Diagnosing the cause of bruxism is important for determining treatment options. Over 80% of bruxers are unaware, in denial or ashamed they have a grinding habit.40 Utilizing printed patient education materials as well as educational sources, intraoral cameras, radiographic images, websites and pamphlets will help give patients a visual view. Also, educating patients by personalizing and making them aware of the damage already done and what the future consequences could be for them if they do not accept treatment. Discussing costs of restorative treatment such as restorations, crowns and even possible future implants versus the cost of a night guard or behavioral changes will usually motivate a patient into positive action.
It is always more beneficial if the problem can be resolved rather than only treating the symptoms. If the bruxism is caused by stress, then stress-relieving techniques should be implemented, possibly involving the patient’s physician. The following points are important to patient education:
Periodontal patients who show any symptoms of bruxism, or patients who acknowledge they grind their teeth, should be informed of the need for a night guard.
If bruxism is caused by medication, discuss ways to have the medication lowered or completely eliminated. Consult with the patient’s physician. If the medication is temporary, let the patient know bruxism is a side effect so they can be aware of changes in the oral cavity.
If the patient engages in tobacco use, drinking or recreational drugs that caused the bruxism, then cessation discussions should be considered.
If bruxism is caused by occlusion dysfunction, whether it is a slight or severe malocclusion, missing teeth or a high bite, a thorough examination with a treatment plan would be more beneficial for the patient than maintaining the symptoms.
Caution the patient to avoid stimulating substances in the evening. Avoid caffeinated drinks such as coffee, tea or soda after dinner and avoid alcohol and tobacco use during the evening, as they may worsen bruxism.
Advise the patient to reduce stress. Listening to music, taking a warm bath or exercising can help the patient relax and may reduce the risk of developing bruxism.55
Ask the patient about their sleep habits, i.e., do they talk in their sleep, move, twitch or jump (muscle spasms) a lot while sleeping? Do they feel unrested after sleep, do they experience nocturnal awakenings? These could be signs of not sleeping well, which could be a cause of bruxism.55
Schedule regular dental examinations. Dental examinations are the best way to identify bruxism. Monitoring growth and eruption patterns in children will detect and negate future bruxism issues. Regular visits for early intervention and diagnosis is most beneficial before too much damage has occurred.