口腔の健康と歯の管理

概要

Extended Case Report. Bruxism with a History of Early Onset in a 25-Year-Old Male

Veronica Mercu

This paper reports the case of a 25-year-old male patient with bruxism who has been monitored for more than 20 years. Once his permanent teeth had erupted, his bruxism led to advanced wear at the palatal aspect of the maxillary incisors. The patient is physically normally developed but has muscle hypertrophy of the scapulohumeral belt, without having practised any physical exercises for developing the muscles in this area. Psychologically, he is well balanced, very meticulous, conscientious, intelligent, and a cooperative patient. He reported that he was a great consumer of caffeine-based soda drinks (about 2l per day). He gave a history of grinding his teeth from a very early age while sleeping and stated that he used to wake up during these teeth-grinding episodes, with his jaws clenched. On the basis of the history, a provisional diagnosis of bruxism was made. Since he was 14 years old, his bruxism has been monitored by one of the authors of this case report and the minimal criteria for diagnosis set by American Sleep Disorder Association and revised by American Academy of Sleep Medicine have been applied. The patient presented three conclusive signs, included in these minimal criteria: tooth wear, teeth grinding, and jaw clenching. The major factor that triggered his bruxism could not be identified. He has worn a night guard, had topical fluoride applications, and has been advised to reduce his intake of caffeine and carbonated drinks and try to minimise stressful factors in his life.