Bruxism (Teeth Clenching or Grinding) - Bruxism (Teeth Grinding)

Bruxism (Teeth Clenching or Grinding)
Advice, Links, Resources
February 10, 2007

This hypertext provides a literature review, internet and library resources, and practical advice for bruxers (teeth clenchers or grinders) and for dentists, physicians, and other clinicians concerned with the treatment of bruxism. Clinicians may also wish to consult my When the splint fails: non-traditional approaches to the treatment of bruxism (an article in The Orthodontic Cyberjournal ), and, offline, a similar review in the Journal of Oral Science.

You may find out more about me (Dr. Moti NissaniÛthe writer of these lines) by visiting my internet homepage or looking up my resume. Unfortunately, owing to a shift in my research interests, frequent field work in places where I have no ready access to the internet, and the great volume of mail I receive on a daily basis, I am unable to provide bruxism-related advice or therapy.

Please bear in mind that the recommendations below are based on my own experiences and interpretations of the extensive bruxism literature. Needless to say, my efforts to portray an accurate picture may have failed. I may have, for instance, overlooked or misinterpreted some critical research. Moreover, I can only update this page once every two years or so. So the material below should be read critically and supplemented by these readings and others.

All forms of bruxism entail forceful contact between the biting surfaces of the upper and lower teeth. In grinding and tapping this contact involves movements of the lower jaw and unpleasant sounds which can often awaken housemates. Click here to hear the grinding of one patient (who has been grinding her front teeth, some 12 minutes a night, for the past 50 years). Clenching (or clamping), on the other hand, involves inaudible, sustained, forceful tooth contact unaccompanied by significant mandibular movements. Although the two conditions are often grouped together or not even distinguished in the professional and lay literature, they may actually be quite distinct, with different etiologies, symptoms, and consequences.

Educate Yourself. The first step for both clinicians and bruxers involves education. Although you may not become an expert, here even a little knowledge is a good thing. You may wish to begin with my Definition of Bruxism, then read about the Incidence of Bruxism. It is particularly important for both clinicians and patients to become fully aware of the Effects of Chronic Bruxism. Among other things, bruxism may cause severe tooth damage, headaches, and hearing loss. It may (or may not) lead to temporomandibular disorders (TMDs, also known as temporomandibular joint [TMJ] syndrome)Ûa condition which can, according to one expert, "devastate its victim" (Goldman, 1992, p. 191; see also Reynolds, 1994).

Other useful links are the Online Sleep Disorders Guide and bruxism guide. As well, the hypertext you are reading offers the following links:

What is Bruxism?
Incidence of Bruxism
Symptoms, Signs, and Consequences of Bruxism
Traditional (but Fairly Ineffective) Treatment Approaches to Bruxism
A Taste-Based Approach to the Prevention of Bruxism (an article from the journal Applied Psychophysiology and Biofeedback)
Books and Articles about Bruxism
A (badly-translated) Spanish version of this page (Espa“ol? Haga Clic AquÃ o AquÃ, por favor)
One convenient way of approaching the professional literature is PubMed, a database which you may be able to access at no cost from your home or the nearest public or academic library. Once you are there, type in a term (such as bruxism), select other preferences, and click go. You now have the references to that term. To see summaries, choose the drop-down Abstracts (not summaries), click display, and you'll get summaries of most scholarly manuscripts on the subject. Similarly, you can type the name of a bruxism specialist (e.g., Glaros) to read summaries of his/her medically-related articles.

In their professional writings (but not, one hopes, in their personal lives), researchers are required to use jargon-filled, technical language. Such language has something to recommend it, but it needlessly renders the scientific literature inaccessible to most people. So, when you start looking up articles in PubMed and in a dental library, you may wish to consult a glossary of medical and dental terms. Such glossaries can be found in most medical and dental libraries. Simpler versions are also available online (cf. The On-line Medical Dictionary).

Another interesting online source is US Patent Full-Text Database Boolean Search, which provides un-copyrighted full texts and images of all patents awarded since 1976. But be careful: the main criterion for awarding patents is novelty, not effectiveness!

If you want to consult the original literature, you may wish to visit the nearest dental, and perhaps also medical, libraries. If it's your first visit to an academic library, the reference librarian will show you how to navigate that system. You can then look up the references you identified in your Medline search and elsewhere.

However, the number of articles on the subject is enormous; besides, many are either outdated or of little scientific or practical value. Also, Medline at the moment doesn't include the best and most accessible general source: chapters in books on sleep disorders, dentistry, or clinical psychology. My bruxism bibliography may help your library self-education program by supplementing Medline and other useful databases.

Search engines such as Google, Alta Vista,or Vivisimo are becoming increasingly important in clinical research. It used to be said that the internet, like the Platte River, is one-mile wide and one-foot deep. But this is no longer true. Governments, research institutions, and academics increasingly place their best materials online. The trick here is to separate wheat from chaff, using common sense and intuition. For example, all things considered, a government or a university source (with the endings .edu or .gov) is more trustworthy than a private (.com) source. Likewise, an internet copy of an article that appeared first in a refereed professional journal should be taken more seriously than most commercial, profit-driven, claims.

A couple of hints may facilitate your online search. If you are looking for a complex term like teeth grinding in a search engine like Alta Vista, type "teeth grinding" (bracketed by quotation marks) and not just teeth grinding. Alta Vista will then only produce pages where the two words are joined. For a less stringent search, type +teeth +grinding (this will cull all the pages in which both words appear, even if they are separated by other words). Here is another useful example of how to limit your search. Go to www.alltheweb.com/advanced, and in the filters, choose:

Must include edu In the URL

This restricted search will only yield results posted by academic institutions. A similar option is available with the Google search engine..

But no one has developed yet a magic formula for detecting qualityÛthere is no substitute for critical thinking, no matter where you find yourself! To see one example of irresponsibility in action, click here.

Diagnosis of Bruxism. How can you tell a bruxing patient when you see one? How can you tell if you yourself suffer from chronic bruxism? Here, I'd like to draw your attention to a few non-invasive early detection procedures.

Unfortunately, because ...