Most people who brux are unaware of the problem, either because there are no symptoms, or because the symptoms are not understood to be associated with a clenching and grinding problem. The symptoms of sleep<unk>  are usually most intense immediately after waking, and then slowly abate, and the symptoms of a grinding habit which occurs mainly while awake tend to worsen through the day, and may not be present on waking.<unk>  may cause a variety of signs and symptoms, including: View from above of an anterior (front) tooth showing severe tooth wear which has exposed the dentin layer (normally covered by enamel). The pulp chamber is visible through the overlying dentin. Tertiary dentin will have been laid down by the pulp in response to the loss of tooth substance. Multiple fracture lines are also visible. * A grinding or tapping noise during sleep, sometimes detected by a partner or a parent. This noise can be surprisingly loud and unpleasant, and can wake a sleeping partner. Noises are rarely associated with awake<unk> . * Other parafunctional activity which may occur together with<unk> : cheek biting (which may manifest as morsicatio buccarum and/or linea alba), and/or lip biting. * A burning sensation on the tongue (see: glossodynia), possibly related to a coexistent "tongue thrusting" parafunctional activity. * Indentations of the teeth in the tongue ("crenated tongue" or "scalloped tongue"). * Hypertrophy of the muscles of mastication (increase in the size of the muscles that move the jaw), particularly the masseter muscle. * Tenderness, pain or fatigue of the muscles of mastication, which may get worse during chewing or other jaw movement. * Trismus (restricted mouth opening). * Pain or tenderness of the temporomandibular joints, which may manifest as preauricular pain (in front of the ear), or pain referred to the ear (otalgia). * Clicking of the temporomandibular joints. * Headaches, particularly pain in the temples, caused by muscle pain associated with the temporalis muscle. * Excessive tooth wear, particularly attrition, which flattens the occlusal (biting) surface, but also possibly other types of tooth wear such as abfraction, where notches form around the neck of the teeth at the gumline. * Tooth fractures, and repeated failure of dental restorations (fillings, crowns, etc.). * Hypersensitive teeth, (e.g. dental pain when drinking a cold liquid) caused by wearing away of the thickness of insulating layers of dentin and enamel around the dental pulp. * Inflammation of the periodontal ligament of teeth, which may make them sore to bite on, and possibly also a degree of loosening of the teeth.<unk>  is usually detected because of the effects of the process (most commonly tooth wear and pain), rather than the process itself. The large forces that can be generated during<unk>  can have detrimental effects on the components of masticatory system, namely the teeth, the periodontium and the articulation of the mandible with the skull (the temporomandibular joints). The muscles of mastication that act to move the jaw can also be affected since they are being utilized over and above of normal function. Pain Most people with<unk>  will experience no pain. The presence or degree of pain does not necessarily correlate with the severity of grinding or clenching. The pain in the muscles of mastication caused by<unk>  can be likened to muscle pain after exercise. The pain may be felt over the angle of the jaw (masseter) or in the temple (temporalis), and may be described as a headache or an aching jaw. Most (but not all)<unk>  includes clenching force provided by masseter and temporalis muscle groups; but some bruxers clench and grind front teeth only, which involves minimal action of the masseter and temporalis muscles. The temporomandibular joints themselves may also become painful, which is usually felt just in front of the ear, or inside the ear itself. Clicking of the jaw joint may also develop. The forces exerted on the teeth are more than the periodontal ligament is biologically designed to handle, and so inflammation may result. A tooth may become sore to bite on, and further, tooth wear may reduce the insulating width of enamel and dentin that protects the pulp of the tooth and result in hypersensitivity, e.g. to cold stimuli. The relationship of<unk>  with temporomandibular joint dysfunction (TMD, or temporomandibular pain dysfunction syndrome) is debated. Many suggest that sleep<unk>  can be a causative or contributory factor to pain symptoms in TMD. Indeed, the symptoms of TMD overlap with those of<unk> . Others suggest that there is no strong association between TMD and<unk> . A systematic review investigating the possible relationship concluded that when self-reported<unk>  is used to diagnose<unk> , there is a positive association with TMD pain, and when stricter diagnostic criteria for<unk>  are used, the association with TMD symptoms is much lower. In severe, chronic cases,<unk>  can lead to myofascial pain and arthritis of the temporomandibular joints. Tooth wear Many publications list tooth wear as a consequence of<unk> , but some report a lack of a positive relationship between tooth wear and<unk> . Tooth wear caused by tooth-to-tooth contact is termed attrition. This is the most usual type of tooth wear that occurs in<unk> , and affects the occlusal surface (the biting surface) of the teeth. The exact location and pattern of attrition depends on how the<unk>  occurs, e.g., when the canines and incisors of the opposing arches are moved against each other laterally, by the action of the medial pterygoid muscles, this can lead to the wearing down of the incisal edges of the teeth. To grind the front teeth, most people need to posture their mandible forwards, unless there is an existing edge to edge, class III incisal relationship. People with<unk>  may also grind their posterior teeth (back teeth), which wears down the cusps of the occlusal surface. Once tooth wear progresses through the enamel layer, the exposed dentin layer is softer and more vulnerable to wear and tooth decay. If enough of the tooth is worn away or decayed, the tooth will effectively be weakened, and may fracture under the increased forces that occur in<unk> . Abfraction is another type of tooth wear that is postulated to occur with<unk> , although some still argue whether this type of tooth wear is a reality. Abfraction cavities are said to occur usually on the facial aspect of teeth, in the cervical region as V-shaped defects caused by flexing of the tooth under occlusal forces. It is argued that similar lesions can be caused by long-term forceful toothbrushing. However, the fact that the cavities are V-shaped does not suggest that the damage is caused by toothbrush abrasion, and that some abfraction cavities occur below the level of the gumline, i.e., in an area shielded from toothbrush abrasion, supports the validity of this mechanism of tooth wear. In addition to attrition, erosion is said to synergistically contribute to tooth wear in some<unk> s, according to some sources. Tooth mobility The view that occlusal trauma (as may occur during<unk>  is a causative factor in gingivitis and periodontitis is not widely accepted. It is thought that the periodontal ligament may respond to increased occlusal (biting) forces by resorbing some of the bone of the alveolar crest, which may result in increased tooth mobility, however these changes are reversible if the occlusal force is reduced. Tooth movement that occurs during occlusal loading is sometimes termed fremitus. It is generally accepted that increased occlusal forces are able to increase the rate of progression of pre-existing periodontal disease (gum disease), however the main stay treatment is plaque control rather than elaborate occlusal adjustments. It is also generally accepted that periodontal disease is a far more common cause of tooth mobility and pathological tooth migration than any influence of<unk> , although<unk>  may much less commonly be involved in both.
Bruxism
Vitalism
Rape trauma syndrome
Manganism
Cherubism
Stiff skin syndrome
Oral galvanism
Mirror syndrome