Bruxism and TMJ

As our society becomes more complex and the personal stresses increase, the incidence of the Bruxism and Temporomandibular Joint Dysfunction seem to be on the increase. Bruxism is the medical term for tooth grinding and/or the clenching of the teeth together. Both of these usually occur at night while sleeping and you are not aware of the habit until symptoms appear. Nocturnal Bruxism may be the most destructive form of bruxism because the patient is not aware of the habit until it is too late. Temporomandibular Joint Dysfunction (TMD) is an complex problem that affects a smaller percentage of the population but can cause severe and irreversible damage to the jaw joints.

Although a wide variety of treatment approaches and appliance designs are available for the treatment of these disorders, the most common appliance is a splint, other names you may have heard in reference to an appliance worn at night might be; night guard, occlusal guard, night appliance or bruxism appliance. A splint can protect the patient against the destructive forces of nocturnal bruxism and act as a diagnostic and treatment tool in the early intervention can prevent many of the severe problems associated with Bruxism and TMJ dysfunction.

Occlusal splints are removable appliances that are usually made of hard acrylic and fit over the occlusal surface of either the maxillary or mandibular dentition to create a precise occlusal relationship with the teeth of the opposing arch. Splints are some of the most versatile tools used in dentistry.

A properly designed splint can:

  • Protect the teeth from abnormal forces that may create a tooth fracture or breakage of restorations.
  • Protect bony and soft tissue supportive structures from abnormal forces that cause their breakdown.
  • Introduce an optimum occlusal position.
  • Deprogram the musculature and reorganize neuromuscular reflex activity.
  • Encourage normal muscle function.
  • Alleviate any occlusal stresses to the posterior teeth by providing anterior guidance.
  • Establish a new vertical relationship.
  • Alleviate occlusal stresses to the anterior teeth by controlling the vertical dimension.
  • Provide the teeth with protection from diurnal and nocturnal bruxism.
  • Provide a more stable or functional joint position.

Before treating any of these problems, an accurate history and examination is vital to a sound diagnosis as breakdown in the system may occur at the level of the teeth in the form of wear, the periodontium in the form of mobility or the TMJ in the form of muscle spasms or splinting.

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