HCV Management Pearl: Teeth Grinding and Its Aggravator

A significant percentage of those living with chronic Hepatitis C infection find themselves dealing with an array of oral health challenges. Bruxism, otherwise known as grinding, gnashing or clenching the teeth is a common habit that can be especially problematic for those managing the Hepatitis C virus (HCV). To protect yourself from the potential pitfalls of bruxism, make sure you know what makes it worse, what to look out for and how to put an end to this tension-building, potentially harmful habit.

Bruxism Causes

Even though there are a number of causes linked to bruxism, HCV in and of itself is not directly responsible for jaw clenching. However, several of the known precipitators of bruxism are often associated with Hepatitis C. Typical culprits include:

Misalignment – where the upper and lower teeth don’t fit together properly
Excessive drinking
Sleep disorders
Antidepressant medications – such as SSRIs
Neuromuscular disease of the face
Between its social implications, symptoms, treatment, management and progression, those with chronic HCV are not strangers to stress or anxiety. The pressures of living with this liver virus tend to spawn tension – which frequently lodges in the jaw and can lead to bruxism. Additionally, Hepatitis C patients may contend with sleeping problems and/or depression. Antidepressants, one of the known causes of bruxism, are commonly prescribed for HCV.

Symptoms and Effects of Bruxism

Just as the degree by which someone clenches his or her jaw or grinds his or her teeth ranges from mild to severe, so are the severity of symptoms. Symptoms that may point to bruxism include:

Ear or jaw pain
Injured gums
If steps are not taken to ease bruxism, the symptoms can intensify and create more unwanted effects such as:

Teeth Sensitivity – Continual grinding of the teeth can slowly wear away the outer enamel of the teeth and can lead to sensitivity.
Physical Damage – Besides wearing down enamel, excessive grinding can also damage teeth and dental fillings, loosen teeth and cause recession of the gums.
Local Pain – The muscular tension created by bruxism can lead to facial pain, intense headaches and jaw pain. The jaw pain is frequently linked to misalignment of the temporomandibular joint – a disorder that has been described as excruciating.
Bruxism Co-Factor

Formally known as xerostemia, a dry mouth is extremely common in those with Hepatitis C. Studies have shown an increased incidence of xerostemia in those with HCV, especially if on antidepressants. The mouth’s natural lubrication has many roles, including cleaning, chemical protection and antibody formation. As such, insufficient saliva can have an array of detrimental effects on oral health.

Indicators of xerostemia include:

A severely dry mouth – especially at night
Sore oral tissues – particularly gums, tongue and cheeks
Frothy, foamy and stringy saliva
Difficulty talking, eating and swallowing
Bad breath
Dental decay and tooth sensitivity
Gone untreated, a severe case of xerostomia can lead to increased levels of tooth decay and mouth infections. According to Dr. Martin Greenberg, chairman of the department of the School of Dental Medicine at the University of Pennsylvania, “If a patient has a dry mouth, the chance of dental caries (cavities) climbs.”

When it comes to tooth decay and sensitivity, adding xerostemia to bruxism magnifies the likelihood of poor oral health. Those with HCV are especially prone to both conditions. Thus, these individuals are advised to be proactive in minimizing their jaw’s tension and maximizing their mouth’s lubrication.

Being Proactive

Tips for managing dry mouth and teeth clenching can go a long way in preserving teeth. The management of xerostemia generally involves the following:

Boosting the mouth’s lubrication with sugar-free chewing gum, increased fluid intake and artificial saliva (if necessary).
Improving oral hygiene (regular brushing and flossing) to remove as much dental plaque as possible.
Using saliva replacements to protect against the breakdown of oral tissues.
Key ways to manage bruxism involve:

Stress Relief – To contend with bruxism, experts suggest stress relief as one of the most important treatments. Stress relief could entail counseling, therapy, biofeedback, exercise, yoga, meditation, aromatherapy or receiving a massage. Whatever solution works best for you, find a healthful stress relief approach to prevent bruxism from continuing.
Teeth/Jaw Alignment – If the bruxism is linked to dental problems, a dentist will evaluate correcting the teeth or jaw alignment. This could involve crowns or onlays to give a new shape to the teeth biting surfaces, or a mouth guard or bite plate to protect teeth and realign the jaw.
Medication Switch – If you take antidepressant medications and grind your teeth, make sure to discuss it you’re your physician, as the problem may be solved by switching to a different antidepressant.
For some, bruxism is mild and may not require treatment. However, teeth grinding has the potential to damage teeth – especially when paired with a dry mouth. Since those with Hepatitis C seem to be prone to both of these conditions, it’s important to know their signs and symptoms, seek regular dental care, practice good oral hygiene and be proactive in managing your mouth.

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