What is Bruxism?
Bruxism is an issue that affects over 80% of the population at some stage in their life. Bruxism is the medical term for grinding or clenching teeth and jaw. If left untreated, bruxism can lead to several side effects for the sufferer, which can be both painful and persistent.
Possible symptoms include:
-migraines and headaches upon waking,
-stiff neck and jaw,
-earache,
-poor sleep quality,
-teeth/jaw damage
Except for the latter, there is little that implies bruxism could be at the root of the problem, which is often why it remains heavily overlooked and underdiagnosed in the UK.
What are the causes?
Why bruxism occurs is not always clear, though many contributing factors could suggest why a patient may be clenching or grinding.
The bruxism organisation http://bruxism.org.uk/ suggests:
1. Stress - The highest cause of bruxism, most sufferers of stress and anxiety are often unaware that they are bruxing. These conditions, whether job or lifestyle related, can often lead to disrupted sleep patterns and restlessness.
2. Lifestyle - Substances such as tobacco, caffeine and alcohol have all been linked as co-factors of bruxism. Known to affect sleep, bruxism rates are significantly higher for individuals who use these psychoactive substances.
3. Sleep disorders - Snorers and those suffering from obstructive sleep apnea (OSA) or sleep paralysis are more likely to suffer bruxism. OSA seems to be the highest risk factor, as snoring and gasping can result in clenching and grinding.
How is it diagnosed?
A general lack of awareness amongst the public, and the wide array of symptoms, means that it is common for those exhibiting signs to consult their GP for advice without considering their dentist. Typically, this leads to ineffective treatments that don't stop the pain from occurring. Habitual bruxing will affect the
physical appearance of the teeth, with worn-down incisors often present. If a patient expresses symptoms of bruxism, it is important to check for obvious dental signs, including tooth surface loss or cracked and broken teeth. This should be closely monitored at each check-up. In addition to dental issues, bruxism can cause muscular pain in the head and neck and abnormalities in jaw mobility. It can also be a symptom of other conditions, including Myofascial Pain Syndrome. Once correctly diagnosed, there are various treatment options for patients to take.
What treatments are available?
Due to a high percentage of cases being caused by stress and anxiety, behavioural therapy may play an essential role for some sufferers. Other treatment options include muscle relaxants as well as medications. However, an occlusal splint may be the only viable option for habitual bruxers. Several splints and mouthguards are available, including soft bite-raising appliances, nightguards, and the SCi splint.
What is an SCi?
An SCi is an occlusal splint placed over the upper or lower front teeth to reduce the parafunctional intensity of the temporalis, masseters and lateral pterygoids, eliminating posterior and canine contact. Two versions of the SCi occlusal splint are available: Chairside and Lab-made, which are both designed and manufactured for you in surgery. The SCi Chairside kits contain all you need for immediate fitting and include 5 pre-formed splint matrixes. There are 5 kits to choose from: Starter, IGR Reduced Vertical, Increased Vertical, Daytime and Universal. The SCi+ (lab-made) reduces chair time and is made exclusively in our laboratory by our skilled technicians. The device is made to the patient's specification, increasing retention with an entire arch or retaining maximum comfort with the traditional partial arch design. There are several SCi+ variations available, and we can also build the discluding element into patients' retainers.
What evidence is there?
Whilst occlusal splints are often a preferred treatment choice for many, there is a wide variety available, with some better than others. Off-the-shelf options offer a more cost-effective solution for sufferers but are often ill-fitting compared to those made by a dentist and usually result in low compliance and little impact.
In a study by Okeson (Academia), it was found that rigid splints significantly reduced muscle activity in 80% of participants, whilst soft guards significantly increased activity in 50% (1987). The relaxation by altering the force SCi was developed to reduce bruxing- providing heightened muscle vectures (vectures appears as a spelling mistake, but I don't know what it's supposed to be to rectify it), reducing EMG levels by as much as 80%. This treatment is not a cure for TMD, but there are significantly reduced symptoms and no better method on the market to switch off chronic bruxing.