Investigating Patients With Bruxism
Bruxism is a naturally occurring phenomenon that affects an estimated 5-8% of adults in North America. And although for some the condition does not require any treatment, for others it can lead to jaw pain, headaches and even cracked teeth.
In part 1 of this two-part discussion, Dr. John O’Keefe invites Dr. Tom Shackleton, a general practitioner from Calgary AB, to share his approach to investigating patients with bruxism.
Here are the key takeaways from the conversation:
- Patients presenting with bruxism may or may not be aware that they are a ‘bruxer’. Gathering a good clinical history is a key first step.
- There are two types of bruxism:
- Sleep or nocturnal bruxism
- Awake bruxism
- The etiology of sleep bruxism is not fully understood but it is suspected that it is centrally driven. Contributing factors include:
- A tendency to run in families
- Caffeine, alcohol, and tobacco use
- Medications – SSRIs can contribute to nocturnal bruxism. Amphetamines can contribute to both nocturnal and awake bruxism.
- The pathophysiology between sleep and awake bruxism seems to be different but more research is needed.
- Triggers that warrant intervention include:
- Patient complains about bruxism
- Patient wakes with a sense of tightness in their jaw/face
- Patient wakes with pain in the jaw/face
- Cracked teeth/fillings
- Investigations should include:
- Good clinical history
- Panoramic radiograph
- Palpation of orofacial muscles and joints
- Checking of range of motion of mandible and documentation of baseline
- There is no cure for bruxism. Management strategies include:
- Passive stretching/home-based therapy
- Appliance therapy
- Adjusting of medication
We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.
Until next time!
CDA Oasis Team