A few weeks ago I was asked a very simple question ” Why does dentistry focus so much on tooth wear instead of seeking to identify and treat Bruxism as a disease?”. This question lead to a very spirited discussion.
I had just completed a talk where I demonstrated Nox T3’s electromyographic (EMG) leads for testing muscle activity during clenching and grinding while asleep. This is accomplished with an electrode on the masseter and one on the zygomatic arch with a ground behind the ear. The Noxturnal software scores these electrical signals and presents an easy to read Bruxism report. As usual in this discussion I mentioned the research paper by Gagnon et al “Aggravation of respiratory disturbances by the use of an occlusal splint in apneic patients: a pilot study”. This study is widely quoted and presents the notion that, an occlusal splint when made for a patient suffering from sleep disordered breathing may actually aggravate the patients existing condition.
It is not hard to imagine that this group of Drs. who have made occlusal splints for their patients for their entire careers were interested to discover that there is a whole range of unconsidered elements to this practice. Dr Gordon Christensen in January of 2014 released an excellent video where he suggested EMG testing as a next step for patients with tooth wear before a restorative treatment plan is adopted.