It is common for the chronic TMD sufferers to have over stretched the ligaments of the TMJ.Â This results in the joints being too loose.Â When sleeping, the jaw often falls back and interfers with breathing.Â There are studies that link bruxism ( clenching and grinding) to Sleep Disordered Breathing.Â
Gilles Lavigne, a researcher in the Faculties of Dentistry and Medicine at UniversitÃ© de MontrÃ©al, explains that â€œthe development of neurobiology has enabled us to better understand the structure of sleep in clenchers and to define bruxism clearly as one of many cyclic phenomena that are characteristic of sleep.â€ The researcher and his team at SacrÃ©-CÅ“ur hospital in MontrÃ©al have now gained international recognition for establishing criteria to identify nocturnal bruxism.
Many medications that are classified as Selective Serotonin Reuptake Inhibitors (SSRI) have been shown to induce clenching especially during sleep.Â
Drugs in this class include (trade names in parentheses): (source: Wikipedia)
- citalopram (Celexa, Cipramil, Dalsan, Recital, Emocal, Sepram, Seropram)
- dapoxetine (no trade name yet; not yet approved by the FDA)
- escitalopram (Lexapro, Cipralex, Esertia)
- fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Fluctin (EUR), Fluox (NZ), Depress (UZB))
- fluvoxamine (Luvox, Fevarin, Faverin, Dumyrox, Favoxil, Movox)
- paroxetine (Paxil, Seroxat, Sereupin, Aropax, Deroxat, Rexetin, Xetanor, Paroxat)
- sertraline (Zoloft, Lustral, Serlain)
- zimelidine (Zelmid, Normud)
These medicines are used so commonly for a long list of indications, this is definitely something to be aware of.
When I wear my seat belt before driving my car on the street, it does not show a lack of confidence in my driving ability.Â There are other drivers on the road that may be impaired or inattentive.Â There may be a mechanical problem such as a blown tire from a nail on the street.Â So wearing a seat belt is a sensible thing to do.
If we prescribe a sleep appliance such as Somnomed MAS after finishing a Neuromuscular Reconstruction, it shows prudence.Â Not a lack of belief in our ability.Â Just like wearingÂ a seat belt.