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Bruxism: The Grind of the Matter

Course Number: 485

History of Bruxism

Bruxism, a common condition seen in adults, is becoming more prevalent in adolescents and children.1 Early treatment can help prevent acute pain and, in severe cases, chronic pain, periodontal involvement and possible tooth loss.2

Historically, bruxism has been considered a normal habit. Frequency of episodes and strength of forces on the orthodontia and periodontium can cause the habit to evolve into extensive pathological consequences. It may be as minor as slight wear on the teeth, to major consequences of consistent jaw pain to eventual loss of teeth. Early invention will lead to longevity of a properly functioning oral cavity and improved overall health.

The references of gnashing the teeth historically were described in negative annotations. The phrase to “grit one’s teeth” refers to grinding or clenching of the teeth in anger or to accept a difficult or unpleasant situation and deal with it in a determined manner.3 Clenching the teeth is generally used in humans and animals to display anger, hostility or frustration. In humans it was once an evolutionary instinct to clench the teeth for display to use as weapons to threaten a rival or predator. In many cultures the gnashing of teeth has been associated with suffering, physical pain, madness and possession. The history of bruxism, in the terms of gnashing and clenching, is mentioned in the Bible in several verses. Examples include: Psalm 35:16 “Like profane mockers at a feast, they gnash at me with their teeth.” Psalm 112:10 “The sinner shall see and be angry as he shall gnash his teeth and consume away.”

Over the years research has identified many reasons why people grind their teeth. In the beginning of the twentieth century, Moritz Karolyi, a Viennese dentist, described bruxism as “traumatic neuralgia” and stated “it was the cause of a periodontal condition called pyorrhea (periodontitis).” In 1907 the French term “Bruxamine” was introduced by Marie and Pietkiewicz. In 1931 Bertrand Frohman, MD created the term bruxism, which comes from the Greek expression “brychien odontas.”4 Sigmund Freud, scholar and psychiatrist, also had a theory concerning bruxing in the oral cavity. He claimed it to be a prime significance in the psychosexual development and behavior of the individual. Between 1966 and 2007 research and treatment were focused on occlusal adjustments and oral splints. During the 1960s, a periodontist, Sigurd Peder, DDS, PhD,5 promoted the theory that occlusal factors were responsible for bruxism. While therapy centered on the removal of occlusal interference remained unsatisfactory, behavioral approaches in research also declined during 1966-1986.

Occlusal habits can be a source of gratification or an outlet for aggression or frustration. For example, children suck their thumb for satisfaction or conversely children bite objects or people in anger or frustration. The adult is guided by morals, customs, traditions and other behavioral patterns where they cannot satisfy their emotional requirements as easily as children. Through the oral structure the adult will tend to resort to nail, lip and cheek biting along with clenching, grinding, clamping, and tapping of the teeth to release aggressions.6

The most recent research identifies there are many factors that are involved with bruxism including: lifestyle, stress factors, medications, mental and physical disorders and malocclusion.4