A Case of Worn Dentition Due to Bruxism
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