As our society continues to increase in complexity, the incidence of Bruxism and Temporomandibular Joint Dysfunction (TMJD) continues to rise. 

Nocturnal Bruxism may constitute the most destructive form of bruxism (due largely to the fact that the patient tends to be unaware of the habit until it is too late) and TMJD is an extremely complex problem that impacts an increasingly significant percentage of the population.

Although a wide variety of treatment approaches and appliance designs are available for the treatment of these disorders, the most common appliance of choice is a splint.

The biggest problem observed in adult dental patients is ABNORMAL OCCLUSAL WEAR.  This ends up causing a decrease in the vertical dimension of the patient -- wearing down teeth to the point where full mouth reconstruction is inevitable.

 Best solution: deliver an orthotic or splint earlier in their care to prevent the problems from occurring in the first place.

A splint can protect the patient against the destructive forces of nocturnal bruxism and can also function as a diagnostic and treatment tool in the management of Temporomandibular Dysfunction. Regardless of the preferred treatment technique, early intervention can prevent many of the severe problems associated with bruxism and TMD.

Whether you are treating a bruxism problem or a joint dysfunction, splint therapy is almost always your first line of defense. Why? Because splint therapy is generally reversible, non-invasive and exceedingly effective at reducing symptoms

There are several varieties of splints. Each design is designed to address and eliminate a specific causative factor. To select the right splint, you must first accurately identify the factor. Therefore, the importance of a thorough history, exam and diagnosis cannot be overemphasized in the interest of arriving at a sound diagnosis

Breakdown in the system may occur at the level of the teeth in the form of wear; at the periodontium in the form of mobility; or at the TMJ in the form of muscle spasms or splinting.

This examination should include:

1. Radiographic information (FMX, Panorex, Cephalogram, Tomograms)
2. A physical exam that includes palpation of the muscles; listening to joint sounds; observation of the mandible during functional movements; and a thorough investigation of the timing and duration of the pain.

Preformed bands are one of the most important –and widely used --tools in use by orthodontists today. Pretty obvious, I know.

But the message here is not that every dental professional uses them, but that no dental professional wants to run out.

It’s important to have a preformed band supplier that is both reliable and viable. At SML, we offer both adult and pediatric bands for every tooth -- sizes 23 to 42. We stock preformed bands that are tailored to upper teeth and lower teeth and we even have half-sizes so that you can offer your patients the very best fit possible.

Splints are something that EVERY dentist in EVERY practice should be using EVERY single day.

BEFORE YOU BEGIN…IT IS ABSOLUTELY CRITICAL THAT YOU PERFORM AN AIRWAY ANALYSIS.

WHY? Because bruxism may in fact, be a sign that your patient does have a serious airway issue – one that will need to be addressed prior to treatment.

SML (Space Maintainers Laboratories) began in 1957 with the commitment to offering more than just a laboratory service to dentists. From that day through to the present time, we have established a tradition of service beyond previously established boundaries and expectations.

We created a worldwide network of labs renowned for providing dental practitioners with the opportunity to receive the service and caring of a mom-and-pop lab coupled with the technological expertise, assets and resources of a large, globally realized company.

Digital Dentistry can help if a dentist cannot master every diagnosis, especially when patients present with such a varied litany of symptoms. Sometimes patients don’t know how to describe their symptoms effectively, or complain about symptoms that are related to two (or more) distinct issues.

If you find yourself in need of a second opinion or a treatment recommendation, avail yourself of SML’s Digital Diagnostic Dental Lab. Our experienced staff clinicians can digitally review your cases and help you make the right diagnosis for your patients.

Awareness has been growing dramatically regarding the link between concussions and future brain damage. The Academy of General Dentistry released a study in 2014 that found that high school football players who wore custom mouth guards were half as likely to suffer a concussion as players who wore over-the-counter mouthguards.

A recent study published in the medical journal JAMA has fueled the rising consensus that contact sports can lead to chronic traumatic encephalopathy (CTE). The researchers in the study discovered that 110 out of 111 brains of deceased NFL players showed signs of CTE, as did 48 out of 53 brains of former college football players.

A new study out of the United Kingdom found that adults who get less sleep are more likely to be overweight. The study of 1,615 adults was led by Laura Hardie from the University of Leeds. Hardie found that adults who only got six hours of sleep had waistlines 1.2 inches bigger than participants who enjoyed nine hours of sleep.

One primary cause of sleeplessness is sleep apnea, which affects an estimated 18 million American adults. Being overweight increases the chances of having sleep apnea – excessive body tissue can result in airway obstruction. The more overweight, the greater likelihood of increasingly severe symptoms.

Instituting a mouthguard program in your office is one of the best ways to build your practice. Pick a sport and pick a team!

I offered to make a mouthguard for all the kids on my son’s Little League Team. I did it as a charitable donation, absorbed the costs and took the tax write off. It was the best money I ever spent. Half of the team and their families became my patients!

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Develop a regular mouthguard program/protocol in your office. It’s essentially not any different from any other system you might develop for regular assessment and treatment.

SCREEN the patient for involvement in sports or activities

DISCUSS the potential need for using a mouthguard for protection and inform the patient of available options

You operate within a competitive market. Finding a way to distinguish yourself from all the other dentists in your area is always good business – good for you, good for your patients. A better idea in the case of sleep because your sleep patients are most likely already on the roster.   

Consider that the Sleep Foundation estimates that sleep apnea has a minimum prevalence of 2- 3% in the U.S. population. Many more people are likely undiagnosed! As a sleep specialist, you can make your patients aware of potential airway issues, work with physicians to get those issues diagnosed and offer special customized appliances for opening up the airway so that your afflicted patients can get a restful night’s sleep.

For high-velocity sports (hockey, football, rugby, soccer) protection, a hard polycarbonate layer can be added between soft ethylvinyl acetate. We’ve actually got one just for competitive martial arts…

When it comes to injury prevention and protection for athletes of all ages, all levels, all sports and activities, SML provides a full spectrum of custom-fit, dentist approved options that far outdistances the competition.