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What is Bruxism?

Beuxism is an involuntary act of clenching or grinding your teeth, especially during sleep. Some people with bruxism unconsciously clench their teeth together during the day, often when they feel anxious or tense. This is different from tooth grinding or clenching that occurs at night, which is called sleep bruxism. Most children who are bruxers do so at night, while adults are either daytime or nighttime bruxers. Bruxism can lead to jaw disorders, headaches, damaged teeth and other problems. Unfortunately, people with sleep bruxism usually aren't aware of the habit, so they aren't diagnosed with the condition until complications occur. That's why it's important to know the signs and symptoms of bruxism and to seek regular dental care. What Bruxism Causes Bruxism is caused by stress and nervous tension, and may do serious harm to your teeth. The most visible damage is progressive wear, possibly with chipping, but most of all those who suffer may also have problems such as: - Jaw Joint Pain - Neck Pain - Vertigo and headaches Furthermore bruxism is also one of the causes of parainsomnias (sleep disorders), which make night-time rest difficult and not restoring. A more serious cause are Temporomandibular disorders -- which occur in the temporomandibular joints (TMJs), located just in front of your ears and felt when opening and closing your mouth.

The TMJ connects the lower jaw to the skull (temporal bone) under your ear. Certain facial muscles control chewing. Problems in this area can cause head and neck pain, a jaw that is locked in position or difficult to open, problems biting, and popping sounds when you bite. Who suffers from it? 50% of the population - adults and children - suffer with or without being aware of it. Even sportsmen suffer, especially those who practice intense concentration sports, such as racing and motorbike drivers. In a nutshell, the greater the tension, the greater the bruxism. Symptoms of Bruxism Diffuculty opening your mouth wide when you wake up Teeth grinding or clenching, which may be loud enough to wake your sleep partner Teeth that are worn down, flattened or chipped Worn tooth enamel, exposing the inside of your tooth Increased tooth sensitivity Jaw pain or tightness in your jaw muscles Earache -- because of severe jaw muscle contractions, not a problem with your ear Headache Chronic facial pain Chewed tissue on the inside of your cheek

What is TMJ Syndrome?

Temporomandibular joint (TMJ) syndrome or TMJ joint disorders are medical problems related to the jaw joint. The TMJ connects the lower jaw (mandible) to the skull (temporal bone) in front of the ear. Certain facial muscles control chewing. Problems in this area can cause head and neck pain, a jaw that is locked in position or difficult to open, problems biting, and popping sounds when you bite. The TMJ is comprised of muscles, blood vessels, nerves, and bones. You have two TMJs, one on each side of your jaw. Muscles involved in chewing (mastication) also open and close the mouth. The jawbone itself, controlled by the TMJ, has two movements: rotation or hinge action, which is opening and closing of the mouth, and gliding action, a movement that allows the mouth to open wider. The coordination of this action also allows you to talk, chew, and yawn.

If you place your fingers just in front of your ears and open your mouth, you can feel the joint and its movement. When you open your mouth, the rounded ends of the lower jaw (condyles) glide along the joint socket of the temporal bone. The condyles slide back to their original position when you close your mouth. To keep this motion smooth, a soft disc of cartilage lies between the condyle and the temporal bone. This disc absorbs shock to the temporomandibular joint from chewing and other movements. Chewing creates a strong force. This disc distributes the forces of chewing throughout the joint space. TMJ Syndrome Causes TMJ syndrome can be caused by trauma, disease, wear due to aging, or habits. Trauma: Trauma is divided into microtrauma and macrotrauma. Microtrauma is internal, such as bruxism (grinding the teeth) and clenching (jaw tightening). This continual hammering on the temporomandibular joint can change the alignment of the teeth. Muscle involvement causes inflammation of the membranes surrounding the joint. Teeth grinding (bruxism) and clenching are habits that may be diagnosed in people who complain of pain in the temporomandibular joint or have facial pain that includes the muscles involved in chewing (myofascial pain). Macrotrauma, such as a punch to the jaw or impact in an accident, can break the jawbone or damage the disc. Bruxism: Teeth grinding as a habit can result in muscle spasm and inflammatory reactions, thus causing the initial pain. Changes in the normal stimuli or height of the teeth, misalignment of the teeth, and changes in the chewing muscles may cause temporomandibular joint changes. Generally, someone who has a habit of grinding his or her teeth will do so mostly during sleep. In some cases, the grinding may be so loud that it disturbs others. Clenching: Someone who clenches continually bites on things while awake. This might be chewing gum, a pen or pencil, or fingernails. The constant pounding on the joint causes the pain. Stress is often blamed for tension in the jaw, leading to a clenched jaw. Osteoarthritis: Like other joints in the body, the jaw joint is prone to undergo arthritic changes. These changes are sometimes caused by breakdown of the joint (degeneration) or normal aging. Degenerative joint disease causes a slow progressive loss of cartilage and formation of new bone at the surface of the joint. Cartilage destruction is a result of several mechanical and biological factors rather than a single entity. Its prevalence increases with repetitive microtrauma or macrotrauma, as well as with normal aging. Immunologic and inflammatory diseases contribute to the progress of the disease. Rheumatoid arthritis: Rheumatoid arthritis causes inflammation in joints and can affect the TMJ, especially in children. As it progresses, the disease can cause destruction of cartilage and erode bone, deforming joints. It is an autoimmune disease involving the

antibody factor against immunoglobulin G (IgG). Chronic rheumatoid arthritis is a multisystem inflammatory disorder with persistent symmetric joint inflammation. Symptoms of TMJ Syndrome Pain in the facial muscles and jaw joints may radiate to the neck or shoulders. Joints may be overstretched. You may experience muscle spasms from TMJ syndrome. You may feel pain every time you talk, chew, or yawn. Pain usually appears in the joint itself, in front of the ear, but it may move elsewhere in the skull, face, or jaw. TMJ syndrome may cause ear pain, ringing in the ears (tinnitus), and hearing loss. Sometimes people mistake TMJ pain for an ear problem, such as an ear infection, when the ear is not the problem at all. When the joints move, you may hear sounds, such as clicking, grating, and/or popping. Others may also be able to hear the sounds. Clicking and popping are common. This means the disc may be in an abnormal position. Sometimes no treatment is needed if the sounds give you no pain. Your face and mouth may swell on the affected side. The jaw may lock wide open (then it is dislocated), or it may not open fully at all. Also, upon opening, the lower jaw may deviate to one side. You may find yourself favoring one painful side or the other by opening your jaw awkwardly. These changes could be sudden. Your teeth may not fit properly together, and your bite may feel odd. You may have trouble swallowing because of the muscle spasms. Headache and dizziness may be caused by TMJ syndrome. You may feel nauseous or vomit.

Will your TMJ splint be covered by your insurance company?

Filing a splint has become extremely difficult and a lengthy process. Therefore, we no longer file TMJ splint preauthorizations. In the past it has taken months to get an explanation of benefits. If you are suffering from TMJ and are in pain, waiting months is probably not what you want to do. Insurance companies have made it impossible for us to know every plan's specifications. It is your responsibility to know your individual insurance plan benefits. If you would like to know what the "out of pocket" cost will be, contact your insurance company. Check with your health and dental insurance with the codes listed below to determine benefits. Make sure your insurance will pay for these benefits if you go to a general dentist opposed to an oral surgeon. Dental Insurance: TMJ Splint Procedure Code 09927

Diagnostic Casts Health Insurance: TMJ Splint Diagnostic Casts

Procedure Code 00470 Diagnosis Code 524.60 Diagnosis Code 524.50 Procedure Code 21085 Procedure Code 99070

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