term) is characterized by involuntary grinding of the teeth during
sleep or when awake. In severe cases, bruxism can cause teeth
destruction, making them useless. This can lead to jaw disorders
and even headaches, and affects children and adults. Predominantly
occurring in children, this should disappear during the adolescent
stages. However, bruxism may not be conspicuous enough, which
can lead to complications.
The exact cause and means of this condition is still unclear,
but consensus about bruxism is multifactorial in origin. Two
factors are involved in bruxism: peripheral or morphological
factors and psychological factors.
Several authors distinguish wakefulness bruxism and sleep related
bruxism to have different factors involved in their manifestations.
But, these two types of bruxism are hard to discern since articles
often see these according to its related involuntary acts.
Morphological factors involved in teeth grinding
Before, it was believed that teeth occlusion and alignment of
upper and lower jaw teeth are vital in the manifestation of bruxism
and persistence. These misfits cause oddity between teeth. However,
modern studies showed that occlusional or alignment defects are
not vital in bruxism. The focus is more on the nature of characteristics
that need coping than correcting defects. An author stated that
after occlusional adjustments has been made, bruxism will disappear
due to changes in grinding mechanisms.
In another perspective, one author believed that occlusional
defects may have an effect in initiating bruxism. However, there
are doubts regarding this conclusion, especially when introduction
of artificial occlusion studied reduces activity in the masticatory
muscle involvement during sleep. Other advanced studies results
shows removal of occlusional defects and alignment of flaws are
ineffective towards bruxism. In addition, research shows that
not every client with bruxism has occlusion or alignment defects,
and not every client with these defects have bruxism.
In modern perspective, occlusion anomalies may contribute to
the distribution of forces initiated by teeth grinding but has
no contribution to initiation of bruxism. Two studies concluded
that no definitive evidence was found in the anatomic role of
the oro-facial region in developing bruxism.
Psychological factors involved in teeth grinding
Studies have shown that there is an increasing pathopsychological
involvement in initiating bruxism. This condition is interlinked
with sleep disorders, altered brain chemistry, certain drugs
or illicit drugs, smoking, drinking, trauma and certain diseases.
Arousal response in sleep disorder has been investigated thoroughly.
Arousal response is characterized by a sudden change in sleep
depth wherein the person wakes up or goes from a deep sleep to
a light sleep. These abrupt changes can lead to heavy body movements,
increased heart rate, respiratory abnormalities and muscle hyperactivity.
Studies linked this with arousal response in about 86% of the
cases which opted bruxism as a reaction to arousal response.
Successive studies showed that some disturbances in the central
neurotransmitter might be interlinked with bruxism.
Amphetamine misuse can increase dopamine concentration in the
body that can lead to bruxism. Amphetamines like XTC are lately
connected with excessive wearing of tooth. Bruxism occurs twice
as much in smokers than in non-smokers because nicotine intake
stimulates dopamine activity. Excessive alcohol intake can also
cause bruxism. These information confirms bruxism as a centrally
Psychological factors involved in teeth grinding
Psychological factors in adults like anxiety, stress, tension,
anger suppression, frustration, aggressive behavior and hyperactivity
might be related with bruxism but is currently vague as to their
role in the development. One major obstacle with this is operationalizing
psychological factors. The complexity to research influencing
factors on inaccurately defined disorder such as bruxism can
be a hindrance. However, a wide number of studies by utilization
of questionnaires linked psychological factors to that of bruxism.
Research produced results that clients having bruxism are emotionally
unstable and likely to manifest other psychological abnormalities.
A conventional client with bruxism would be observed to be a
perfectionist and a higher tendency towards anger and aggression.
One vital study used 100 subjects and found no important correlation
between stress and bruxism as reported by the subjects. There
were only 8 subjects who reported bruxism associated with stress.
In a controlled polysomnographical study, only one person showed
anxiety correlating this with bruxism.
Research results exhibited psychological factors contributed
bruxism development is still unclear. If stress and other psychological
factors contributed to bruxism, then it is considerably less
than what was expected.