The ABCs of Advanced Dentistry: Airway, Bruxism and Craniofacial Pain

It has become increasingly clear that there is a link between sleep apnea (airway), bruxism and craniofacial pain, in some patients and dentists should be knowledgeable in all three areas. Most dentists are not knowledgeable or well-versed in dental sleep medicine, etiologies of bruxism or craniofacial pain conditions. For this reason many dentists are unable to recognize the risk of sleep apnea, let alone manage patients with oral appliances.

The same goes for craniofacial pain and bruxism. While bruxism is often more noticeable, it is often overlooked. By understanding the unique connections between the airway, bruxism, craniofacial pain and other conditions, dentists can open their practice to more services for diagnosis and treatment options for their patients. Here are the ABCs of advanced dentistry are Airway, Bruxism and Craniofacial Pain.

Airway (Sleep Apnea)

Dental practices are in a unique position to identify patients at risk for conditions involving the airway, such as sleep disordered breathing (SDB). There are many levels of diagnosis a patient may receive once testing has been completed to evaluate a suspect compromised airway, which is where continuing education comes into play. Understanding the airway and how it can affect a patient’s sleeping patterns due to sleep apnea and other sleep disordered breathing conditions is vital in maintaining your patients’ health and improving service offerings.

Bruxism

The gnashing and grinding of the teeth that occurs without a functional purpose is called Bruxism, which can cause a lot of problems for our patients. Whether a patient has a nervous habit, is experiencing stress or is unknowingly grinding their teeth at night, bruxism can cause a lot of damage to not only their teeth, but their overall health as well. Due to the breakage of dental restorations, tooth damage, induction of temporal headaches and temporomandibular joint disorders (TMD) can occur.

Craniofacial Pain (TMD)

And now it comes full circle with craniofacial pain. Covering a wide spectrum of symptoms, Craniofacial pain can be exhibited in many areas of the head and neck. In particular, a majority of craniofacial pain complications can be associated with temporomandibular joint disorder (TMD). Because of this, an essential part of routine dental examinations for all patients should include evaluation for TMD. This includes the gold standard for the diagnosis of TMD, which is based on history, clinical examination, and imaging when appropriate.

There appears to be a relationship apparent in some individuals between the airway, bruxism and craniofacial pain. While it is not found in every patient, there still remain some individuals that require further attention because the connection seems apparent. As a dentist, it is important to understand that clenching or grinding of one’s teeth can be a way for the brain to protect itself from suffocation during sleep.

Each condition can be a sign for a deeper problem, but what do you do about it? Educate yourself. The more you know, the more you can help your patients if this apparent connection arises in various cases. And, while it might not occur in every case, it is vital that we understand it for those certain individuals suffering from all three conditions.  

Let’s Talk About Bruxism

I cringe at the thought of bruxism, or teeth grinding, don’t you? There is a significant need for treatment of bruxism, and even sleep bruxism–don’t worry, we will cover it shortly.

What is Bruxism or Sleep Bruxism?

Bruxism is a term used to describe gnashing and grinding of the teeth that occurs without a functional purpose. Whether a patient’s teeth grinding is due to a nervous habit, stress or unknowingly, bruxism can cause a lot of damage to their teeth, as well as health. Bruxism affects both children and adults, but is most common among 25-44 year olds.

There are two prominent reasons why people grind their teeth at night:

  1. Stress – this is particularly evident for women
  2. Genetics – grinding teeth can be something inherited by family

In 2005, sleep bruxism was categorized as a sleep related movement disorder and defined as an oral parafunctional activity characterized by tooth grinding or jaw clenching during sleep, which is usually associated with sleep arousals. So, why do we care about microtrauma? Because of breakage of dental restoration, tooth damage, induction of temporal headaches and temporomandibular joint disorders (TMD).

Long Term Damage

In comparison to five years ago, dental and orthodontic practices have seen an increase in patients coming into their office with teeth grinding complaints. Whether a person is waking up with a sore jaw, or have been told by their sleep partner that they have been grinding their teeth at night, studies found that nearly 70% of bruxism cases are caused by anxiety. With cases on the rise, whether it is bruxism or sleep bruxism, it is more important than ever to begin treatment and screening immediately.

Take charge of your patients’ health by screening for bruxism. To learn more, contact my office or sign up for an upcoming lecture.