The Oral Health Foundation recently raised concerns about teenagers bruxing in their sleep, because it can be a sign of being bullied.
According to a recent study (Serra-Negra et al, 2017), 65% of adolescents who were subjected to verbal bullying in school suffered from sleep bruxism, compared to just 17% in those who were not.
It would seem imperative, therefore, that dentists raise awareness of this indicator with parents, as well as offering advice on how what preventive measures can be taken to minimise damage to the dentition, whilst other parties address the social issues of the problem, to help maintain and build self-esteem.
If a patient presents with pain and/or tooth wear that can be attributed to bruxism, a three-step treatment plan may be appropriate:
1. Prescription of short term muscle relaxants, particularly if an acute situation
2. Treatment with a physiotherapist or osteopath with specialist knowledge of the temporomandibular joint
3. Nightly use of a mouthguard, primarily of the Michigan Splint design
It may also be a good idea to ensure patients are brushing effectively but gently with a relatively soft toothbrush and a toothpaste that is low in abrasivity where there is clear evidence of tooth wear, as well as suggesting they do something relaxing before bed such as reading or having a bath.
Serra-Negra J et al. Is there an association between verbal school bullying and possible sleep bruxism in adolescents? J Oral Rehabil. 2017; 44(5): 347-53