Treatment of Teeth Grinding (Bruxism) and Joint Disorders

Treatment of Teeth Grinding (Bruxism) and Joint Disorders

Teeth clenching / grinding disorder (bruxism) is the most common disorder encountered in parafunctional activities. The patients start to experience this disorder with complaints of sometimes pain and sometimes painless sounds in joints. The ligaments in the joints are damaged over time due to the extra load caused by the increased parafunctional activities, i.e. movements beyond ordinary functions. The temporomandibular joint is the joint with which we perform the chewing function. Occlusal (biting) surfaces of the teeth erode over time, which is a type of wear called attrition, and loss can be observed on the vertical dimension of the face. This is a condition characterized by increased pain in the joint area and / or the surrounding chewing muscles, particularly in the early morning. Among the parafunctional activities of the musculoskeletal system, tooth wear is considered the most harmful as it causes periodontal tissue damage, joint and muscle damage.

Due to attrition caused by teeth grinding, a shortened crown appearance and a “gummy smile” are caused on the teeth exposed to occlusal force over time. The reduced vertical dimension causes reduction in the distance between the chin and the tip of the nose, causing individuals to have a profile of older age.

diş sıkma bruksizm tedavisi

Treatment can be planned based on the severity of the joint disorder and the type of damaged anatomical structures. The treatment process and type are determined by splints that require short and long-term use. Protective night guards produced with a prosthetic point of view to be used in the long term should be applied to patients with joint disorders. Whether or not there is loss in vertical dimension due to wear, protective night guard application is essential for breaking parafunctional habits, preventing tooth wear and keeping the joint in the most orthopaedic position.

For patients that suffer loss in vertical dimension, the vertical dimension should be increased gradually and the teeth should be restored to provide better function and aesthetics. The method to be used for increasing vertical dimension and the type of permanent restoration to be used may differ for each patient. Therefore, the treatment should be determined by detailed examination and analysis at the clinic.