presentation to the patient is unconscious and disappears when the subject becomes aware, at this stage lesions may be present dento-facial structures in which requires a comprehensive treatment to ensure their elimination. The habit may be reversible grade II, if not treated it can develop into a habit Grade III.

* Grade III The reproduction is constant within the family environment and social inclusion of the patient. The presentation is well established and strengthened, is too irresistible for the subject that suffers from even being aware. Lesions in the dentofacial structures are of considerable magnitude and in some cases the injuries are permanent. The habit is mighty difficult to use and results of treatment are unsatisfactory, they require more attention and dedication in developing techniques for the dental implements.

The bricomania or bruxism affects children and adults and both sexes equally although the most common age of onset is between 17 and 20 years, and spontaneous remission is often produced at the age of 40 years in cases of chronic bruxism, although it may disappear by itself at any time of life, this is attributed to the fact that bruxism was not well established.

The gender distribution appears to be similar. The diurnal bruxism often gnashed that tight, the night bruxism can be both ways: at any time of day, whether for work or any other cause, has taken the habit of squeezing with the teeth at the same time.