#17 Bruxism and TMD/TMJ

Bruxism is the technical and scientific term used to describe clenching and/or grinding of the teeth due to involuntary motion of the lower jaw.  Bruxism can occur during the day, Awake Bruxism (AB) or at night, Night Bruxism (NB).  Bruxism is very common, and it is estimated that roughly half the population bruxes and most people are not aware of it.  One recent published review on bruxism cited 2,358 scientific articles on this topic. ⁽¹⁾ As I have stated previously, “The number of scientific articles written on a topic is inversely proportional to how well the topic is understood”.  In other words, the more articles, the less we know.  This is certainly true regarding bruxism.

But we do know one thing about bruxism.  It has been scientifically and statistically proven that people who brux are more likely to develop one or more of the symptoms of TMD/TMJ.  And that is all we really know for certain about bruxism.  Bruxism causes TMD/TMJ. That is fact. The remainder of the information contained in these 2,358 articles is only theory.

Not all people who brux develop TMD/TMJ.  And not all people who have TMD/TMJ brux.  Bruxism is only one of the three causes of TMD/TMJ.  The other two are acute trauma and functional malocclusion.  But bruxism appears to be the most common cause.

Bruxism is an involuntary event, whether during the day (DB), or at night (NB).  Involuntary functions in the body are monitored by the involuntary nervous system, called the Autonomic Nervous System (ANS). This is distinguished from the Voluntary Nervous System (VNS).  The ANS also monitors things like heart rate, respiratory rate, sweat glands, night vision, and hundreds of other involuntary functions of the body.  There may be an adaptive and positive reason for bruxism that we are not aware of, but we are certain there are destructive and negative effects of bruxism.  The most damaging effect of bruxism is TMD/TMJ.  The second most damaging effect is damage to the teeth, bone support, and gums.  There appears to be nothing good about bruxism.

Since bruxism is regulated by the Autonomic Nervous System you have no control of Bruxism whether during the day (DB) or at night (NB).  Let me repeat that. “You have no control of bruxism”.  That is a controversial statement since there are thousands of doctors and hundreds of articles stating that, using psychological training of one kind or another, you can control bruxism.  Following this rationale and guidance is a waste of time and money.  It is true that anxiety, fear, and emotional upset is related to bruxism.  But we don’t know how it is related.  Everyone experiences anxiety, fear, and emotional upset in their lives.  So why doesn’t everyone brux.  There are no answers to this question.  So those recommending psychological training to decrease bruxism don’t have a scientific leg to stand on.

What about those who recommend drugs of one kind or another that are purported to relieve stress and therefore to decrease bruxism.  There have been no scientific studies which show these drugs decrease bruxism and hundreds of studies which show these drugs have substantial and sometimes life altering damaging side effects.  We do not even have a good definition for “stress”. “Drugs do not decrease Bruxism”.

There is no known proven treatment that decreases bruxism.  But if bruxism is the most common cause for TMD/TMJ, what can a patient do who bruxes and has TMD/TMJ.  The answer is: Don’t try to stop bruxing but simply unload the temporomandibular joints so that no matter how much you brux, you don’t further damage the joints allowing the inflammation to resolve and allowing the symptoms of TMD/TMJ to diminish.  Since you have no control over bruxing, go ahead and brux all you want but unload the joint in a healthy and predictable manner using the Urbanek Device and Protocol.  How the Urbanek Device and Protocol decreases inflammation within the TMJ is covered extensively in this blog and elsewhere.

(1)

J Indian Prosthodont Soc. 2010 Sep; 10(3): 141–148.

Published online 2011 Jan 22. doi: 10.1007/s13191-011-0041-5

PMCID: PMC3081266

PMID: 21886404

Bruxism: A Literature Review

Shilpa Shetty,¹ Varun Pitti,² C. L. Satish Babu,¹ G. P. Surendra Kumar,¹ and B. C. Deepthi