I read this article and thought I would share with my opinion with you. Whilst I find it useful that the subject of malocclusion and bruxism is getting more coverage, I think this article over simplified a far more complex issue and the currently available treatments.
There cannot be a ‘one size fits all’ approach to teethgrinding.When it comes to bruxism, teeth position and the muscles of your head and neck are not limited to the Temporalis muscle and malocclusion . There are at least four different muscle groups that play their part as well as the balance of your jaw in its sockets. Simply relaxing the muscles does not eliminate the incorrect tooth position, it provides a helpful though temporary respite.
When I treat a person with tooth grinding symptoms, I first assess all the muscles in the head and neck area identifying any trigger points by gently pressing the muscles to see how much pain is felt by the patient. This palpation of the muscles is critical to understanding the patients perception of the pain they feel as well as any tension because of increased activity.I also assess the tension through biting pressure, checking for muscle enlargement and tenderness. I look for any unnatural movements on opening or closing of the jaw, or when teeth first touch when closing. I would then prescribe a treatment according to this assessment which may include adjusting the teeth, building the teeths biting surfaces up, replacing missing teeth or making a hard occlusal splint for wearing at night time which will be able to effect and retrain all muscles of mastication.
Unless you deal with the position of teeth, the jaw cannot seat properly, imbalancing the bite . The treatment goal is a comfortable position with the chewing load evenly distributed. Muscle pain tends to be a malocclusion and jaw pain is different to muscle pain. Signs such as teeth wear, teeth cracking and breaking can be indicators not only of bruxism but clenching which has different symptoms- Clenchers are usually in pain and their habit can occur as much during the day as night.
Splint therapy has been proven over more than 30 years, but it requires the patient to take ownership of their condition. There is no quick fix to this. PLease visit the website www.pankeydentist.org for more information.
Estimate cost of treatment splint therapy- £ 600-£1000
Best wishes
Tom
Dr Tom Keppel
Clinical Director
Grand Smile Designs
London
