Grinding or clenching and locking of the teeth (Bruxism) are involuntary, unconscious actions of the chewing muscles in a cyclical manner. These phenomena can occur during sleep or while awake. Bruxism during wakefulness is manifested mainly in the form of teeth clenching and jaw locking, but not teeth grinding. Sleep bruxism is often manifested by teeth grinding, it is an involuntary action that can be caused by unspecified reasons. It may be caused as a side effect of certain medications, drugs, various neurological diseases, PTSD, and various stress and anxiety situations. Arousal bruxism is often considered a response to stress or concentration situations.
The most common damages of bruxism are grinding of teeth in a way that causes fractures in the crowns or roots of the teeth, failure of restorations (fillings), creation of cracks in the teeth, loosening of crowns, and failure of implants. In addition, there may be an injury to the mucous membranes of the cheek, tongue, and lips. The abnormal muscle activity can also cause facial pain and headaches. In sleep bruxism facial pain and headaches in the morning upon awakening due to increased muscle activity are common. Pain in these areas at the end of the day raises the suspicion of bruxism while awake.
The treatment:
Before treating sleep bruxism, it is necessary to rule out that the person does not suffer from an obstructive sleep disorder (Sleep Apnea) because the body sometimes uses bruxism as a means to open the airways. Treatment of apnea greatly relieves teeth grinding, but on the other hand, it was also found that treatment of bruxism for those patients using an occlusive splint ("night splint") increases the number of breath pauses per hour. Therefore, in some cases, a referral to another specialist such as a sleep specialist or gastroenterologist will be required before treatment.
If it is decided that it can be treated, the treatment may include the installation of a night splint, medication, or Botox (botulinum toxin) injections into the chewing muscles.
In the case of bruxism while awake, it is important to bring the phenomenon to the patient's awareness, in addition, here too there is efficacy for treatment using Botox (botulinum toxin) injections into the chewing muscles. Other treatments that are effective in the treatment of bruxism: are cognitive behavioral therapy (CBT), biofeedback therapy, mindfulness, or any stress management technique.
The treatment using botulinum toxin (Botox):
One of the main chewing muscles is the master muscle (stomach muscle), the muscle is responsible for chewing movements, lifting the lower jaw, and moving forward.
An injection of Botox into the master muscle weakens the muscle's ability to contract, thus preventing the erosion of the teeth and bringing significant relief to the resulting pain. The effect of the substance lasts between 3 and 6 months and later the muscle activity is gradually renewed.