Type to search

Supporting Your Practice

A Case of Worn Dentition Due to Bruxism

Dr. Cecilia Aragon
Prosthodontist, London ON

Loss of tooth structure due to bruxism is a challenging clinical presentation involving a condition for which there is no cure. The treatment of patients with tooth wear due to bruxism is not simply a matter of replacing what they have lost, but also a matter of designing restorations that will withstand the condition in the long term.

In this episode of CDA Oasis Live, Dr. John O’Keefe, Director of Knowledge Networks CDA, invites Dr. Cecilia Aragon, a prosthodontist from London ON, to take a deep dive into the dental rehabilitation of patients with severe occlusal wear due to bruxism.

Citing a recent study from the Journal of Prosthodontics, and using two case studies from her own practice, Dr. Aragon outlines the key considerations in restoring the dentition of patients with severe occlusal wear.

Here are some of the key points from the presentation…

  • There is no cure for bruxism. Some evidence supports treatment with occlusal devices and biofeedback therapy.
  • There is moderate evidence that psychological factors such as stress and mood are associated with bruxism. There is also evidence that caffeine, alcohol, and smoking produce sleep bruxism.
  • There is conflicting evidence supporting the use of Botox injections, and no compelling evidence to support drug therapy.
  • If a patient has a history of bruxism, it is very important to treatment plan for prosthetic restorations in advance. Possible post-restoration problems include rapid wear of natural dentition, fracture of crowns, and postoperative pain.
  • Use caution in the dental rehabilitation of patients with severe occlusal wear. It is not just a case of replacing what the patient has lost as the bruxism will destroy restorations if prostheses are not designed in a way that they will last.

We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.

Until next time!
CDA Oasis Team


Full Conversation (24.46")


  1. Vasant Ramlaggan July 22, 2021

    Thanks for the good start on this conversation!

  2. Nenko Nenkov July 27, 2021

    Thank you for your presentation.

    From my perspective the view on the bruxing/clenching was quite narrow – it all was about teeth, pictures were of the mouth and teeth only and the radiographs were 2D.
    That can explain the “no cure for bruxing” notion.

    It is my opinion that the cases have to be approached from a broad view of TMD, OSA, Myofunctional habits, Midfacial underdevelopment, Nasopharyngeal and Oropharyngeal constrictions and overall craniofacial biology insufficiency.
    If the underlying cause of brxing is diagnosed properly and a proper treatment is provided, I believe the symptom – bruxing, will be greatly influenced.

    The cases shown at the presentation were pretty easy to treat, in my experience, since they were lacking the chronic craniofacial pain component. However, in my opinion, they were far from being bruxing only cases. The first one had a PAN that did not even had the LTMJ on it – obviously TMD not in the picture of diagnosis, but not having pain does not mean healthy jaw joints either.

    In Dentistry we can find scientific research published to show bruxing as a separate entity that somehow exists on its own. At the same time there will be literature to show the complete opposite.

    I believe it is our professional expertise to play a definite role which one we would believe.


Leave a Comment

Your email address will not be published. Required fields are marked *