Teaching patients how to stop bruxing habits
Jeremy Shulman, D.D.S., M.S. J Am Dent Assoc, Vol 132, No 9, 1275-1277. © 2001
There … is widespread agreement that bruxing and other nonfunctional jaw movement or posturing habits are major contributing causes of temporomandibular disorders (TMDs) …Occlusal modifications and splints are the most common initial therapies. … various types and designs of splints have been developed to help counteract the dysfunctional effects of bruxing habits, as aids in correction of nonideal jaw and occlusal relationships, or both. … treatment usually is focused on correcting the most visible and easily identifiable findings, such as occlusal and jaw relationship abnormalities, or it focuses on guarding against further damage. (…)
Therapy starts with a complete explanation of the dysfunctional symptoms and the cause-and-effect mechanisms of bruxing. This is followed by precise instruction in techniques for habit modification, both during the day and especially during sleep when clenching and grinding habits are prevalent. Clinicians should stress the importance of daytime awareness of bruxing or posturing habits, and instruct patients to say “Mississippi” every time the jaw is not in a resting posture, as is attained at the end of the word. To help in this reprogramming, a splint should be constructed, but dentists should not identify it as a guard, but as a nighttime (and daytime when needed) aid that serves as a tool for modified biofeedback training. (…)
The clinician teaches the patient that any jaw posturing habits or tooth contacts other than those involved in chewing or swallowing are parafunctional. Patients must understand that the appliance serves to remind them of any such contact, since its mere presence as well as the difference in tooth contact sensation between when the splint is in place and when it is not in place present a sensory input to which they must react by dropping the mandible into a resting posture. (…)
It might be hard to believe that such a simple, quick and noninvasive treatment really works, but once the proper diagnosis is made and major bruxing habits are eliminated, then the dysfunction is controlled and the symptoms disappear.
See: Teaching patients how to stop bruxing habits
Jeremy Shulman, D.D.S., M.S.