EditorialKeywords:Treatment; Elderly; Medicine
Abbreviations: TMJ: Temporomandibular Joint; SSRIs: Serotonin Reuptake Inhibitors; REM: Rapid Eye Movement
Editorial
Bruxism is one of the most important challenges in old age
because many families suffer from it because of its abnormal
sound that causes discomfort and suffering to others or is so
severe as to cause injury and also that there are definite treatment
for This disease does not exist. A wide range of conditions and
symptoms, including hardening, grinding, and grinding of teeth,
are considered a subset of Bruxism, the most common functional
activity of the oral area, and a stomatognathic type that occurs
during sleep and wakefulness [1-4]. Symptoms include severe
facial muscle contraction, tooth wear, tooth mobility, pain in the
temporomandibular joint (TMJ) or jaw muscle, temporal headache
and poor sleep, loss of occlusal morphology, and flattening of
occlusal surfaces [3,5]. Determining the exact prevalence of bruxism
is difficult because most population studies, due to technical / cost
constraints, are usually based on self-report questionnaires and
more than 80% are unaware of their habit. In most studies, about
13% of middle-aged adults and only 3% of older people brush their
teeth while sleeping [6]. Currently, there is no specific treatment
that can stop bruxism in sleep, the management of bruxism relies on
recognizing the potential factors associated with the deterioration
of bruxism. Which is usually aimed at protecting / restoring teeth,
reducing bruxism and relieving pain [3]. Although the use of a variety
of drugs has been reported to manage bruxism, only clonidine,
L-dopa, and clonazepam have been shown to reduce symptoms in
controlled clinical trials. When compared with placebo, clonazepam
significantly reduces the index of bruxism. It also improves sleep
quality, sleep continuity, improves sleep duration, reduces arousal,
as well as reduces mental sleep and improves the quality of waking
up. It is also recommended to limit its long-term use due to the risk
of dependence and other psychological side effects [6].
Topically administered botulinum toxin (BTX type A) has
also been used to manage bruxism [7,8]. BTX-A is a peripheral
cholinergic synapse blocking agent that is considered resistant
to conventional treatment for patients with severe gritted teeth,
especially those with movement disorders. BTX-A has been shown
to reduce the number and severity of bruxism in clinical trials. An
injection of BTX-A for at least one month was effective in controlling
bruxism. Possible side effects of BTX-A master injection include
difficulty breathing, speech disorder, muscle pain, and secondary
facial asymmetry to reduced muscle size due to master atrophy [6]. Short-term use of dopamine precursors such as L-dopa
inhibits bruxism, and long-term use of L-dopa increases bruxism,
serotonin reuptake inhibitors (SSRIs), which have an indirect effect
on the dopaminergic system. They may cause teeth to grind after
prolonged use. Amphetamine, which increases the concentration
of dopamine by facilitating its secretion, causes gnashing of teeth.
Nicotine has also been shown to stimulate central dopaminergic
activity, which may explain why smokers report twice as much
bruising as non-smokers [9]. Other medications include the use of
bromocriptine, propranolol, buspirone, anxiolytics, sedatives, and
muscle relaxants. Medications such as diazepam can be prescribed
for several days to change sleep disorders and anxiety levels. Low
doses of tricyclic antidepressants may be used to prevent rapid
eye movement (REM) sleep [10,11]. Since the definitive treatment
for bruxism is not known but the use of medications Clonidine,
clonazepam, sedatives and antidepressants are the most common
treatments. It is a medicine that has been used in medicine.
Acknowledgement
None.
Financial Support
None.
Conflict of Interest
None.
References
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