Aviation stress and dental attrition

Voluntary clenching of the teeth is a common maneuver used to facilitate peripheral monosynaptic reflexes and motor system excitability. It has also been indicated that an aggressive biting is associated with a significant attenuation of the stress-induced increase of nor-adrenalin turnover in the brain. Therefore, occlusion of the masticatory organ contributes significantly to an individual’s ability to manage stress. Pathological tooth wear is often associated with bruxism, which appears in turn to be influenced by psychosocial factors. Variables such as general stress, work-related stress, and personality traits have been increasingly considered as initiating, predis-posing, and perpetuating factors for bruxism. Bruxism can cause pain and irreversible damage to the teeth, periodontium, masticatory muscles, and temporo mandibular joint. Bruxism in an otherwise normal dentition can be recognized as a valid system prophylaxis for all stress related situations. We sought to evaluate the potential of aviation related stress to induce bruxism and tooth wear leading to dental attrition among Indian Air Force flying pilots. Subjects were 100 Indian Air Force (IAF) officers of Flying branch who were undergoing routine annual dental examinations at an Air Force Dental Clinic during a 4 week period. One Dental officer using set criteria examined each subject and estimated the tooth wear. Subjective evaluation was based on questionnaire including conscious awareness of bruxism, hypersensitivity and temporomandibular joint pain or discomfort. Awareness of bruxism was also noted as to whether continuous and persistent, momentary while undertaking flying tasks and maneuvering or nocturnal while resting. Bruxism was found in 51% of the overall group of pilots: 61% of the helicopter pilots, 57% of fighter pilots and 32% of transport pilots. Of the total group, twelve subjects had a score of over four and required immediate attention for the condition. 37% of the subjects were aware of their parafunctional habit and resorted to the same as a measure to overcome occupational stress. Air force aircrew may be relatively vulnerable to deleterious effect of bruxism as a consequence of chronic aviation stress. The accelerated rate of tooth attrition in this young population calls for dental and psychological preventive efforts.