Dental Tribune UK Edition, September 13-19, 2010, Vol. 4 No. 21

F or millions of people across the UK, waking up with a headache, stiff neck or aching jaw every morn- ing, is as common as waking up on a Monday and wishing it was still the weekend. As dentists, many of you will see patients everyday that complain of issues such as these, and if so, then it is more than likely that they are suffering from bruxism. Affecting up to 80 per cent of the population, bruxism is a con- dition that is not only incredibly common, but also worryingly under-diagnosed and poorly un- derstood by a large percentage of dentists. Broadly character- ised by teeth grinding and jaw clenching, bruxism causes tooth wear and breakage, disorders of the jaw and headaches to name but a few symptoms. Although sometimes a problem during the day, nocturnal bruxism is the most common and is usu- ally the most damaging due to our lack of motor or conscious control over our movements or their intensity. Symptoms Symptoms of bruxism are wide ranging, and include: TMD, limitation of mouth open- ing, facial myalgia, migraines, ear ache, stiffness in shoul- ders and neck, abnormal tooth wear, fractured teeth, recession of gums, excess tooth mobil- ity and premature loss of teeth. Although not technically a dangerous disorder, bruxism can be potentially debilitating as it can cause insomnia, intense pain and tinnitus for example, which can result in the suf- ferer’s inability to function at a ‘normal’ level. Dr Barry Oulton, Cosmetic Dentist at the Haslemere Dental Centre, has a long-term, pas- sionate interest in the treatment of bruxism, and in creating greater public and professional awareness of the condition. Dr Oulton explains his dedication to providing treatment for suf- ferers of bruxism, and also why he thinks it is so important that awareness of the condition be- comes more widespread. ‘‘As dentists, we are all too often fixated by teeth, and, as a result, often miss problems with muscles. Bruxism can cause muscle tension, which in turn can lead to referred pain. Some patients presenting with a gen- eralised toothache, more often than not have a trigger point in their temperoralis or masseter that is producing a referred pain which feels like toothache. I re- fer to Travell and Simons trig- ger point chart, and, once the muscle has been massaged, very often the pain goes away. It is now commonplace for me to focus initially on treating mus- cles before teeth, whilst of course ruling out any dental problems too.’’ In October 2010, S4S is launching the first Bruxism Awareness Week in order to bring the issue into greater fo- cus for both patients, and dental professionals. Although many practices across the country do provide treatment for bruxism, there is still a large number that don’t. By raising awareness it is hoped that more surgeries will follow suit and offer the treat- ment that is necessary for this troubling condition. It has been reported that a frightening 50 per cent of staff in combat dur- ing the Gulf War have experi- enced PTSD; a condition that has been heavily linked with the occurrence of bruxism. An increasing understanding Dr Oulton welcomes the pros- pect of Bruxism Awareness Week: ‘‘I think, and hope, that the Bruxism Awareness Week could potentially herald the arrival of an increasing understanding in people with regards to this incredibly com- mon but highly destructive condition. Not only does brux- ism physically damage the teeth and, by extension, the aes- thetic appearance of the mouth, it can also have a potentially massive impact on a person’s emotional wellbeing. I treated a patient recently who had been suffering from migraines everyday for the last twenty years and who had become ex- tremely depressed and despond- ent as a result. After my initial assessment, I concluded that she was suffering from brux- ism and so, after briefly explain- ing the condition and its symp- toms, I prescribed an NTI-tss, which I constructed chairside and sent her home with. At her two-week check-up, the results were simply incredible. She told me that after only a day or two her migraines had all but disappeared and that her quality of life had improved 100 per cent’’ Psychological effects As Dr Oulton explained, the psychological effects of brux- ism can be as damaging as its physical impact on teeth, and without the right level of knowl- edge and understanding, den- tists will continue to overlook the condition and send patients away without the treatment that could so vastly improve their life. In terms of treatment, there are ways in which by using the appropriate science and clini- cal understanding, symptoms of bruxism can be limited and controlled, and therefore tooth damage and discomfort in the patient can be alleviated. As a condition, bruxism cannot be ‘cured’ as such, there will al- ways be, to whatever extent, a base level at which it occurs, but the symptoms can certainly be managed effectively if patients are correctly diagnosed. From regularly treating pa- tients for bruxism, Dr Oulton is well versed in the practi- cal treatment options available for sufferers, as he explains: ‘‘Most commonly, bite guards and occlusal splints are used in the treatment of bruxism. Full coverage splints may well protect the teeth from the effects of bruxism, but usu- ally do not result in a decrease in muscle problems. For the vast majority of my patients who are being treated for bruxism, I recommend the NTI- tss, which vastly reduces mus- cle problems.’’ Used since the 1930s, bite guards and splints have played an important role in the treat- ment of teeth clenching, brux- ism and TMJ disorders. The NTI-tss (Nociceptive Trigeminal Inhibition – tension suppres- sion system) from S4S is an in- creasingly popular and effec- tive choice for dentists treating patients for bruxism. Dr Oulton himself wears an NTI device nightly, and can’t stress enough the difference that it makes. ‘‘The NTI-tss is such a sim- ple device but one that makes such an outstanding difference. I wear one every night, and on the occasions that I’ve been unable to, I’ve woken up in in- tense pain which will then last for several days. I am so confi- dent in this device, that when I prescribe them to clients I al- ways offer a money back guar- antee. That’s how good this product is!’’ Grindcare In addition to the NTI device, S4S has also recently launched a new treatment for bruxism called Grindcare. Using ground- breaking technology, Grind- care measures the movement of facial muscles during sleep through a small electrode placed on the temple. Clinical stud- ies have shown that Grindcare can reduce instances of brux- ism by more than 50 per cent in just three weeks, and up to 80 per cent after six–eight weeks. Dr Oulton’s surgery is the first Grindcare centre in the UK, and he is confident in the positive trajectory of the treatment. ‘‘I think that the Grindcare solution from S4S is a really important development in the treatment of bruxism. If we as dentists really get behind the Bruxism Awareness Week, and embrace the idea of exp- anding our knowledge and ability to treat the condition, I think that the millions of people throughout the UK suf- fering from bruxism will benefit immeasurably.’’ Bruxism Awareness Week The need for a better, more com- prehensive understanding of the condition of bruxism is clear, and, with the exciting launch of the first Bruxism Awareness Week in October, perhaps we are on our way to providing patients with the information and clini- cal expertise and understanding that they deserve. For dentists interested in the new Grindcare treatment and occlusal splints, S4S has a range of options to meet the requirements of every patient, and also offers compre- hensive training on this specific area of dentistry. For your free information/ promotion pack, contact S4S on: 0114 250 0176. Or email: info@ s4sdental.com DT Grinding down the pain of bruxism for your patients Dr Barry Oulton discusses the troubling condition of bruxism Dr Oulton: ‘‘I think, and hope, that the Bruxism Awareness Week could potentially herald the arrival of an increasing understanding in people with regards to this incredibly common but highly destructive condition’’ September 13-19, 201026 Feature United Kingdom Edition