Bruxism White Paper
(page 11)
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Nutritional Supplements. Magnesium's vital role in nerve and muscle function led at least two researchers to the suspicion that bruxism may be traceable to insufficient consumption, or inefficient utilization, of this metal. A magnesium-deficient diet is said to cause frequent teeth grinding in both sleeping and awake pigs (cf. Lehvila, 1994, p. 219). In humans, the suggested treatment involves magnesium supplements. According to Ploceniak (1990), for instance, prolonged magnesium administration nearly always provides a cure for bruxism. This confirms the earlier report of Lehvila (1974), which claimed remarkable reductions in the frequency and duration of grinding episodes (and at times, their complete cessation) in six patients who took, once a day, a tablet of assorted vitamins and minerals (which included 25 mg {in children} or 100 mg {in adults} of magnesium), for at least five weeks. When the intake of supplements stopped, the symptoms returned.
Earlier, a similar logic led Cheraskin & Ringsdorf (1970) to study the effects of nutritional supplements on teeth grinders or clenchers. Of these, 16 took calcium, vitamin A, vitamin C, Vitamin B5 (pantothenic acid), iodine, and vitamin E. When surveyed a year later, they reported that bruxism vanished. In contrast, the 15 bruxers who only took vitamins A, C, E and iodine showed no improvement. It seemed reasonable to conclude that the active agents were calcium and pantothenic acid (vitamin B5).
More research is clearly needed in this area. Indeed, if such claims apply to even a small proportion of bruxers, they merit a close look because taking these supplements is comparatively convenient, safe, and free of side effects.
The only feedback I have received regarding this approach is this:
I have found that I have unbearable daytime teeth clenching when I have been exercising a lot and sweating heavily. Calcium and magnesium are the only things that stopped the clenching. Interestingly, I do not clench at night at all.
Recommendation: Until such claims are confirmed, narrowed down, or refuted in a large-scale, double-blind study, the best strategy may involve taking the following on a daily basis: magnesium (approximately 100 mg), calcium (150 mg), and pantothenic acid (50 mg), combined with at least the following: vitamins A (1,000 IU), C (300 mg), E (60 mg), and iodine (0.1 mg=100 mcg). If bruxism subsides, patients should be advised to continue taking these pills. If no improvement is observed within 8 weeks or so, the approach should be given up.
Notes and Cautions:
- In these nutritional studies, bruxers typically take a number of vitamins and minerals, not just one; thus, it is not yet possible to pinpoint the effective nutritional agent. Moreover, these supplements often work synergistically or cooperatively, so a few minerals and vitamins need to be taken to correct a deficiency in one. That is why, until we know more about the subject, all the supplements above should be taken, not just magnesium or calcium.
- The available evidence tells us little about optimal dosages, so there is an element of uncertainty in deciding how much to take.
- Children should take proportionately less. For instance, an eight-year-old weighing about 70 lbs. should take about half the recommended dosage.
- Magnesium should be avoided in cases of renal impairment and acute dehydration. It should not be taken if it causes diarrhea, other adverse reactions, or if it interferes with other medicines. One should refrain from prescribing more than 100 mg a day, as taking too much, or prolonged treatment, may cause fatigue and respiratory problems. 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. In my view, roughly 0.7 mg a day per pound of body weight is all that should be taken (so a person weighing 143 lbs. needs to take no more than 100 mg of magnesium).
- A large-scale experiment on the effectiveness of nutritional supplements is long overdue.
