Oral Parafunctional Teeth Grinding Disorder – Treatment

  Despite the high incidence of teeth grinding in life and the large amount of clinical or basic research conducted by scholars at home and abroad, there is no specific method for the treatment of teeth grinding so far. The current method is actually the strategy of “treating the foot and headache”. Currently there are five types of commonly used treatment methods, briefly described as follows: 1, behavioral medicine treatment: including psychological treatment, muscle relaxation therapy, etc.. Psychological tension leads to muscle tension is a common cause of the disease. Eliminate tension, release unnecessary concerns, reduce stress appropriately, and arrange work reasonably. Measures such as resting and relaxing before going to bed, doing appropriate exercises, avoiding excitatory foods, and improving the sleep environment are all helpful to reduce the excitement of the brain. Mobilize the patient’s self-awareness and self-control to reduce the occurrence of teeth grinding disorder. Muscle relaxation including the use of muscle relaxation apparatus, body therapy, massage and other methods, all have certain effects.  2, biofeedback therapy: through biofeedback, the patient is installed with “electronic devices”, so that the patient is awakened by the sound and other electrical signals to temporarily stop grinding teeth when it occurs. However, due to the “limitations” and “frightening” of patient acceptance, this method has not yet been promoted to the treatment of patients with clinical teeth grinding disorder.  3.Dentistry treatment: including the use of teeth adjustment treatment and occlusal plates.  (1) The treatment of teeth adjustment refers to the elimination of teeth grinding by adjusting and grinding a small amount of dental tissues, removing occlusal interference and establishing a balanced dental relationship in order to achieve a physiological balance among teeth, muscles, temporomandibular joint and jaw bone. Patients with dental and maxillofacial deformities are first treated with orthodontic, prosthetic or orthognathic surgery to correct the problem.  ②Bite plate treatment refers to the creation of a pad that is worn on the teeth at night before bedtime and removed in the morning to relieve muscle tension and protect the teeth from wear and tear during grinding. Currently the most easily accepted by patients, but does not cure teeth grinding.  4, the change of bad habits: often maintain a “posture”, rest the muscles, temporomandibular joints and teeth. Correct bad habits such as sideways chewing, pencil biting, betel nut chewing, gum chewing, etc. According to clinical research, these habits may induce teeth grinding disorder.  5.Medication: ① Intramuscular injection of botulinum toxin in the masticatory muscle Pharmacological studies have confirmed that local use of botulinum toxin is effective in treating dyskinesia. So in the clinic, some doctors try to inject botulinum toxin into the chewing muscles on both sides of patients with perennial teeth grinding, and the study results show that some patients can get 4 weeks after the injection, and the teeth grinding situation begins to reduce or stop. However, there are a few patients who have difficulty opening and closing their mouths or swallowing; as a doctor, to perform this treatment, you must communicate well with the patient and inject Botox only when the patient understands and accepts the premise of complications.  ②Central nervous system drugs Clinical studies have confirmed that the use of dopa to regulate the central nervous system can significantly reduce the number of teeth grinding, but it is easy to cause nausea, vomiting, insomnia, cardiac arrhythmia, psychotic episodes, etc.. Pharmacological treatment of teeth grinding is only considered when other treatments are ineffective.  ③Other Targeted medication for diseases such as intestinal parasitic infections, gastrointestinal dysfunction, endocrine imbalance, allergies, vitamin D deficiency, accumulation of food in children, and indigestion to remove the possible causes of teeth grinding.  In conclusion, teeth grinding as an oral parafunction is a “difficult disease” in the dental clinic, and its etiology is unknown, and its treatment and efficacy are uncertain. In clinical practice, any treatment method may be effective and at the same time may be ineffective. Only after the doctor and patient communicate deeply and establish a mutual “trust” relationship, treatment can begin.