Investigating Patients With Bruxism

Dr. TOM SHACKLETON                

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:
  • • Stress
    • 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
    • Botox
    • Adjusting of medication

FURTHER RESOURCES:

PDF Download: Bruxism Fast Facts

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