Sleeping Disorders

Sleep Bruxism (Tooth-Grinding)

Bruxism (a term derived from the Greek βρυγμός, which means grinding) is grinding or clenching of the teeth.  Sleep Bruxism is grinding or clenching of the teeth during sleep, both of which can cause a range of problems.

Symptoms

Sleep Bruxism often occurs during sleep, and may even occur during short naps.  Usually, the canine teeth and incisors are ground against each other with a side to side motion, which abrades tooth enamel, removes the sharp biting surfaces, and flattens the edges of the teeth.  The molar teeth may also be ground together.

Causes

The causes of Sleep Bruxism are thought to include a combination of one or more of the following:
· a lack of symmetry in the teeth / occlusal disharmony (where teeth do not bite down on each other correctly),
· anxiety / emotional stress,
· digestive problems,
· a disturbed sleep pattern
In addition, some drugs are known to cause bruxism as a side-effect, such as MDMA and others of the amphetamine-based family.

Diagnosis

During a routine dental examination, a Dentist will comment if there seems to be an excess wear of the teeth.  This excess wear may be caused by Sleep Bruxism.
A device, called a BiteStrip, enables testing for Sleep Bruxism and can help diagnose bruxism before teeth are seriously damaged.  The BiteStrip is a miniature electromyograph machine that senses jaw muscle activity while the patient sleeps.  A dentist can use the data collected by the device to establish the presence of Bruxism and the associated severity level, and then use this information to select the most appropriate treatment.
The effects of the condition may be quite advanced before sufferers are aware they brux. Abraded teeth may be brought to the patient's attention during a routine dental examination. If enough enamel is abraded, the softer dentine will be exposed, and abrasion will accelerate. This opens the possibility of dental decay and tooth fracture, and in some people, gum recession. Early intervention by a dentist is advisable.

Complications / Issues

Sometimes, Sleep Bruxism sufferers may grind their molar teeth together so hard that the grinding sound can be loud enough to wake a sleeping partner.
In addition, over time the teeth may become shorter and blunter, and this may lead to pain in the jaw joint (called the Temporomandibular Joint) and headache.
Teeth hollowed or weakened by previous decay may collapse if the grinding pressure is too high, leading to the need for dentures, plates, or other procedures.
If enough enamel is abraded, the softer dentine of the teeth may be exposed, and the abrasion will accelerate.  This may lead to increased dental decay and other tooth and gum issues such as tooth fracture and gum recession.

Treatment

Unfortunately, there is no specific cure for Sleep Bruxism at this stage.
The best way to prevent or treat Sleep Bruxism is for the sufferer to work with their doctor to discover the cause for their bruxism (see above), so that the causes can be treated, removed, or reduced.
For example, it may be beneficial to reduce stress and anxiety before bedtime, by a winding-down activity, such as massage, meditation or reading, and eating early enough to ensure a fairly empty stomach at bedtime.
Damage to the teeth can be treated and repaired by replacing the worn natural crown of the tooth with an artificial crown.  Materials that are strong and long lasting are preferred.  For example, porcelain fused to metal crowns may be used in the anterior (front) of the mouth, and in the posterior (back) gold is the preferred material.
Further damage to the teeth and ongoing management of bruxism can be achieved by preventing further abrasion of tooth surfaces by wearing an acrylic dental guard, created to the shape of the individual's upper teeth from a bite mould.

Prevention

The best way to prevent the onset of the symptoms and complications of Sleep Bruxism is for the sufferer to work with their doctor to discover the cause for their bruxism (see above), so that the causes can be treated, removed, or reduced.
If you are taking any prescription drugs or medicines that are causing the bruxism, then discuss this with your doctor, as alternative drugs may be available that alleviate the bruxism.
If you are taking other drugs that cause bruxism (such as amphetamines and/or other  illegal drugs), then stop taking these drugs.

Sleep Paralysis