With exam season upon us, this is worrying news indeed, as it could result in a vicious circle of stress-related bruxism both during the daytime and nighttime, disturbed sleep patterns and everyday anxiety caused by the prospect of GCSEs, A levels and finals.
Immediate, short-term and reversible presentations might include sensitivity and/or tenderness of specific teeth as well as temporomandibular joint or related muscular discomfort. Management should be directed toward immediate relief of symptoms and this is one scenario where a soft biteguard can be extremely helpful.
Should such bruxism continue in the longer term, however, the following rather more substantial signs and symptoms might present with action being required:
- Sensitive teeth due to exposed dentine
- Discolouration, including yellowing and loss of shine due to loss of enamel
- Sharp or chipped anterior teeth
- Occlusal surfaces wearing flat and taking on a shiny, pitted appearance
- Altered occlusion as vertical height changes
- Abfraction lesions developing cervically.
For the management of any signs or symptoms associated with longer term bruxism, and in addition to any specific treatment that may be required for the teeth themselves, a three-step treatment plan may be most appropriate:
- Prescription of muscle relaxants
- Treatment with a physiotherapist or osteopath with specialist knowledge of the temporomandibular joint and related muscles
- Nightly use of a Michigan splint.
It may also be a good idea to ensure patients are brushing effectively yet gently with a relatively soft toothbrush and a toothpaste that is low in abrasivity, as well as suggesting they do something relaxing before bed such as yoga, reading or having a bath.
The study by Mrug et al was published in the March 2016 issue of Physiology & Behavior.