Topics of the day:

1. Re: Bruxism
2. Re: Bruxism
3. Re: Bruxism
4. Re: Bruxism
5. Re: Bruxism
6. Re: Bruxism
7. Re: Need your kind professional opinions
8. Transition from paper to computer charting
9. Topics about tissue engineering
10. ESCO - The Electronic Study Club for Orthodontics

Dear colleague,

Some proposals for help in cases of persisting, severe bruxism:
1. integration of lateral flanges to the splint to prevent lateral excursive movements (a bimaxillary removable like an activator could do the same)
2. control of day-time bruxism by instructing the patients to keep his or her teeth apart, visual reminders like small, self-adhesive spots are recommendable
3. a procedure for general muscle relaxation should be learned, e.g. progressive muscle relaxation
4. stress management, for #3 and #4 in fact a specially trained psychologist would be the best address
5. the last resort for extreme cases: medication for muscle relaxation, because of the side -effects preferably in a single-dose at bedtime.

Of course the treatment need depends totally on the patient's view and not on our's, so I would discuss the issue thoroughly with the patient, addressing possible damages to the teeth or other tissues and, conversely, the burden of any treatment modality.

Sincerely,
Henning Madsen
____________________________________________________________________________

Dr. Henning Madsen
Orthodontist
Ludwigstr. 36
67059
Ludwigshafen
Germany
Tel 0049+621+59 16 80 Fax 0049+621+59 16 820
http://www.madsen.de

Re:  Bruxism

Dear T.N.

Did your splint have anterior and canine guidance?  i.e. did she have full disclusion upon lateral and anterior movements?  Wearing through a hard acrylic splint that has proper guidance built in is hard to do.  A splint that is badly worn out is an invitation to an open bite and a worsening of the whole situation.  You are right to seek some help, try and find someone local who you can learn from.   

I claim no expertise, just the wisdom to tread carefully, and not let to much of this TMD stuff creep into my practice.

Good luck

John McDonald
Orthodontist Salem, OR

To Dr. Reddy,

Before you can ask for an opinion, please give us a comprehensive TMD history and clinical exam.  But for argument sake, let say that your cousin has the world's worst bruxism habit.  In those select cases( which are very few) I have made an upper and lower full acrylic splints that are balanced in excursive moments that are worn simultaneously at night.  This is a last resort when all else fails.  In the last 26 years, I believe that there is only one article in the TMD journals so this is a technique that is reserved for the worst of the worst.  Again I would like to stress diagnosis, diagnosis, and then diagnosis before treating.

Good Luck,
Roy King

Psychiatry to treat bruxism, or psychiatry to treat anything else, is a waste of time...they have no science,,,they do not get products,,,all they do is drug people, which does not help anybody. Try re-doing the hard splint, making it a little thicker, and eliminate inteferences that might provoke grinding.

Jim Eckhart

Dr.T.N.Sainath Reddy,

In my opinion, anterior touch in oclusion and deep bite associated was observed in most of all cases of bruxism and when treated begin to disapear. Dr.Ricketts explained that the most several cases in maloclusions was caused by a vertical problems, and with a braquicefalic craneum and good muscular competency generaly causes bruxism. Another possible somatotrofic factor  could be a bucal breath that colapses auditive tube and the organism repare with muscular ativation in the nigth. You always must check anterior relation and molar-canine relations ok?

Best regards,
Dr. Fabio Motta, DDS MS

Re: Night time bruxism

Sometimes 10mg of cyclobenzaprine (Flexeril) at bedtime will work wonders. And often for a short time.

Kevin Walde, Washington, MO

Dear Saleh,

I am a postgraduate student in a 3-year Msc Course at UK. I am in third year now and planning to continue to PhD in 2007. The program you have sent to us is a very good programme. Could you let me know where it is?

all the best,
Mojtaba

Dear ESCO members,

Anyone have any advice on making the transition from paper to computer charting. We are going to be using Orthotrac treatment card.

Thank you,
Todd Walkow
Newport Beach, CA

My name is Miriam Pasalagua from Mexico City. I study Orthodontics in the Hospital General Dr. Manuel Gea González. On January 2006, I will have a tissue engineering course and I need know any topics about this subject because I will organize the themes to be interested in Orthodontic.

Thank you very much.

Miriam Pasalagua
Mexico City

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