Bruxism

The cause for bruxism is unknown. Factors that may contribute to the condition include stress, facial or oral trauma, nervous system malfunction, poor diet, and allergies. Alcohol and drug use also increase the occurrence of bruxism.

Children with bruxism usually stop grinding their teeth before adulthood. However, bruxism can affect adults for an indefinite period of time. Adults with bruxism have increased occurrence of grinding during times of stress (e.g., health-related, family-related, or job-related).

Bruxism causes tempromandibular joint syndrome (TMJ), in which the cartilage around the joints of the upper and lower jaws becomes irritated. This irritation can cause pain in the jaw and ears. Headaches associated with joint and muscle strain are common symptoms associated with bruxism.

The occlusal (meeting) surface of the upper and lower teeth can be ground down so much that an imbalance in closure between the left and right sides of the mouth is created, which can result in periodontal disease and structural stress to the tissues and roots of the teeth.

Like most sleep disorders, bruxism affects people other than those with the condition. The sound of teeth grinding can be quite loud and disruptive to bed partners or roommates. As a result, those who must cope with their partner's habitual grinding develop secondary symptoms, like poor sleep. In fact, it is often a partner or family member who detects bruxism.

A dentist usually detects or suspects bruxism when, during a routine checkup, he or she discovers the characteristic wear on the teeth. Wear associated with grinding is most evident on the molars, which are in the back of the mouth. The diagnosis is generally based on the patient's dental history and a dentist's careful reexamination.

There are two primary objectives in the treatment of bruxism: stress reduction and tooth care.

Relaxation therapies may reduce stress associated with habitual grinding. Meditation and body-calming activities are thought to reduce the psychological stress that seems to aggravate bruxism. Biofeedback training may reduce the occurrence of nocturnal grinding. Biofeedback programs train people to control their involuntary nervous system with learned responses to fluctuating body conditions. During a training session, a monitoring system emits sound to alert the patient to these fluctuations. Participants then learn to recreate states of relaxation, breathing patterns, and pulse rates that help them relax and achieve a calm emotional state.

Text F

Sedative and hypnotic drugs

A sedative or tranquilizer is a substance that induces sedation by reducing irritability or excitement. Doctors often administer sedatives to patients in order to dull the patient’s anxiety related to painful or anxiety-provoking procedures. Although sedatives do not relieve pain in themselves, they can be a useful adjunct to analgesics in preparing patients for surgery, and are commonly given to patients before they are anaesthetized, or before other highly uncomfortable and invasive procedures like cardiac catheterization , colonoscopy or MRI. They increase tractability and compliance of children or troublesome or demanding patients.

All sedatives can cause physiological and psychological dependence when taken regularly over a period of time, even at therapeutic doses. Dependent users may get withdrawal symptoms ranging from restlessness and insomnia to convulsions and death. When users become psychologically dependent, they feel as if they need the drug to function, although physical dependence does not necessarily occur, particularly with a short course of use. In both types of dependences, finding and using the sedative becomes the focus in life. Both physical and psychological dependence can be treated with therapy.

The sedatives include tranquilizers, hypnotics, benzodiazepines, and anti-anxiety medications (anxiolytics).

Hypnotic (also called soporific) drugs are a class of psychoactives whose primary function is to induce sleep and to be used in the treatment of insomnia and in surgical anesthesia. When used in anesthesia to produce and maintain unconsciousness, "sleep" is metaphorical and there are no regular sleep stages or cyclical natural states; patients rarely recover from anesthesia feeling refreshed and with renewed energy. Because drugs in this class generally produce dose-dependent effects, ranging from anxiolysis to production of unconsciousness, they are often referred to collectively as sedative-hypnotic drugs. Hypnotic drugs are regularly prescribed for insomnia and other sleep disorders, with over 95% of insomnia patients being prescribed hypnotics in some countries. Many hypnotic drugs are habit-forming and, due to a large number of factors known to disturb the human sleep pattern, a physician may instead recommend alternative sleeping patterns, sleep hygiene, and exercise before prescribing medication for sleep. Hypnotic medication when prescribed should be used for the shortest period of time possible.

Text G