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Órgano Oficial de la Asociación Dental Mexicana

2015, Number 2

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Rev ADM 2015; 72 (2)

Advances and challenges in the treatment of patients with bruxism.

Guevara GSA, Ongay SE, Castellanos JL

Language: Spanish
References: 40
Page: 106-114
PDF size: 400.11 Kb.


ABSTRACT

Ever since the term was introduced, bruxism has been the subject of debate, the result of numerous attempts to define it both in terms of its causes and its consequences. However, there is to date no generally accepted definition among clinicians. A search for bruxism-related references in the EBSCO database produced 63 results, from which 40 articles published between 1988 and 2015 were chosen for review. The only organization that distinguishes between two types of bruxism, conscious and unconscious, is the American Academy of Orofacial Pain. In this regard, the prevalence of sleep bruxism among the general population is reported at 8%, whereas for awake bruxism it is estimated to be around 20%, a figure which decreases with age. While the etiology of nocturnal (sleep) bruxism is of central origin and includes peripheral aggravating factors, diurnal (awake) bruxism is attributed to psychosocial factors. Bruxism can be diagnosed using a range of methods, the most effective of these being polysomnography (PSG) and electromyography (EMG). The treatments used in the publications reviewed include occlusal guards, occlusal adjustment, drug treatment, and behavioral therapy. By differentiating between the two types of bruxism, we are able to employ specific global dental treatments and management approaches. In patients with diurnal bruxism, treatment can begin with the use of a mouth guard and behavioral therapy, and in more severe cases, drug therapy. In patients with nocturnal or unconscious bruxism, initial management includes the use of a mouth guard, behavioral therapy and behavior modification, biofeedback, and treatment for sleep disorders, among others. By addressing the underlying causative factors, the severity of the condition can be controlled, so allowing reconstruction of the damaged dental structures and functional orofacial rehabilitation, with a more positive prognosis. This review will look at and discuss a number of methods for treating and managing bruxism.


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