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cerecdoctors.com
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quarter 4
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2013
affects at least 20 percent of the popula-
tion (more than 60 million Americans).
Sleep bruxism, although not as preva-
lent, is defined as the awareness of tooth
grinding as reported by family members
and affects approximately 8 percent of
the population.
2
Regardless of the type of bruxism, 24 to
60 million Americans are affected by this
pathology. Anecdotally, dentists will typi-
cally say that 40 percent or
more of their patients grind
their teeth severely enough
to require a night guard.
bruxism can manifest itself in
multiple forms and can be described
as diurnal or nocturnal parafunction,
characterized by clenching, bracing,
gnashing or grinding of teeth and jaws.
1
Awake bruxism is defined as the aware-
ness of jaw clenching, with some studies
suggesting that this type of bruxism
The Dreamgard Appliance:
A Digital Solution to Bruxism
An Approach to Treating Grinding With CEREC
c a s e s t u d y
| | |
b y S a m e e r P u r i , D . D . S .
occlusal equilibration, splint therapy,
physiotherapy and acupuncture.
Despite what final treatment doctors
recommend for their patients for the
treatment of bruxism, one thing that
most clinicians can agree on is the fact
that many patients will benefit from
some form of oral appliance to minimize
There can be many causative factors
such as GERD
3
and central dopamineric
disturbances.
4
Recent publications have
suggested that sleep bruxism, the focus
of this article, can be secondary to sleep-
related “micro arousals” where the
activity in the musculature is amplified
during REM sleep.
Soft inner layer
for comfort
Hard outer layer
for protection
Regardless of the cause, there have
been more than 177 papers published on
various aspects of treatment of bruxism
in the past 40 years.
5
Obviously, this is an
area in dentistry where there is a lot of
interest in proper treatment.
The effects of bruxism can lead to
simple issues such as sensitive teeth, as
well as more pronounced issues such
as damaged teeth, depending on the
severity of the bruxism.
Meanwhile, different clinicians have
differing opinions on the treatment of
bruxism. Treatment can range from
the damage of the parafunction on the
teeth. Essentially, if the patient is going
to grind, then they may as well grind on
an appliance and destroy the appliance,
rather than grind on their teeth or resto-
rations, damaging those entities.
A night guard is the most recom-
mended treatment for bruxism. Of the
different types of night guards, a full-
occlusal, flat-plane night guard is the
solution that works for the greatest
percentage of bruxism patients. At the
very least, a simple guard to cushion the
teeth and surrounding structures from
The Dreamgard appliance
