Bruxism White Paper
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Additional Approaches to Treating Bruxism:
Given the limited success of traditional approaches, and given, moreover, the high incidence of bruxism and its harmful consequences, clinicians and sufferers may occasionally be interested in experimenting with non-intrusive, safe, less widely known, treatment modalities.
Wait and See. In a few lucky cases, bruxism may vanish spontaneously. In others, grinding and clenching may occur so seldom, or are so weak, as to hardly justify any action at all.
In particular, young children often require different therapeutic approaches than adults. To begin with, the damage to their teeth, for the most part, is transitory, for only the primary teeth may be affected, not the permanent teeth. Moreover, bruxism in children, according to some studies, usually resolves spontaneously. In one study, for example, 126 children between the ages of 6 and 9 were diagnosed with bruxism. Five years later, upon re-examination, only 17 children seemed to have retained the bruxing habit. Thus, juvenile bruxism is probably "a self-limiting condition which does not progress to adult bruxism and which appears to be unrelated to TMJ symptoms" (Kieser & Groeneveld, 1998). Another study suggests that "observation and reassurance, rather than intervention, are warranted in most cases" (Thompson, Blount, and Krumholtz, 1994). However, when the damage to a child or adult is severe, or when the habit persists, treatment is mandatory.
Recommendation: If bruxism occurs only sporadically and intermittently, especially in children, waiting may provide the best strategy. If the condition does not spontaneously disappear in a few months, keeps recurring, or is accompanied by worrisome side effects (e.g., hearing loss or locked jaw), action is required.
Stress. In some cases, emotional stress is alleged to trigger, or exacerbate, bruxism. On the other hand, the popular belief that stress is the leading cause of bruxism (and not merely one aggravating factor among many) is, in all likelihood, mistaken. Still, negative stress is bad for one's health, regardless of its effects on bruxism. It may be worth while therefore to try to reduce stress levels (with such things as yoga, hypnosis, changed lifestyle, or autosuggestion tapes).
Stress reduction is easier said than done. Besides, it's unlikely to prevent bruxism, even if successful. So, while of great value in its own right, stress reduction will, in most cases, need to be complemented by other treatment modalities.
Counteracting Trauma. In some cases, bruxism may commence shortly after such dental procedures as fillings, crowns, or bridges; after an injury to the mouth; or after a prolonged operation in or through the mouth. To be sure, at times bruxism may be caused by the psychological stress of the treatment or injury (and not by the injury itself). In other cases, coincidence may play a key role (that is, bruxism starts after trauma but is not traceable to it). Nevertheless, it may be still worth while looking into a causal connection and taking remedial actions right away, before the new bruxing habit becomes entrenched. A new high crown may be ground down a bit to reduce any possible interferences, or an old mercury amalgam may be replaced.
Recommendation: In those comparatively rare instances when bruxism seems to immediately follow dental manipulation, mouth surgery, or injury, correction may succeed. In this case, the corrective procedure should be undertaken as soon as possible, to prevent entrenchment of the bruxing habit.
