I-Bruxism

I-Bruxism yisimo esivamile samazinyo esiheha ososayensi nodokotela bemikhakha ehlukahlukene, njengodokotela, odokotela bamazinyo, ochwepheshe be-orofacial, kanye izazi zezinzwa. Abantu abaningi abazi ukuthi bane-bruxism kuze kube yilapho bethola izimpawu noma amabala abo odokotela bamazinyo izimpawu zokuguga emazinyweni abo. Le bhulogi ihlola izimpawu, izimbangela, kanye nokwelashwa kwe-bruxism. Icubungula iqiniso lokuthi kungani abanye abantu beququda amazinyo ebusuku, izizathu ezingaba yi-bruxism, nezindlela ezehlukene zokwelapha nokuvimbela lesi simo.

Iyini i-Bruxism?

I-Bruxism yisimo esivamile se-orofacial esiphawulwa ukugaya, ukufiphaza, noma ukugedla (ukugedla) kwamazinyo. Lokhu kuziphatha ngokuvamile kwenzeka ngokungazi futhi kungenzeka phakathi kokubili kokuphaphama nokulala.

• I-Awake bruxism (AB), okwenzeka phakathi nosuku, kuhilela ukuququda noma ukugedla amazinyo nomhlathi ngokuzenzakalelayo lapho umuntu ephapheme futhi eqaphile. 
• I-Bruxism yokulala (SB), okwenzeka ebusuku, kuxhaphake kakhulu futhi kufundwe kabanzi kunozakwabo wasemini.

I-Bruxism ihilela ukufinyela okunesigqi kwemisipha ye-masseter, enesibopho sokuhlafuna. Lokhu kufinyeza kuvame ukuhambisana nokugedla kwamazinyo nokududulana kwe-mandible. Phakathi neziqephu ze-bruxism yokulala (i-nocturnal bruxism), abantu ngabanye bangase basebenzise amandla afinyelela kumakhilogremu angu-250 emazinyweni abo, okungaholela ekulimaleni kwamazinyo okuphawulekayo ngokuhamba kwesikhathi. I-Bruxism ebusuku ngokuvamile ivela ezigabeni zokuqala zokulala, ikakhulukazi phakathi nesigaba soku-1 nesesi-2 sokulala okungeyona i-REM. 

Ukusabalala kwe-bruxism kuyahlukahluka kuwo wonke amaqembu eminyaka. I-sleep bruxism ivame kakhulu ezinganeni nasebancane, ihlasela u-15% kuya ku-40% wezingane, kanti u-8% kuya ku-10% wabantu abadala bayayithola. I-Ake bruxism, ngakolunye uhlangothi, ithinta ama-22.1% kuya ku-31% wabantu.

Izimpawu Ezivamile Ze-Bruxism

I-Bruxism inezinhlobonhlobo zezimpawu ezingathinta impilo yomlomo kanye nokuphila kahle. Abantu abaningi abanalesi simo bangase bangawazi umkhuba wabo wokugedla amazinyo, ikakhulukazi uma kwenzeka ngesikhathi sokulala. Kodwa-ke, izimpawu ezithile zingabonisa i-bruxism, njenge:

• Ukusula Nokugaya Amazinyo Ngokungazikhetheli: Lokhu kuziphatha ngokuvamile kwenzeka ngeziqephu ezimfushane ezithatha amasekhondi ambalwa. Imvamisa yalezi ziqephu ingahluka, futhi ukugedla kwamazinyo kungase kungenzeki njalo ebusuku.
• Pain: Abantu abane-bruxism bavame ukuzwa ubuhlungu ebusweni babo, intamo, nasemahlombe. 
• Ukungakhululeki Emhlathini: Kuvamile futhi kungaholela ku-temporomandibular disorder (TMD).
• Ikhanda Lasekuseni: Lezi izinhlungu zekhanda ngokuvamile uzizwa njengobuhlungu bekhanda obucindezelayo futhi ungahlala amahora noma ngisho nezinsuku.
• Izinkinga Zamazinyo: Amazinyo agugile noma aphukile, ukwanda kokuzwela, nokulahlekelwa amazinyo nokugcwaliswa kuyimiphumela evamile. 
• Ezinye Izimpawu: Lokhu kubandakanya izindlebe, tinnitus (ekhala ezindlebeni), aphazamise ubuthongo. 

Izimbangela Eziyisisekelo kanye Nezici Zengozi Ye-Bruxism

I-Bruxism ayinayo imbangela eyodwa. Esikhundleni salokho, kuhilela izici eziningi, okuhlanganisa izakhi zomzimba, ezengqondo, nezofuzo. 

• Ukucindezeleka Nokukhathazeka: Abantu abanokucindezeleka noma ukuphazamiseka kokukhathazeka okujwayelekile kunamathuba amaningi okuthi baququde futhi baququde amazinyo ebusuku noma babambe imihlathi emini.
• Imithi: Imithi ethile, njenge-selective serotonin reuptake inhibitors (SSRIs), ingase futhi iqalise i-bruxism njengomphumela oseceleni.
• Izimo Zezokwelapha: I-Bruxism ingabonakala ngezinkinga ezithile zempilo yengqondo nezokwelapha, njenge-gastroesophageal reflux disorder (GERD), isifo sikaParkinson, ukuwohloka komqondo, isithuthwane, ukwesabeka ebusuku, kanye ne-attention-deficit/hyperactivity disorder (ADHD).
• Izinkinga Zokulala: Izimo ezifana ne-apnea yokulala zinesixhumanisi esinamandla se-bruxism. 
• Imikhuba Yendlela Yokuphila: Ukubhema, ukuphuza utshwala, kanye nokudla i-caffeine eningi kungaphinda kabili ingozi yokugedla kwamazinyo.
• Izinhlobo Zobuntu: Abantu abanolaka, abanokuncintisana, noma abakhuthele kakhulu bangase bathambekele kakhudlwana ku-bruxism. 
• Ubudala: I-Bruxism ingakhula kunoma iyiphi iminyaka kodwa ivame kakhulu ezinganeni ezincane kanye nentsha.
• Umlando Womndeni: I-bruxism yokulala noma yasebusuku ivame ukwenzeka emindenini. 

Izinkinga

I-Bruxism ingaholela ezinhlobonhlobo zezinkinga ezithinta kokubili impilo yomlomo kanye nokuphila kahle okuphelele, okuhlanganisa:

• Ukulimala kwezinyo: Ngokuhamba kwesikhathi, ukulokhu ukugaya nokuhlanganisa kungabangela amazinyo ukuba aguge, abe isicaba, noma aqhekeke. Lokhu kugqokwa kungaholela ekwandeni kokuzwela kwamazinyo, ikakhulukazi emazingeni okushisa ashisayo nabandayo, njengoba ungqimba oluvikelayo loqweqwe lwawo luguguleka.
• Izinkinga ze-Temporomandibular joint (TMJ): Abantu abane-bruxism bangase babe nokuqina kwemihlathi nobuhlungu, kube nzima ukuvula nokuvala umlomo, nokuzwa imisindo yokuchofoza noma ephumayo lapho unyakazisa umhlathi. 
• Iziphazamiso Zokulala: Abantu abaningi abanalesi simo babika ubunzima bokulala, ukuvuka njalo ebuthongweni, nokuzizwa bengaqabulekile ekuseni. Lokhu kungaholela ebuthongweni basemini, ukungasebenzi kahle kwengqondo, nokuncipha kokusebenza kwezemfundo noma emsebenzini.
• Pain: Ukucindezeleka okubekwa emisipha yobuso ngenxa ye-bruxism kungabangela ubuhlungu bekhanda obungapheli, izindlebe, nobuhlungu bobuso. 
• Ukulimala Kwe-Dental Prosthesis: I-Bruxism ingalimaza umsebenzi wamazinyo njengemiqhele, ukugcwaliswa, nokufakelwa, okuholela ekushintshweni njalo kanye nezinqubo ezengeziwe zamazinyo.

Sifo

• Umlando Wezokwelapha Nokuhlolwa Komlomo: Odokotela bamazinyo badlala indima ebalulekile ekuxilongeni i-bruxism. Bangase babuze ngezimpawu ezinjengobuhlungu bomhlathi wasekuseni, ubuhlungu bekhanda, noma ukuvala imihlathi. Bazobuza ngekhwalithi yokulala, umlando womndeni, nezici eziyingozi ezifana nengcindezi, ukukhathazeka, noma ukusetshenziswa kwemithi. Phakathi nokuhlolwa komlomo okuvamile, bahlola amazinyo ukuze babone izimpawu zokuguga, njengamathiphu abacaba noma amazinyo aphukile. Lokhu kungahambi kahle kwamazinyo kungaba izinkomba zakuqala ze-bruxism. 
• Ama-X-ray: I-X-ray yamazinyo ne-maxillofacial ingase futhi ihlole umonakalo emazinyweni nasezakhiweni zamathambo ezingaphansi.
• Isifundo sokulala: Ngezinye izikhathi odokotela batusa isifundo sokulala (i-polysomnography). Lokhu kuhlola kurekhoda amaza obuchopho, ukushaya kwenhliziyo, namaphethini okuphefumula phakathi nokulala. Nakuba kungadingeki ngaso sonke isikhathi ukuhlonza i-bruxism kuphela, kungasiza ukukhomba ukuphazamiseka kokulala okuhlobene njengokuthi ukulala ubuthongo.

Ukwelashwa kwe-Bruxism

Ukwelapha i-Bruxism kugxile ekuvimbeleni ukulimala okwengeziwe kwamazinyo nokukhulula izimpawu ezihambisanayo. Izindlela ezahlukahlukene ziyatholakala, kufaka phakathi:

• Ukungenelela Kwamazinyo: Izindlela zamazinyo ngokuvamile ziwumugqa wokuqala wokwelashwa kwe-bruxism. 
  • Odokotela bamazinyo bangase batuse izintambo zokuphotha noma izinsimbi zokuvikela umlomo, eziklanyelwe ukugcina amazinyo ehlukene futhi siwavikele emonakalweni obangelwa ukuhlanganisa nokugaya. 
  • Ezimweni ezimbi kakhulu, ukulungiswa kwamazinyo kungase kudingeke, okubandakanya ukulungisa kabusha izindawo zokuhlafuna noma ukusebenzisa imiqhele ukulungisa umonakalo.
• Amasu okuziphatha: 
  • Izindlela zokulawula ingcindezi, njenge-yoga, ukuzindla, nokuhlola izinto zokuzilibazisa.
  • I-Biofeedback, indlela esebenzisa izinto zokuqapha ukuze ifundise ukulawula ukusebenza kwemisipha emhlathini, ingase izuzise labo abazabalaza ukushintsha imikhuba yabo.
• Imithi: 
  • Iziphumlisi zemisipha ezithathwe ngaphambi kokulala isikhathi esifushane zingasiza. 
  • Ezimweni eziphikisayo, izidakamizwa ezinjengama-antidepressants noma i-anti-anxiety zingasetshenziswa.
  • Imijovo yobuthi be-botulinum ku-masseter & nemisipha yesikhashana njalo ezinyangeni eziyisithupha ingase ikhulule iziguli ezine-bruxism enzima.

Uzoyibona Nini Udokotela

Kufanele ubone udokotela wamazinyo uma uzwa ubuhlungu obungapheli bomhlathi, ukungaphatheki kahle kobuso, noma ubuhlungu bendlebe. Lezi zimpawu zingase zibe izimpawu ze-bruxism noma izifo ezihlangene ze-temporomandibular. Ukwengeza, uma umlingani wakho ekubona ukuthi ugedla amazinyo ngesikhathi sokulala, sekuyisikhathi sokuthintana nochwepheshe.

Kwezinye izimo, ungase uthunyelwe kumelaphi noma umeluleki uma kusolwa ukuthi izici ezingokwengqondo zidlala indima ku-bruxism yakho. 

Prevention

Ukuvimbela i-bruxism kuhilela inhlanganisela yezinguquko zendlela yokuphila kanye nezinyathelo ezisebenzayo. Lokhu kubandakanya:

• Ukugqoka i-mouth guard ebusuku  
• Ukuzijwayeza izindlela zokuphumula ngaphambi kokulala kungasiza ekudambiseni ukungezwani okuvame ukuholela ekugedleni kwamazinyo. 
• Ukuzivocavoca njalo kusiza ukunciphisa amazinga okucindezeleka futhi kungasiza ekuvimbeleni i-bruxism.
• Ukugcina inhlanzeko yokulala kubalulekile. Misa isimiso sokulala esingaguquki futhi wenze indawo yekamelo lokulala eliphumulele. Lokhu kungase kuhlanganise ukugeza okufudumele, ukufaka i-pad yokushisisa emhlathini wakho, noma ukuphuza itiye le-herbal engenayo i-caffeine ukuze uphumuze imisipha yobuso bakho.
• Zijwayeze ukuqaphela futhi uhlole ngezikhathi ezithile ukuthi ubambe ukucindezeleka emhlathini wakho. 
• Gwema ukuhlafuna izinto ezingezona ukudla njengezikepisi zamapeni noma iqhwa, njengoba le mikhuba ingaqinisa ukubopha imihlathi. Ngezinsuku lapho i-bruxism yakho ivutha, gwema ukudla okuhlafunwayo okudinga ukunyakaza kwemihlathi kakhulu.

Isiphetho

I-Bruxism yisimo samazinyo esiyinkimbinkimbi esithinta izimpilo zabantu abaningi. Ukubhekana ne-bruxism ngokuvamile kudinga inhlanganisela yezindlela. Lokhu kungahlanganisa ukusebenzisa imilomo, ukulawula ukucindezeleka, kanye nokuphuza imithi ngezinye izikhathi. Ukuthatha isinyathelo kusenesikhathi kungavikela amazinyo akho futhi kuthuthukise inhlalakahle yakho iyonke.

Imibuzo Evame Ukubuzwa

1. Ungakwazi yini ukuyeka i-bruxism ngokwemvelo?

Kunezindlela eziningana zemvelo zokuphatha i-bruxism. Amasu okwehlisa ingcindezi njengokuzivocavoca ukuphefumula okujulile angasiza ukuphumuza imisipha yomhlathi. Ukugcina inhlanzeko yokulala kahle, ukugwema i-caffeine notshwala ngaphambi kokulala, nokuzilolonga emihlathini nakho kungase kube yinzuzo. 

2. Ingabe i-bruxism iyaphela?

I-Bruxism ebusuku ayihlali iyodwa, ikakhulukazi kubantu abadala. Ezinganeni, kuvame ukuxazulula njengoba zikhula. Ukubhekana nezimbangela eziwumsuka ezifana nengcindezi noma ukuphazamiseka kokulala kungasiza ekwehliseni izimpawu kubantu abadala. Nokho, kungase kudingeke ukuphatha isikhathi eside ezimweni eziningi.

3. Yiziphi izimbangela eziphambili ze-bruxism?

Imbangela eqondile ye-bruxism ayiqondwa ngokugcwele, kodwa izici ezimbalwa zingaba nomthelela. Ukucindezeleka nokukhathazeka yizimbangela ezivame kakhulu. Ukuphazamiseka kokulala, imithi ethile, nemikhuba yokuphila njengokubhema noma ukusebenzisa i-caffeine ngokweqile nakho kungadlala indima. Amazinyo angalungile noma izinkinga zemihlathi ngezinye izikhathi zingaholela ku-bruxism ebusuku.

4. Ingabe i-bruxism ibucayi?

Nakuba kungekona ukuphila engozini, i-bruxism ingaholela ezinkingeni ezingathi sína zamazinyo nempilo uma ishiywe inganakiwe. Kungabangela ukulimala okukhulu kwamazinyo, ubuhlungu bemihlathi, ikhanda elibuhlungu, ngisho nokuphazamiseka kwamalunga e-temporomandibular. Ukugedla amazinyo njalo kungawohloka koqweqwe lwawo lwamazinyo, kwandise ukuzwela kwamazinyo, futhi kubangele ukulahleka kwesakhiwo samazinyo. 

5. Yikuphi ukuntula okubangela i-bruxism?

Ucwaningo lwakamuva luphakamise ukuxhumana phakathi ukushoda kukavithamini D kanye ne-bruxism. Amazinga aphansi kavithamini D angaphazamisa i-calcium homeostasis, ethinta ukusebenza kwe-neuromuscular futhi engase iholele emisipha yemisipha. Ukuntuleka kwe-Magnesium kuye kwaxhunyaniswa nokwanda kokungezwani kwemisipha kanye ne-bruxism. 

UDkt. Sreenivasa Rao Akula

BDS, MDS, Fellow ICOI (USA), Dental Surgeon Periodontist & Implantologist
Izibhedlela ze-CARE, Nampally, Hyderabad, CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

1