Thursday 19 May 2011

Bruxism. How does stress influence our dental condition?

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Stress is the body's biological state of tension, triggered by various somatic and / or psychological stimuli known as stressors. As a result of stressors the body starts the complex adaptive responses. Stress can have positive effects on the body if it lasts for short period of time, for example, the reflex of keeping distance caused by sudden roar. A long-term stress has usually a destructive nature. Stress not only causes psychological symptoms, but symptoms from the locomotor, cardiovascular, endocrine, immune, sympathetic and parasympathetic systems.

Organism acts out stressful situations by using the motor response. A chewing organ, which was overloaded by strong stimuli that caused stress, tries to relieve the situation by making aimless motor activity - parafunctions. Parafunctions can be divided into two groups: mutual contact of the teeth, such as clenching and grinding, or parafunctions, which are habits and take place without the mutual contact of the teeth, such as biting your nail and skin around the nails, chewing gum, biting items such as pencils, pens, etc., biting lips . It is believed that parafunctions are responsible for diseases of the mouth in 40-50% of children and 60-80% of teenagers and adults.

Parafunctions cause the occurrence of the following groups of symptoms:

1. Intraoral symptoms:
a) located in the teeth and / or periodontium:
• enamel dysplasia, enamel cracks, wedge cavities
• teeth movement
• fracture of teeth with vital pulp
• symptoms similar to inflammatory pulp
• radiation of pain as a result of overloading of teeth
• strong rubbing off of teeth (pathological)
• teeth crimping and / or grinding
b) located outside the dental arches and the periodontium:
• traces of applying any pressure cheek mucosa and / or lips
• pressure marks of teeth on the tongue
• aphthae
• feeling of an obstacle presence
• pain during swallowing
• speaking with clenched teeth
• metallic taste in mouth
• disorders of saliva production
• soft tissue tumors
c) located on the dental-alveolar pond:
• loosening of individual teeth
• loosening of teeth groups
• tooth movement

2. Symptoms within the temporomandibular joint:
• abnormal condylar motion 
• pathological sounds such as cracks, crackle
• painful temporomandibular joint with pressure
• deviation of the mandible at the time of its abduction and / or adduction
• deviation of the exiting
• diverse range of lateral mandibular movements
• hypermobility of the mandible
• reduction of jaw movements

Patients with dysfunctions of the stomatognathic system inducing mental state can be classified into three groups:

Group I:
Dysfunctions are caused by the primary factors (barriers to normal relations of teeth), which triggers a reflex increase in muscle tension in order to remove obstacles through attrition, which usually leads to severe clashes, shift bumps and grooves in different places than they occur in naturally, may be also interfering tooth movement resulting in the formation of individual occlusions. Disturbances in the occlusion and the accompanying stress lead to bruxism.

Group II:
Long-term presence of stress factors triggers strong psychological tension which leads to excessive muscle tension. Tension is unloaded in the dental arches by the action of movement. Excessive chewing muscle activity leads to a characteristic of taurus clash.

Group III:
Mental illnesses and disabilities, often hidden depression, may lead to disorders of chewing system. Patients with mental illnesses often focus on the dental arches and the bite, which they consider to be the main source of their ailments. Even a slight dental treatment can induce such persons to occlusal neurosis, which is revealed by increased masticatory muscle tension, there is also grinding and clenching of teeth. Mental illnesses are contraindications for occlusal therapy. Moreover, in this group occurs a frequent presence of periodontal disease and poorer hygiene than in those without mental disorders.

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Bruxism

Bruxism is a kind of parafunctions, which consists of an unconscious grinding and tightening of teeth, which leads to the disturbing activities of the stomatognathic system. There are two types of bruxism - centric-occurring normally during the day which consists of a strong tightening of teeth in centric occlusion and eccentric bruxism which appears usually at night during sleep - its main symptoms are involuntary teeth grinding.
Bruxism occurs as a result of prolonged stress, central nervous system disorders, habitual gum chewing for several hours or unilateral chewing. Other causes of this condition are irregularities in the dealings of own teeth or poorly treated teeth with wrongly modelled fillings and surface of crowns, bridges or dentures as well as missing teeth.
Treatment of bruxism consists in identifying and eliminating its cause.

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