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Hi Henning,

There are many individuals who brux and have no other clinical symptoms than excessive wear of the chewing surfaces of their teeth. In fact the majority of bruxers are symptom free.

One's occlusion (how the teeth meet and function) has three components. Frist the confirmation of the temporomandibular joint, second the relationships of the upper and lower teeth to each other and third the amount of incisal guidance that is present. The dentist can only readily treat the second and third components with predictable results.

If an individual is suffering from bruxism with severe symptoms (these are the folks who mistakenly at times are diagnosed with migrane) this usually means there is insufficient incisal guidance to keep the teeth apart when parafunctional activity is taking place.

Instead of resorting to drugs with all the assorted side affects etc. One should first explore the possibility that physical incompatibilities and interferences may be causing the severe muscle spasms, temperature sensitivity of teeth and joint soreness that often accompany this malady.

A custom made hard plastic splint with what amounts to an anterior incline plane can be constructed. Simple adjustments and equilibrations usually will result in a symptom free individual in a very short time. This type of splint will not limit nor inhibit any of the individuals ability to move his/her mandible or effect other functions such as speech. The splint allows the joint to function in its physiologically healthiest manner and the other components that govern occlusion are modified to be compatible within these joint established parameters.

Because severe long term bruxing also causes the loss of teeth (even in "asymtomatic" cases) I would only consider drugs of some sort as a last ditch resort and also a questionable long term one.

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