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MANAGING BRUXISM  PATIENTS

An article by Mr. Ian L Withers, Senior Consultant to MyoHealth Global Corporation

People often complain to me that they wake up with a feeling of discomfort or tenderness in the jaw region. Researchers explain that this and other symptoms such as jaw clicking, headaches, wear and damage to teeth, and tooth sensitivity are all indicators of excessive and uncontrolled clenching and grinding. We use the term Bruxism to describe this condition. I’ll bet that if you selected 10 people at random, say at your next dinner party, you will find that half of those people show signs of wear on their cuspids or incisors. In many instances these same people will tell you that they have never been tooth grinders-even when excessive tooth wear is evident.
Fortunately, more and more dentists are learning how to take action to manage patients with Bruxism.

Different Stages of Tooth Damage
If left untreated, grinding and clenching can lead to severe wear and damage of teeth and dental work. This can result in extensive dental treatment including root canal therapy and crowns. Poor cosmetics and a prematurely aged appearance are other problems that can develop from continuous tooth wear.

We know that it is not only healthy teeth that suffer from clenching and grinding, but most restorations are prone to fracture if Bruxism is allowed to continue unchecked. These fractures, even if small, usually require replacement of the entire veneer, crown, or restoration. A great deal of time and money can be saved if dental restorations are protected against the forces of Bruxism.                         
 

What  Can You Do?
There are several methods that you can use to help your patients to manage their Bruxism. These methods will protect teeth and stop jaw pain and headaches. A very effective way of dealing with grinding is to prescribe the

laboratory made anterior splint known as the BiteSoft™ or MCI splint™. This new generation splint is only available from dental labs that have completed thorough training from the developers. Multiple research studies support the use of such splints and also show them as very effective in preventing or reducing headaches and jaw pain (2;3;4).

The BiteSoft™ (MCI™) Splint is much smaller and therefore more comfortable than the traditional full mouth splint which covers all the teeth of one jaw. A recent study has demonstrated that this type of splint design may reduce the forces of clenching and grinding by up to 70% (5).

While the BiteSoft™ is a simple and effective method of dealing with grinding and clenching at night during sleep, there is also a need to assist patients with their day-time clenching. Because teeth are not meant to touch during day-time, it is important to teach patients to keep their jaw in the rest position, when not chewing, with the teeth apart. There is evidence that Bruxism can increase during times of stress and anxiety. Stress can also directly lead to muscle tension and pain. Seeking support in utilising the following methods can help deal with excessive stress and minimise Bruxism:

• Hypnosis
• Muscle relaxation
• Exercise
• Massage
• Yoga
• Counseling
• Relaxing Music
• Social support
• Goal setting
• Time management skills

Stress reduction techniques, jaw muscle relaxation during the day and the use of a splint during sleep are the best ways to overcome clenching, grinding and their effects.

References
1. Prevalence of Bruxism Awareness in a Sardinian Population.
Marcello et al J of Craniomandibular Practice April2003, Vol. 21 No2 p.144-151

2. Migraine: the effect of acrylic appliance design on clinical response. Br Dent J 1996 Feb 24;180(4):137-4

3. Migraine and Tension-Type Headache Reduction Through Pericranial Muscular Suppression. W Shankland. The Journal of CranioMandibular Practice Oct 2001 Vol 19 No 4

4. The Result of Treatment of the Masticatory System of Chronic Headache Patients. Schokker et al. J Craniomandibular Disorders: Facial & Oral Pain 1990:4:126-130

5. Effect of a prefabricated anterior bite stop on electromyographic activity of masticatory muscles.
Becker et al J Prosthet Dent, 82(1):22-6 1999 Jul

To visit the bitesoft splint official website, please click here

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