With the technical-scientific progress and the migration of people to cities increasing the number of people per square meter, man is exposed to more and more stressors (stress-causing agents). High levels of these may lead to various changes in physical health (back pain, muscle spasms, headaches, erectile dysfunction, muscle aches, etc.), psychic (anger, anxiety, depression, fatigue, concentration problems etc); behavioral (abuse of alcohol, tobacco, drugs, etc.) of humans. One of the effects of stress, conditioned by other predisposing factors, also has an effect on the oral cavity through Bruxism.
The oral cavity performs in addition to the masticatory, phonetic and physiognomic functions and the expressive-emotional function.
In the case of patients with bruxism, the oral cavity is used as a means of releasing stressful or stressful mental states from individual emotional manifestations of psychic or physical origin.
Bruxism, commonly referred to as “gnashing of teeth”, is a form of parafunction (the use of teeth for other activities than the physiological mastication) of the dento-maxillary apparatus caused by the hyperactivity of the masticatory muscles, affecting the morphology of dental arches, marginal periodontal and temporomandibular joints.
Bruxism is present in children with deciduous (temporary) or mixed teeth, as well as in adults.
For children, it is more common until the age of 12 and is not accompanied by pathological changes in the dento-maxillary apparatus, but there are also situations in which it gets dysfunctional forms and requires the dentist’s intervention to remove or relieve it.
Most bruxomenos are unaware of the presence of pathology.
Depending on some differences in clinical manifestations, bruxism may be: nocturnal, diurnal, centric and eccentric.
The general clinical manifestations of bruxism are:
1. The teeth of the teeth
– is a characteristic noise and is the first sign of bruxism that can alert the patient or his or her relatives.
– the noise amplitude is considered to be directly proportional to the muscle contraction force and the number of tooth pairs performing occlusion reports.
– to show at night (during sleep) or day (during periods of maximum mental or physical stress).
– is the major sign of bruxism;
– it leads to the removal of the occlusal relief, the decrease of the coronary height, the enlargement and the enlargement of the occlusal surfaces of the posterior teeth (fig. 2), in some cases the whole crown of the tooth can be destroyed and it can be associated with the bloating of the alveolar processes.
– the presence of characteristic non-carious cervical lesions (fig. 1).
– cracks and dental fractures can occur without any trauma of a past.
3. Periodontal changes
– The clinic is in the form of gingival retraction associated with alveolar atrophy and dental mobility. (Figure 3)
4.Meaning of muscles
– Hypertrophy and hypotonia of masticatory muscles, especially masseter, are associated with their fatigue and pain that patients perceive when they wake up or the early hours of the morning.
– Pain can be felt as an embarrassment, tension, most common discomfort with masseteric localization, and sometimes associated with difficulty opening the mouth that disappears during the day.
5. Loss of soft oral tissues
– Bone soft tissue damage occurs, usually located on the jaw (cheek) mucosa at the level of the occlusion plane.
6. Fractures and decays of prosthetic restorations
7.Modification of the jaw bone
– Bone remodeling is manifested by the presence of exostosis on the vestibules of the alveolar processes.
In order to increase the success rate of treatment, it is necessary for the patient to be aware of the presence of the condition and to determine the moments of maximal manifestation.
The treatment of bruxism is long-lasting and the beginning focuses on managing the daily behavior of the patient by controlling stress, determining and removing / reducing in agreement with the patient some possible excitatory factors such as: excessive consumption of alcohol, tobacco, coffee, overfeeding, etc.
Depending on the situation, antidepressant, anxiolytic, miorelaxant and anti-inflammatory medication may be prescribed.
The essential element in the treatment of Bruxism is the occlusal balancing, it determines the decrease of hyperactivity of the masticatory muscles and the obtaining of as many occlusal contacts of equal intensity