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Occlusion and Bruxism

What is Occlusion?

Teeth that “fit together” badly, teeth grinding, or jaw clenching are problems that affect many people and can damage the teeth and general health.

Occlusion establishes the functional connection between the teeth, gums, temporomandibular joint and other components of the oral cavity. Therefore, it is also the area of dentistry that diagnoses, prevents and treats problems related to malocclusion – when the teeth fit together incorrectly when closing the mouth – and temporomandibular dysfunctions – problems with the jaw joint.

What is Bruxism?

Bruxism is a disorder that can be detected by signs such as teeth grinding, clenching of the chewing muscles, clenching of the teeth, and cheek or tongue biting, both during the day and at night during sleep.

Other associated symptoms may range from:

  • Worn, chipped or broken teeth;
  • Pain associated with the muscles on the face or in the temporomandibular joint (TMJ) – the place where the temporal bone articulates with the jaw (lower jaw) and which enables several movements, such as opening and closing the mouth to be performed;
  • Tension in the face and neck when waking up or at the end of the day;
  • Tooth sensitivity;
  • Headaches;
  • Cracking or grinding of the temporomandibular joint;
  • Blockage or difficulty in opening or closing the mouth;
  • Marks on the tongue (jagged tongue);
  • Marks on the inside of the cheek (alba line).

The connection between Bruxism and an anxious personality is becoming increasingly common. There is also a pattern that associates people who are focused, perfectionists or have a high level of professional, personal or emotional pressure with the appearance of the signs and symptoms of Bruxism.

 

The temporomandibular dysfunction

Temporomandibular dysfunction refers to changes in the temporomandibular joint (TMJ) and the masticatory muscles. The main reason for its appearance is the lack of lubrication in the TMJ, caused by excessive tension in the muscle groups that control chewing, swallowing and speaking. In these cases, Bruxism is one of the main factors that trigger, aggravate and make the temporomandibular dysfunction endure.

But the root cause is not always clear, and, in many cases, temporomandibular dysfunction can have its origin in several factors, such as trauma to the jaw, head and neck. Other systemic conditions can also have an influence, such as rheumatoid arthritis, fibromyalgia, irritable bowel syndrome or any situation that causes chronic pain.

Also, stress, focus, anxiety, genetic or hormonal conditions can be considered risk factors for bruising and temporomandibular dysfunction.

The symptoms of temporomandibular dysfunction

There are several signs and symptoms that often relate to those caused by bruxism and to which you should be attentive, namely:

  • Jaw discomfort or pain, most prevalently on waking or at the end of the day, or difficulty in chewing;
  • Headaches and/or pain behind the eyes, face, shoulders, neck, and back – here, there is a need for medical evaluation if the pain appears suddenly and in a very intense way;
  • Pain or ringing in the ears that is not caused by an infection of the inner ear canal and/or feeling of a blocked ear;
  • Snapping or grinding in the jaw (gritty feeling);
  • Temporary or permanent blockage in opening or closing the mouth and/or limited movement of the mouth;
  • Clenching or grinding of teeth;
  • Changes in the teeth’s proper position.

Education, behavioural therapy and pharmacological therapy

Analysing the cause of temporomandibular dysfunction makes it possible to explain how to control the causes that may contribute to perpetuating the dysfunction.

Subsequently, behavioural therapy is initiated, which, today, is one of the most effective tools for treating this dysfunction.

 

Physiotherapy

Physiotherapy shows excellent results in the treatment of temporomandibular dysfunction, with a focus on manual therapy and behavioural therapy.

 

Occlusal tray

The occlusal tray is an intraoral device essential in occlusal rehabilitation, which alters the relationship between the maxilla and the mandible. It creates a change in position, not only muscular but also cognitive, which can improve the symptoms of temporomandibular dysfunction, pain and muscle fatigue, and mandibular movements and prevent dental wear.

 

Ideally, it is a rigid acrylic device, flat, with coverage on all teeth and is used on only one jaw (upper or lower).

 

Infiltrations

Infiltrations may be articular with the application of hyaluronic acid and are administered in the dental office. They are used in carefully selected cases when all conservative treatments have failed, where the joint has a degenerative pathology (bone wear) accompanied by pain and restricted mouth opening.

In cases of muscular pain, it is possible to apply infiltrations with an anaesthetic, reducing the pain level. In exceptional cases, infiltration can be carried out with botulinum toxin, which also helps to control pain.

This treatment is minimally invasive.

References

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