Re: Bruxomania

[Anonymous]

If disagnosed early, finding and eliminating the original cause may cure bruxism. Later on, habitual bruxism can be treated by habit-modification.Treating associated factors can reduce or eliminate the behavior in cases where bruxism has not become habitual
Dental guards and splints
A dental guard or splint can reduce tooth abrasion. Dental guards are typically made of plastic and fit over some or all of upper and/or lower teeth. The guard protects the teeth from abrasion and can reduce muscle strain by allowing the upper and lower jaw to move easily with respect to each other. Treatment goals include: constraining the bruxing pattern to avoid damage to the temporomandibular joints; stabilizing the occlusion by minimizing gradual changes to the positions of the teeth, preventing tooth damage and revealing the extent and patterns of bruxism through examination of the markings on the splint’s surface. A dental guard is typically worn during every night’s sleep on a long-term basis. Dental guards do not cure the condition.A repositioning splint is designed to change the patient’s occlusion, or bite
Another option is a NTI-tss (nociceptive trigeminal inhibitor) dental guard. Nociceptor nerves sense and respond to pressure. The trigeminal nerve supplies the face and mouth. The NTI appliance snaps onto the front teeth. Normally when the mouth is closed, the upper and lower front teeth overlap: The NTI prevents this overlap and translates the bite force from attempts to close the jaw normally into a forward twisting of the lower front teeth. The intent is for the brain to interpret the nerve sensations as undesirable, automatically and subconsciously reducing clenching force. Unfortunately, for patients who do not subconsciously clench less using an NTI devce, the NTI can lead to more severe damage from clenching. The NTI device must be fitted by a dentist.
The efficacy of such devices is debated. Some writers propose that irreversible complications can result from the long-term use of mouthguards and repositioning splints. Randomly controlled trials with these type devices generally show no benefit over other therapies. Clenching hard while wearing an NTI device may cause worse damage, because the NTI changes the forces on the teeth and the tempormandibular joint. NTI patients require ongoing monitoring by a dentist.
Damaged teeth can be repaired by replacing the worn natural crown of the tooth with prosthetic crowns. Materials used to make crowns vary; some are less prone to breaking than others and can last longer. Porcelain fused to metal crowns may be used in the anterior (front) of the mouth; in the posterior, full gold crowns are preferred. All-porcelain crowns are now becoming more and more common and work well for both anterior and posterior restorations. To protect the new crowns and dental implants, an occlusal guard should be fabricated to wear during sleep.