Dental Tribune Untited Kingdom Edition

Taking diagnosis and treatment of bruxism to a new level GrindCare Measure is the ideal tool for dental professionals who seek to • present hard facts to patients denying to be bruxers • sell a treatment plan based on clinical facts • manage risk when planning reconstruction work or • measure the effect of a chosen treatment GrindCare Measure is the first ever tool for acurately measuring whether and how often your patients grind their teeth. Within just 3-5 nights of use, GrindCare Measure identifies and quan- tifies the patients’ grinding pattern. GrindCare Clinic is a breakthrough solution for reducing grinding and clenching. GrindCare records the activity in the temporalis muscle via a small electrode that adheres to the temple. Each time the patient grinds, the device transmits a mild elec- trical impulse that stimulates a conditioned reflex in the jaw muscles, instantly interrupting the grinding. Actually reduces teeth grinding Clinical studies have shown that GrindCare can reduce grinding by at least 50% in just 3 weeks. By reducing the grinding activity, GrindCare helps reduce the accom panying symptoms. For more information, please contact: Prestige Dental Tel: 01 274 721 567 email: info@prestige-dental.co.uk www.grindcare.com * F. Jadidi, E. Castrillon & P. Svensson: Effect of conditioning electrical stimuli on temporalis electromyographic activity during sleep. Journal of Oral Rehabilitation, 2008. Teeth grinding Headaches Tension Pain Waking others Sleep disturbances Dental damage 27April 16-22, 2012United Kingdom Edition Clinical fering from between 15 and 18 migraines a month. After treatment both patients were happy, even though the fre- quency at which they suffered the migraines had remained constant. The improvement had been in the duration of the migraines: instead of suf- fering for up to two days each time, the migraines were last- ing for an hour and could, lit- erally, be slept off. To treat bruxism effective- ly, practitioners must be open- minded about issues such as occlusion, says Pav. “The fact is that occlusion is not the driving factor in a lot of these issues. It can sometimes be a modifying factor but it is not a driving factor. That is not to say that doing something oc- clusally will not give pain re- lief, but it is still not the driv- ing factor,” he insists. “What a lot of dentists say is that, if your teeth do not fit perfectly where your jaw joints and muscles harmoniously want to contract, your muscles will fight to find a comfortable position. The theory is that if you remove these interfer- ences from your bite, you let the patient close their mouth correctly and their problems go away. My take on this is actually the other way around: if you suffer from bruxism you are going to clench and grind your teeth, no matter what. And there is strong, scientific evidence to support this. Sometimes your teeth will get in the way, which will exacerbate the pain. Some- times by harmonising the bite you can get resolution of these symptoms, but that doesn’t make it the driving factor.” Pav’s treatment model as- sumes that patients are suf- fering a neurological phe- nomenon, rather than an anatomical one. He achieves considerable success in treat- ing patients with the NTI-tss occlusal splint. This small de- vice fits over the front teeth, and reduces muscle tension intensity by about 75 per cent when patients try to clench in their sleep. It prevents the posterior teeth from occlud- ing and reduces the amount of pressure that can be applied while clenching. “The other thing is that when your teeth touch you get a neurological impulse to your brain telling you they are touching. Because with the NTI-tss the teeth at the back of the mouth are not touch- ing, the amount of sensory overload going back to the brain significantly reduces, and that is how it helps reduce migraine, by reducing exces- sive nocioceptive input to the sphenopalatine ganglion” he says. By preventing the posterior teeth from occluding, the NTI- tss essentially achieves the same function as removing interferences at the back of the mouth, which according to conventional wisdom should prevent clenching and grind- ing. “When you fit an NTI-tss you have no interferences at the back of the mouth, so if the argument is correct the drive for clenching and grinding your teeth should have disap- peared. So how do I explain the scratches that appear on almost 100 per cent of the NTI-tss devices that I fit over time? The bite is not the driv- ing factor.” “People need to realise that NTI-tss is part of a philosophy. The device itself is the easiest way to deliver that philosophy, but it is not the only way to do it,” says Pav. While some den- tists fear, incorrectly, that the device can overload the jaw joint, Pav says that a success rate of over 90 per cent means that patients like the NTI-tss a great deal. DT About the author Dr Pav Kahira, the founder and direc- tor of the Migraine Care Institute, is a dentist with a special interest in migraine and pain management. Shortlisted twice for the accolade of Best Young Dentist, he trained at Kings College London and the Uni- versity of London. He has extensive experience of treating migraine suf- ferers.