Bruxism is a parafunctional occlusal activity, that may exist as either sleep bruxism or awake bruxism. Bruxers have more noticeable signs of dental attrition, abfractions, and occlusal pits on their natural teeth than other patients.
Clinical approaches to managing bruxism can be categorized as acute, preventive and chronic, with the approach depending on the patient’s signs and symptoms. Preventive intervention is required if a patient presents with tooth wear. A primary preventive approach in the treatment of bruxism is the fabrication and utilization of a nightguard.
Sleep bruxism has been characterized as grinding of teeth or clenching of the jaw which may be associated with premature tooth wear, tooth or restoration fracture, temporomandibular disorders, and temporal headache upon awakening. With awake bruxism, unlike sleep bruxism, the patient is aware of jaw clenching. This differentiation can be characterized by a person’s involuntary clenching of the teeth in reaction to specific stimuli, without a grinding component, and can be related to a tic or habit.
Bruxism can also have a major impact on the esthetic appearance of a smile.
An esthetically youthful smile is characterized by maxillary central incisors that are slightly longer than lateral incisors. Worn anterior teeth give the appearance of an older smile with the incisal line of the maxillary incisors having a straight appearance, resulting in the teeth being not only shorter but also appearing wider.
- Occlusal Nightguard Therapy
When the diagnosis of bruxism has been made and tooth wear does not necessitate restorative intervention, a primary approach of prevention using occlusal nightguard therapy is indicated.
Laboratory-fabricated nightguards require at least two office visits and are available as rigid, hard plastic full-coverage designs.