Bruxism (Teeth Grinding): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height.
  • Dental examination
    • [due tosymptoms:
      • Visible damage and wear to the teeth (non-carious related).
      • Pain of the teeth, chewing muscles, in the temporomandibular joints, neck muscles, headaches, back pain.
      • Difficulty opening the mouth when waking up
      • Jaw cracking, noise
      • Hypersensitivity of the teeth
      • Tooth mobility (without periodontal problems).
      • Tinnitus (ringing in the ears)
      • Loss of restorative materials of the teeth (reconstructions, fillings)]
    • [due tosecondary diseases:
      • Craniomandibular dysfunction (CMD) – term for a variety of complaints of the temporomandibular joints, the masticatory system and the tissues associated with them.
      • Gingival recession (recession of the gums).
      • Gingivitis (inflammation of the gums)
      • Hypertrophic (strongly pronounced) muscles of mastication
      • Masticatory muscle complaints
      • Periodontal diseases (periodontitis)
      • Peri-implantitis – progressive inflammation of the bony bearing of a dental implant with peri-implant (“around the implant”) bone loss.
      • Pulpitis (inflammation of the dental nerve)
      • Cracks in the tooth structure
      • Loss of restorative materials of the teeth (reconstructions, fillings).
      • Cheek impressions (indentations of the teeth).
      • Whitish cornification ridge in the flat surface of the buccal mucosa (planum buccale).
      • Root resorption – physiological or pathological (pathological) degradation of root cementum or cementum and dentin in the area of one or more tooth roots, not caused by caries.
      • Tooth structure loss, not caries-related.
      • Tooth loss
      • Tongue impressions
  • If necessary, psychiatric examination
    • [due topossible causes:
      • Anxiety disorders
      • Emotional stress]
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.

Assessment of crunching activity

For this purpose, special splints are used whose surface is colored in the contact area of the teeth of the opposing jaw. When the patient grinds, the layer of color is worn away by abrasion, exposing various layers of color. Based on the number of exposed color layers as well as the size of the grinding surfaces, the extent of grinding activity can be assessed.