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BRUXISM IS DEFINED AS AN UNPRODUCTIVE GRINDING OR GNASHING of the teeth and clenching of the jaws that can occur while awake or during sleep.1 This condition is, for the most part, an unconscious behaviour affecting both genders of all ages.2 The overall prevalence of bruxism is difficult to pinpoint. It may be self-reported or identified only when family members or bedroom partners report sounds of clicking or grinding. The incidence of sleep bruxism in children has been estimated at 15%, becoming more prevalent in the 7- to 10-year age group, and often resolving with the eruption of permanent teeth. In adults, the reported incidence varies widely (5%-96%).1,2
Mild bruxism often goes undetected and does not always require treatment. In more severe cases, patients may complain of tooth hypersensitivity, painful masseter and temporal muscles, as well as headache. Tooth damage or fractured dental restorations can occur.1,2 Damage is understandable, given that patients can have 8 episodes of teeth grinding per night with an average maximum biting force of 162 lb per square inch. Forces as high as 975 lb per square inch are recorded. 2 Dental professionals may observe the signs and symptoms of bruxism during a regular dental visit and subsequently investigate a potential cause. Box 1 lists the symptoms associated with bruxism.
Primary bruxism may not have an identifiable cause, but current and ongoing research suggests a link to genetic and environmental factors, as well as life or psychological stresses. Secondary bruxism may be related to diseases, irregular sleep cycles or drug-induced oral movement disorders such as dystonia and dyskinesia. Box 2 contains a list of medications and illegal drugs reported to cause bruxism.4 Occurrence has been linked to both drug consumption and withdrawal.5
Drug-induced movement disorders are often referred to as extrapyramidal adverse reactions. The mechanism for these disorders is complex, variable and not fully understood. An imbalance...