Bruxism (medical 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 mediated disorder.

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.