Bruxism – colloquially called teeth grinding – (synonyms: Teeth clenching; ICD-10-GM F45.8: Other somatoform disorders; sleep bruxism is also assigned to ICD-10-GM G47.8: Other sleep disorders) (Greek brygmus) is defined as repetitive masticatory muscle activity characterized by jaw clenching and teeth grinding and/or tensing or shifting of the mandible. The movement sequences usually occur unconsciously, in most cases at night.
The following forms are distinguished:
- Sleep bruxism (SB) – the complaints occur during sleep; they are 90% phasic (rhythmic) or combined tonic-phasic (non-rhythmic/rhythmic).
- Waking bruxism (WB) – complaints occur during wakefulness; repeated or sustained tooth contact and/or tensing or shifting of the mandible without tooth contact (tonic/non-rhythmic)
One form does not exclude the other.
Furthermore, bruxism can be divided by cause into primary (idiopathic / no apparent cause) and secondary bruxism (as a consequence) (see below “Classification”).
Sex ratio: In some studies women are more frequently affected, in others men.
Frequency peak: The disease can occur with eruption of the first teeth and into old age. Predominantly, it occurs between the 2nd and 3rd decade of life.
In children, bruxism is part of normal development until the age of 3, as the teeth have yet to find their place in the dentition. Dentists refer to this phase as “teeth clenching.” This is how the correct bite of the upper and lower jaws together develops. Bruxism can also reoccur during the change of teeth and is not a cause for concern. If children talk in their sleep, drool a lot, or otherwise come to sleep anxious (lights left on, door left open), these are possible signs of psychological causes of teeth grinding.
The prevalence of sleep bruxism ranges from 2.5 to 56.5% in children and 12.8% ± 3.1% in adults. The wide variation in the data in children results from the different methods of diagnosis used.The prevalence for awake bruxism in adults ranges from 22.1-31%. Overall, the prevalence decreases with increasing age. If the condition manifests in childhood, the risk of suffering from the condition as an adult is high.
Course and prognosis: Many sufferers are unaware of bruxism, especially when they sleep alone. In the case of awake bruxism, it is not uncommon for it to be the work colleague who draws attention to the teeth grinding/pressing. It is often the dentist who is most likely to see the evidence of bruxism. Early diagnosis is crucial, as the course can be positively influenced by appropriate measures. But it is not only the teeth that are affected (e.g. abrasion (loss of tooth structure), pulpititis (inflammation of the dental nerve)), but also the temporomandibular joint, the masticatory muscles, the periodontium (tooth-supporting apparatus) and even the neck muscles can be affected.The patient must be given extensive information about the clinical picture so that he is able to find the cause through self-observation. In this way, he can reduce the frequency of grinding and pressing. Ideally, the causative factors can be eliminated by a change in lifestyle. If this is not successful, the focus is on protecting the teeth and restorations, reducing bruxism activity, and relieving pain.
