Raising patient awareness of bruxism and attrition at this time of year presents a positive frame in which to let patients know the effect a stressful lifestyle can have on their teeth and offer simple solutions to the problem.
It has been reported that nearly 70% of bruxism occurs as a result of stress or anxiety. It is well documented that job-related stress is the most significant factor associated with bruxism (www.bruxism.org.uk).
Those who do suffer from such grinding and/or clenching activity may complain of tooth sensitivity, problems chewing, headaches and neck ache and, upon clinical examination of such a patient, the dentist may well see problems such as:
• Sharp or chipped anterior teeth
• Occlusal surfaces wearing flat and taking on a shiny, pitted appearance
• Altered occlusion as vertical height changes
• Fractured teeth and/or restorations
• Abfraction lesions developing cervically
• V-shaped notches or shallower cupping present cervically
• Looseness of teeth
The good news to share with patients is that making a few simple lifestyle changes can be of significant benefit, including:
• Doing something relaxing before bed, such as yoga, reading or having a bath
• Learning to brush effectively yet gently with a relatively soft toothbrush and a toothpaste low in abrasivity.
Early diagnosis of parafunctional activity and resulting attrition is the ideal, so that preventive advice can be offered to patients, monitoring undertaken and, perhaps, simpler restorative treatments provided once the situation is under control.
The London Tooth Wear Centreoffers an evidence based and comprehensive approach to managing tooth wear. To request advice, make a referral or for further information on the work of the London Tooth Wear Centre, please visit www.toothwear.co.uk, email info@toothwear.co.uk or call 020 7486 7180.