Manifestations of temporomandibular joint problems are the major development in individuals with bruxism [7]. The condition presents with the following signs and symptoms:

• Grinding and clenching of the teeth, which becomes so noisy, that it can disturb and awaken sleep partner
• Increase in tooth sensitivity
• Headache that originates in the temporal region
• Development of indentations
• Jaw muscles become tight and tired
• Tooth enamel worn outs and the deep layers of the tooth are exposed
• Teeth become flattened and begin to chip or loosen [8]

• Pain

  Author bio Jamison Spencer, DMD, MS, is the director of the Craniofacial Pain Centers of Idaho and Colorado. His practices are limited to helping people with obstructive sleep apnea and TMJ/craniofacial pain disorders. [surgicalrestorative.com]

  However, it can cause permanent damage to the teeth and uncomfortable jaw pain, headaches, or ear pain. [medlineplus.gov]

  […] open your mouth wide, especially in the morning Long-lasting pain in the face Damaged teeth, broken dental fillings and injured gums Painful jaw joint Swelling (occasionally) on the side of your lower jaw caused by clenching. [colgate.com]

• Unconsciousness

  A Solid Solution How can you stop an unconscious habit? A thorough evaluation will allow us to check your teeth, tissues, and muscles. [kalinadds.com]

  In the condition of bruxism, the unconscious movement of muscles occurs repeatedly, and is rhythmic with bit forces lasting for a fraction of second, or in some cases lasting for 1 to 30 seconds. [symptoma.com]

  Tooth Grinding (Bruxism) Bruxism, also known as tooth grinding, is the medical term for clenching or grinding teeth. 25 million Americans unconsciously grind their teeth and/or clench their jaw, either while awake or during sleep. [somnomed.com]

  Bruxism, or the unconscious tendency to grind your teeth, can lead to severe dental damage, and you may not always be aware of the condition. [cedarwestdental.com]

• Inflammation

  Medication is not usually needed to treat bruxism but occasionally anti-inflammatory drugs may be necessary to relieve pain or inflammation around the jaw joint if the grinding is severe. [familydental.ie]

  Physical symptoms headaches earache tired jaws chronic facial pain facial myalgia (muscle pain) Oral symptoms worn, loose or fractured teeth sensitive teeth gum inflammation tongue indentations worn tooth enamel If one or more of these symptoms appear [sleepjunkies.com]

  Ibuprofen, or other Non-steroidal anti-inflammatory drugs (NSAIDs), may be suggested to reduce any pain or inflammation which may occur due to bruxism. [news-medical.net]

  This can lead to painful inflammation in the articular capsule and can inhibit swallowing and eating. [aafp.org]

• Underweight

  Naoki Toyama, Daisuke Ekuni, Ayano Taniguchi-Tabata, Kota Kataoka, Mayu Yamane-Takeuchi, Kohei Fujimori, Terumasa Kobayashi, Daiki Fukuhara, Koichiro Irie, Tetsuji Azuma, Yoshiaki Iwasaki and Manabu Morita, Awareness of Clenching and Underweight are Risk [doi.org]

• Snoring

  The literature shows that children who brux and snore are extremely likely to have sleep apnea. Snoring and bruxism in children are also linked to ADHD, enuresis, and poor school performance. [surgicalrestorative.com]

  CONCLUSION: Habitual snoring and sleep bruxism were commonly found in children attending paediatric clinics. Paediatricians should be aware of these problems and be prepared to deal with them. Habitual snoring and sleep bruxism were closely related. [ncbi.nlm.nih.gov]

  The termination of the apnoea event is often accompanied by a variety of mouth phenomena such as snoring, gasps, mumbling and tooth grinding. [bruxism.org.uk]

• Dysphagia

  […] together, such as a congenital form versus an acquired form of the same condition. psychogenic bruxism ( ICD-10-CM Diagnosis Code F45.8 Other somatoform disorders 2016 2017 2018 2019 Billable/Specific Code Applicable To Psychogenic dysmenorrhea Psychogenic dysphagia [icd10data.com]

  Symptoms include dysphagia, dysarthria, bruxism and tempomandibular joint subluxation. [doi.org]

  The investigators described one subject who experienced dysphagia as a side effect of the injections. [pocketdentistry.com]

  View Article PubMed Google Scholar Bogaardt HC, Grolman W, Fokkens WJ: The use of biofeedback in the treatment of chronic dysphagia in stroke patients. Folia Phoniatr Logop. 2009, 61: 200-205. 10.1159/000227997. [systematicreviewsjournal.biomedcentral.com]

• Nausea

  This damage may be long-term. 3 MDMA'S Effects on the User About 20 to 40 minutes after taking a tablet, the user experiences small rushes of exhilaration, often accompanied by nausea. [web.archive.org]

  Taking too much magnesium may even cause hypermagnesaemia, leading to nausea, vomiting, lethargy, and blockage of the bladder. As in the case of most drugs, dosage should be roughly determined by weight. [drnissani.net]

• Vomiting

  Taking too much magnesium may even cause hypermagnesaemia, leading to nausea, vomiting, lethargy, and blockage of the bladder. As in the case of most drugs, dosage should be roughly determined by weight. [drnissani.net]

  Another possible cause of tooth wear is acid erosion, which may occur in people who drink a lot of acidic liquids such as concentrated fruit juice, or in people who frequently vomit or regurgitate stomach acid, which itself can occur for various reasons [en.wikipedia.org]

• Hypertension

  Continue reading… Insomnia and poor sleep quality are hypertension risks When it comes to high blood pressure – or hypertension – there are many factors that come into play: Diet, weight, smoking and alcohol use can all be attributed to your rising blood [belmarrahealth.com]

  Statistically significant difference was obtained while comparing the two study groups based on the health parameters, namely hypertension, diabetes, and smoking habit. CONCLUSION: Success of dental implant is significantly affected by bruxism. [ncbi.nlm.nih.gov]

  Keywords : sleep, orofacial pain, sleep bruxism, sleep breathing disorders, sleep movement disorders, genetics, headache, hypertension, cardiovascular risk, thyroid disorders, temporomandibular disorders, xerostomia Important Note : All contributions [frontiersin.org]

  Comorbidities include obstructive sleep apnea, snoring, hypertension, headaches, temporomandibular dysfunction, encephalopathy, epilepsy, affective disorders, psychological stress, and anxiety. [medlink.com]

• Bruxism

  Bruxism: Grinding and gnashing of the teeth. Bruxism is due to clenching of the teeth other than in chewing and is associated with forceful lateral or protrusive jaw movements. This results in the grinding or rubbing together of the teeth. [medicinenet.com]

  There are 2 forms of bruxism: sleep bruxism and awake bruxism. Cause: The exact cause of bruxism is unknown. However, interplay of several factors, is known to trigger bouts of teeth clenching and grinding. [symptoma.com]

  The condition, known as bruxism, can be remedied with a nightguard. The Facts About Clenching & Grinding Common symptoms of bruxism include a sore jaw, headaches, or earaches. [kalinadds.com]

  Department of Community Dentistry BRUXISM Prepared by Aneesha Abdu 3rd year BDS Royal Dental College 2. What is bruxism? Bruxism is the medical term for grinding, gnashing or clenching your teeth. This condition affects both kids and adults. [slideshare.net]

  This is called "nocturnal bruxism" or "sleep-related bruxism." Others grind or clench their teeth during the daytime as well. This is thought to be related to stress or anxiety. [colgate.com]

• Jaw Pain

  Bruxism can cause jaw pain, earaches, headaches, and stress. We know that when you are suffering from this type of pain it is hard to feel like yourself. [mansfielddental.com]

  Grinding teeth can damage tooth enamel and cause jaw pain and gum irritation. Bruxism can be prevented by relaxing the jaw and limiting behaviors such as gum chewing, alcohol, and caffeine. [nyp.org]

  Jaw Pain Jaw pain results from the clenching and grinding of the teeth, which puts excessive pressure on the joints in your jaw. Jaw pain may be exacerbated by chewing gum or eating tough foods like steak. [arizonafamilydental.com]

  However, it can cause permanent damage to the teeth and uncomfortable jaw pain, headaches, or ear pain. [medlineplus.gov]

• Dental Caries

  Clinical oral evaluations of the children to determine dental caries, traumatic dental injuries, malocclusion and tooth wear were performed by two researchers who had undergone a training exercise (interexaminer Kappa: 0.70 to 0.91; intraexaminer Kappa [ncbi.nlm.nih.gov]

  Caries Dental caries is the medical term for tooth decay or cavities. It is caused by acid erosion of tooth enamel. [colgateprofessional.com]

  […] metabolic dysfunction, weight gain; when associated with poor oral hygiene, they may cause other oral diseases such as dental caries.35 Stimulants such as amphetamine, 3,4‐methylenedioxymethamphetamine (MDMA, ecstasy) and cocaine exert their effects by [onlinelibrary.wiley.com]

  The exclusion criteria were: dental caries, early tooth loss, systemic and/or mental developmental disorders (including diseases of the endocrine and metabolic systems) and use of medications that could interfere with the central nervous system. [bmcoralhealth.biomedcentral.com]

  Improper tooth cleaning during splint use can lead to dental caries, and, in some cases, appliance use may result in temporomandibular disorders (TMD). A less significant complication is the staining of teeth. [emedicine.medscape.com]

• Microdontia

  Dilaceration Discoloration Ectopic enamel Enamel hypocalcification Enamel hypoplasia Turner's hypoplasia Enamel pearl Fluorosis Fusion Gemination Hyperdontia Hypodontia Maxillary lateral incisor agenesis Impaction Wisdom tooth impaction Macrodontia Meth mouth Microdontia [en.wikipedia.org]

• Tooth Erosion

  Citation : Social anxiety increases the risk of bruxism, tooth erosion, and jaw pain (2015, May 5) retrieved 13 May 2019 from https://medicalxpress.com/news/2015-05-social-anxiety-bruxism-tooth-erosion.html This document is subject to copyright. [medicalxpress.com]

• Otalgia

  Postauricular erythema and swelling; tenderness over mastoid process Otitis externa Pruritus, pain, and tenderness of the external ear Erythema and edema of external auditory canal Otitis media Fever; malaise; otalgia Tympanic membrane dull, bulging, [aafp.org]

  […] which may get worse during chewing or other jaw movement.[7] Trismus (restricted mouth opening).[10] Pain or tenderness of the temporomandibular joints,[10] which may manifest as preauricular pain (in front of the ear), or pain referred to the ear (otalgia [en.wikipedia.org]

• Aggressive Behavior

  Snoring, obstructive sleep apnea (breathing pauses during sleep), talking in the sleep, sleep paralysis, hysteric and aggressive behavior during sleep, hallucinations (occurring when being in the state of being sleeping and awakened). [evadenta.lt]

• Headache

  It can also lead to ear ache, jaw ache and headaches. The exact cause of bruxism is unknown. The interplay of various factors has been known to play foul. [symptoma.com]

  If not resolved, this activity can lead to weakened or cracked teeth, receeding gums, damaged jaw joint, headaches, disrupted sleep and more. [somnomed.com]

  Severe bruxism has caused: Some cases of jaw dysfunction, also called temporomandibular joint disorders (TMJD) Headaches Unexplained facial pain Discomfort when eating, biting or talking [colgate.co.in]

  Often this eliminates bruxism related headaches and/or various kinds of TMJ pain within just a few days of fitting the device! [dentistryofmilton.com]

• Hyperactivity

  Hyperactive Personality Of course, your personality may also be predisposed to teeth grinding. Hyperactive people, including those with attention deficit/hyperactivity disorder, have a greater incidence of bruxism than the general population. [arizonafamilydental.com]

  Further, the device causes the muscles to relax in a stable position, so that you and those hyperactive malfunctioning muscles can rest. [dentistryofmilton.com]

  Methylphenidate (MPH) is a stimulant that is commonly used in the treatment of attention-deficit/hyperactivity disorder in children and adults. Several reports are available regarding the relationship of MPH use and sleep bruxism. [ncbi.nlm.nih.gov]

  Having a personality type that's aggressive, competitive or hyperactive can increase your risk of bruxism. Medications and other substances. Bruxism may be an uncommon side effect of some psychiatric medications, such as certain antidepressants. [mayoclinic.org]

• Insomnia

  Insomnia, eating disorders, and depression can result from bruxism left untreated. A Solid Solution How can you stop an unconscious habit? A thorough evaluation will allow us to check your teeth, tissues, and muscles. [kalinadds.com]

  Bruxism may cause: Depression Eating disorders Insomnia Increased dental or TMJ problems Fractured teeth Receding gums Nightly grinding can awaken roommates or sleeping partners. [medlineplus.gov]

  There can be serious complications from this condition such as jaw pain, temporomandibular jaw (TMJ) disorder, throbbing headaches, neck/shoulder pain, a misaligned jaw, damage to the teeth, receding of the gums, insomnia and other resulting issues. [hospitals.jefferson.edu]

  Possible Complications Bruxism may cause: Depression Eating disorders Insomnia Increased dental or TMJ problems Fractured teeth Receding gums Nightly grinding can awaken roommates or sleeping partners. [mountsinai.org]

• Confusion

  Increased blood pressure, breathing rate, and heart rate Faintness Chills or sweating Blurred vision or nystagmus - rapid quivering of the pupils (while the user is feeling peak effects) Long-Term Effects Long-term effects of ecstasy use can include: Confusion [web.archive.org]

  Another obvious problem is that muscle tension may occur in the absence of bruxism: "numerous other types of orofacial movements unrelated to bruxism. .. can easily be confused with bruxism if only EMG criteria are used for scoring" (Miguel et al., 1992 [drnissani.net]

  This review will complement a recent systematic review which failed to find strong evidence to support the use of biofeedback technology on SB treatment and highlighted the confusing diversity of different forms of biofeedback available [ 31 ]. [systematicreviewsjournal.biomedcentral.com]

A preliminary physical examination, consisting of carefully studying the signs and symptoms of the condition is carried out. Several visits to the dentist will often be required to diagnose the condition. The following tests will be required to diagnose bruxism:

• Dental examination to check for other abnormalities
• X-rays to determine underlying damage to the bones and teeth
• Tests to determine ear infections
• Dental abnormalities such as poor teeth alignment or missing tooth [9]

Mild cases of bruxism do not require treatment. Children with bruxism do not require treatment, and the condition gets corrected by itself. In severe cases, the following methods are employed to treat the condition:

• Splints: Use of splints or mouth guard, help in keeping the teeth separated, which in a way, prevents damage to the teeth that occur due to clenching.
• Dental correction: This is used in cases, when there is poor alignment of teeth. Braces or oral surgery may sometimes be required for dental correction.
• Behavior therapy: Individuals with bruxism, are advised to undergo behavior therapy, that would teach them proper mouth and jaw position.
• Stress management: If stress is the cause, then various relaxation techniques can be followed, to appropriately manage the condition.
• Biofeedback: This is used when individuals cannot successfully change their habits. This is a type of complementary medicine, which utilizes various techniques to teach individuals, to control jaw and muscle movements [10].
• Medications: Certain medications, such as muscle relaxants, and Botox injections are also very effective in controlling bruxism. Muscle relaxants are prescribed for short duration, which is taken prior to sleeping. Botox injections are the method of choice, when other treatment regimes fail to yield desired effect [11].

Prognosis of the condition is not very favorable, as treatment methods are not very effective to significantly reduce the discomfort associated with the symptoms. However, if no kind of treatment is employed, then bruxism can cause permanent teeth damage. It can also lead to ear ache, jaw ache and headaches [6].

The exact cause of bruxism is unknown. The interplay of various factors has been known to play foul. In the past, some theories have suggested an association between general malocclusion and bruxism; this has however not been approved. The following are some of the factors, which are thought to play a role in causation of bruxism:

• Emotional triggers such as stress, anxiety or anger [3]
• Certain types of personality defined by aggressive or competitive behavior
• Sleep disorders
• Side effects of certain medications
• Diseases such as Parkinson disease or Huntington's disease
• Ear ache or tooth ache

According to the statistics provided by ICSD-R, about 85 to 90% of population has the habit of grinding teeth during some point of time in life. However, only 5% of these will develop any disorder related to it. Sleep bruxism occurs during adolescence years, and about 60% of elderly population is affected by it. Overall incidence of bruxism is about 8 to 31.4% [4].

Anatomically, the process of mastication is controlled by the muscles, which are located on both sides, and work together to enable movement of the mandible. Mastication, is a complex neuromuscular process, which is significantly controlled by subconscious and conscious processes.

Under normal conditions, the teeth are not in contact, except for certain activities, such as eating, speaking or swallowing. In the condition of bruxism, the unconscious movement of muscles occurs repeatedly, and is rhythmic with bit forces lasting for a fraction of second, or in some cases lasting for 1 to 30 seconds [5].

Preventing the development of trigger factors can to a certain extent reduce the development of bruxism. Keeping stress away, and practicing relaxation techniques, can also prevent bouts of bruxism.

Bruxism is considered to be a parafunctional activity, which means it is different from the normal functions of eating and talking [1]. Individuals, who suffer from bruxism, are known as bruxers or bruxists. Sleep bruxism equally affects both the sexes, whereas the other form of bruxism is more prevalent amongst the women population. Several treatment regimes have been designed to effectively manage the condition; however, these have little effect on bruxism [2].

Definition: Bruxism is a condition, characterized by repetitive, and rhythmic unconscious contraction of the muscles of mastication. It is a disorder, wherein the affected individuals, clench and grind their teeth. There are 2 forms of bruxism: sleep bruxism and awake bruxism.

Cause: The exact cause of bruxism is unknown. However, interplay of several factors, is known to trigger bouts of teeth clenching and grinding. Factors such as stress, underlying disease conditions, certain medications, ear ache, coping strategies adopted to deal with certain stressful situations, and malocclusion, are known to play foul in causation of bruxism.

Symptoms: Symptoms of bruxism include teeth grinding and clenching, which is so loud that it can awaken sleeping partner, increase in sensitivity of tooth, jaw muscle tightening, headache, ear ache and development of indentations in tongue. Bruxism can also predispose an individual to develop temporomandibular joint (TMJ) problems.

Diagnosis: Bruxism is diagnosed through a preliminary physical examination, to carefully study signs and symptoms. The dentist would also conduct several other tests, to check for signs of underlying diseases of teeth, and to also determine abnormalities.

Treatment: Treatment for bruxism includes splints, dental guards, and adopting strategies to correct dental problems. If stress is the underlying condition, then various behavioral therapies would also be adopted for relieving stress. Medications, such as muscle relaxants, and botox injections, can also help relieve the symptoms. Biofeedback is a type of complementary medicine, which makes use of several monitoring methods to control the muscle activity.

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