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Supporting Your Practice

The Management of Bruxism: Part 2

This is part two of Dr. John O’Keefe’s discussion with Dr. Tom Shackleton, a general practitioner from Calgary, Alberta. In this video, Dr. Shackleton outlines his approach on managing patients who present with this naturally occurring phenomenon.

There is no magic formula when it comes to the management of bruxism. Much of the thinking is driven by what the patient wants and needs. It is important to gather a thorough history, and to establish whether the bruxism is a problem for the patient or just an incidental finding.

Here are some of the key takeaways from the conversation:

APPLIANCES

  • Standard intervention is a full coverage night-time appliance. Appliances can be upper or lower arch and usually consist of hard acrylic or dual flex.
  • Know what you want in an appliance and meet with the lab directly.
  • The fit should be snug but not painful.
  • Appliances should be balanced with even contacts and no sliding of contacts.
  • If the patient is experiencing pain or discomfort, the appliance may need adjusting.

BEHAVIOURAL THERAPIES

  • There is no significant evidence to support behavioural therapies in the treatment of bruxism.

SLEEP HYGIENE

  • Although sleep hygiene will not decrease the amount of bruxing, it has been shown to promote a better night’s sleep.

BOTOX

  • Although it will not decrease the frequency of bruxism, Botox will decrease the force of the clenching.
  • It is expensive and has some unwanted side effects.
  • Botox can induce dry mouth, muscle atrophy and jaw fatigue.
  • Botox is worth considering in extreme cases; however, it is not recommended as first-line of treatment.

HELPFUL LINKS:

CDA Oasis: Part 1: Investigating Patients with Bruxism

CDA Website: Jaw Clenching and Teeth Grinding (Bruxism)

PDF Download: Bruxism Management

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 (15’56”)

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