http://www.is.wayne.edu/mnissani/bruxnet/advice.htm

Bruxism (Teeth Clenching or Grinding)

Advice, Links, Resources

Clickable Table of Contents:  1. Educate Yourself  2.  Consult a Specialist
3. Uncertainty about bruxism  4. Bruxism and TMJ (TMDs)  5. "Cures" to avoid
6. Wait & See?  7. Stress?  8. Trauma  9. Drugs  10. Human Alarms  11. Taste
Biofeedback  12.  Nutritional Supplements  13. Vacuum Prevention  13. NTI
14. Works Cited

This hypertext provides a literature review, internet and library resources,
and practical advice for bruxers (teeth clenchers or grinders) and for
dentists, physicians, and other clinicians concerned with the treatment of
bruxism.  Clinicians may also wish to consult my When the splint fails:
non-traditional approaches to the treatment of bruxism (an article in The
Orthodontic Cyberjournal ), and, offline, a similar review in the Journal of
Oral Science.

You may find out more about me (Dr. Moti Nissani-the writer of these lines)
by visiting my internet homepage or looking up my resume.  Unfortunately,
owing to (i) a shift in my research interests, (ii) the great volume of mail
I receive on a daily basis, (iii) my lack of objectivity (I suspect that, as
of now, the ONLY effective treatment modality is the taste-based
approach-see below), I am positively unable to respond to any
bruxism-related correspondence.  Sorry!

All forms of bruxism entail forceful contact between the biting surfaces of
the upper and lower teeth. In grinding and tapping this contact involves
movements of the lower jaw and unpleasant sounds which can often awaken
housemates. Click here to hear the grinding of one patient (who has been
grinding her front teeth, some 12 minutes a night,  for the past 50 years).
Clenching (or clamping), on the other hand, involves inaudible, sustained,
forceful tooth contact unaccompanied by significant mandibular movements.

Note:  The recommendations below are based on my own experiences and on my
interpretations of the extensive bruxism literature. Needless to say, my
efforts to portray an accurate picture may have failed.   I may have, for
instance, overlooked or misinterpreted some critical research.   So the
material below should be read critically and supplemented by other readings.

Educate Yourself. The first step for both clinicians and bruxers involves
education.  Although you may not become an expert, in this context even a
little knowledge is a good thing.  You may wish to begin with my Definition
of Bruxism , then read about the Incidence of Bruxism.   It is particularly
important for both clinicians and patients to become fully aware of the
Effects of Chronic Bruxism .  Among other things, bruxism may cause severe
tooth damage, headaches, and hearing loss.  It may (or may not) lead to
temporomandibular disorders (TMDs, also known as temporomandibular joint
[TMJ] syndrome)-a condition which can, according to one expert, "devastate
its victim" (Goldman, 1992, p. 191; see also Reynolds, 1994).

Another useful link is the Online Sleep Disorders Guide.  As well, the
hypertext you are reading offers the following links:

What is Bruxism?
Incidence of Bruxism
Symptoms, Signs, and Consequences of Bruxism
Traditional (but Fairly Ineffective) Treatment Approaches to Bruxism
A Taste-Based Approach to the Prevention of Bruxism (an article from the
journal Applied Psychophysiology and Biofeedback)
Books and Articles about Bruxism
A Tentative Spanish version of this page (Español?  Haga Clic Aquí 0 Aqui,
por favor)
One convenient way of approaching the professional literature is PubMed, a
database which you may be able to access at no cost from your home or from
the nearest public or academic library.  Once you are there, you need to
search in Pubmed (default setting) type in a term (such as bruxism), select
other preferences, and click go. You now have the references to that term.
To see summaries, choose the drop-down Abstracts (not summaries), click
display, and you'll get summaries of most scholarly manuscripts on the
subject.  Similarly, you can type the name of a bruxism specialist (e.g.,
Glaros) to read summaries of his/her medically-related articles.

In their professional writings (but not, one hopes, in their personal
lives), researchers are required to use jargon-filled, technical language.
Such language has much to recommend it, but it renders the scientific
literature inaccessible to most people.  So, when you start looking up
articles in Pubmed and in a dental library, you may wish to consult a
glossary of medical and dental terms.  Such glossaries can be found in most
medical and dental libraries.  Simpler versions are also available online
(cf. The On-line Medical Dictionary).

Another interesting online source is the United States Patent Office, which
provides un-copyrighted full texts and images of all patents awarded since
1976.  But be careful: the main criterion for awarding patents is novelty,
not effectiveness!

If you want to consult the original literature, you may wish to visit the
nearest dental, and perhaps also medical, libraries.  If it's your first
visit to an academic library, the reference librarian will show you how to
navigate that system.  You can then look up the references you identified in
your Medline search and elsewhere.

However, the number of articles on the subject is enormous; besides, many
are either outdated or of little scientific or practical value.  Also,
Medline at the moment doesn't include the best and most accessible general
source:  chapters in books on sleep disorders, dentistry, or clinical
psychology.   My bruxism bibliography may help your library self-education
program by supplementing Medline and other useful databases.

Search engines such as Alta Vista or Vivisimo are becoming increasingly
important in clinical research.  It used to be said that the internet, like
the Platte River, is one-mile wide and one-foot deep.  But this is no longer
true.  Governments,  research institutions, and academics increasingly place
their best materials online.  The trick here is to separate wheat from
chaff, using common sense and intuition.  For example, all things
considered, a government or a university source (with the endings .edu or
.gov) is more trustworthy than a private (.com) source.  Likewise, an
internet copy of an article that appeared first in a refereed professional
journal should be taken more seriously than most commercial, profit-driven,
claims.

A couple of hints may facilitate your online search.  If you are looking for
a complex term like teeth grinding in a search engine like Alta Vista, type
"teeth grinding" (bracketed by quotation marks) and not just teeth grinding.
Alta Vista will then only produce pages where the two words are joined
together.  For a less stringent search, type +teeth +grinding (this will
cull all the pages in which both words appear, even if they are separated by
other words).  Here is another useful example of how to limit your search.
Go to www.alltheweb.com/advanced, and in the filters, choose:

Must include
edu
In the URL

This restricted search will only yield results posted by educational
institutions.

But no one has developed yet a magic formula for separating wheat from
chaff-there is no substitute for critical thinking, no matter where you find
yourself!  To see one example of irresponsibility in action, click here.

Consult a Bruxism Specialist.   A second, related, step, involves the
realization that most dentists, doctors, and other clinicians are not
bruxism experts.  So you need to find someone who specializes in bruxism
(psychologists and university-affiliated dentists, overall, are a far better
bet than your typical run-of-the-mill dentist).  Better still, at the moment
your best bet may well be educating yourself and managing your own treatment
program (with or without the help of a clinician).

We Don't Know Much about the Subject.  As you read, you will, sooner or
later, realize that we know precious little about bruxism.  In particular,
there are 1001 speculations about the causes of bruxism, but not a single
proof.  All suggested cures depend therefore on hit and miss, trial and
error, approaches, not on deep understanding of the condition itself.
Incidentally, this is yet another way of separating wheat from chaff:  When
dentists or bruxism experts are too sure of themselves, whatever they say
should be taken with a grain of salt.

TMJ  (TMD) Syndrome.   You need to realize, in particular, that a TMJ or
(TMDs) expert is not necessarily a bruxism expert, and vice versa.  The two
conditions are related, but far from being identical.   Thus, long-term
bruxism may or may not lead to TMDs while TMDs may, or may not, be caused by
bruxism.  Unfortunately, clinicians often fail to make this distinction.

Unrecommended Treatment Options

I do not recommend the following approaches (the evidence and references
leading me to this lukewarm appraisal are given in this link)

Not recommended:  Splint (in all its infinite varieties:  soft, hard,
maxillary, mandibular, partial, aqualizer, etc.; see for example, Wright,
1999).  As the accompanying literature review recounts, for a few weeks the
splint (and most other intraoral devices) may be truly successful in
stopping bruxism, but this is a temporary effect that may lull patients and
dentists alike to the virtual uselessness of the splint over the long term.
In particular, while the splint may provide some protection for the teeth,
it does not stop bruxism and such grave potential consequences as hearing
loss and TMJ syndrome.   Moreover, the splint itself may cause health
problems (.e.g., "complications from long-term use of splints, however, can
be severe and irreversible"--Widmalm, 1999).  Sooner or later, this $1
billion industry (in the USA alone) will give way to better treatment
modalities.

Four Views of the Common Acrylic Splint

Not recommended: Sound alarms, electrical stimulation, and other biofeedback
approaches (except taste-see below).
Not recommended:  Psychotherapy, hypnosis, massed negative practice, drugs.
Note: Psychotherapy and hypnosis may help to reduce stress, and thus to
alleviate bruxism.  But, despite sporadic claims to the contrary, there is
little evidence that they can, by themselves, treat bruxism.

What, Then, Shall We Do With a Bruxing Patient?

Given the limited success of traditional approaches, and given, moreover,
the high incidence of bruxism and its harmful consequences, clinicians and
sufferers may occasionally be interested in experimenting with
non-intrusive, safe, less widely known, treatment modalities. To meet this
need, the remainder of this link focuses on such comparatively unpopular or
recent approaches.

It must be emphasized at the outset that no miracle treatment for bruxism is
yet available.  A bruxer may need to try several approaches, sequentially or
simultaneously, and at the end may-or may not-gain control of this
destructive habit.  At any rate, at the moment the following alternative
approaches seem worth experimenting with.

Wait and See. In a few lucky cases, bruxism may vanish spontaneously. In
others, grinding and clenching may occur so seldom, or are so weak, as to
hardly justify any action at all.

In particular, young children often require different therapeutic approaches
than adults. To begin with, the damage to their teeth, for the most part, is
transitory, for only the primary teeth may be affected, not the permanent
teeth. Moreover, bruxism in children, according to some studies, usually
resolves spontaneously.  In one study, for example, 126 children between the
ages of 6 and 9 were diagnosed with bruxism.  Five years later, upon
re-examination, only 17 children retained the bruxing habit.  Thus, juvenile
bruxism is probably "a self-limiting condition which does not progress to
adult bruxism and which appear to be unrelated to TMJ symptoms" (Kieser &
Groeneveld, 1998).  Another study, however, This suggests that "observation
and reassurance, rather than intervention, are warranted in most cases"
(Thompson, Blount, and Krumholtz, 1994).  In contrast, a more recent report
suggests that childhood bruxism might be more persistent than previously
believed (Carlsson, Egermark, and Magnusson, 2003)  Either way, when the
damage to a child (as in this case) or adult is severe, or when the habit
persists, treatment is mandatory.

Recommendation:  If bruxism occurs only sporadically and intermittently,
especially in children, waiting may provide the best strategy.  If the
condition does not spontaneously disappear in a few months, keeps recurring,
or is accompanied by worrisome side effects (e.g., hearing loss or locked
jaw), then action is required.

Stress.  In some cases, emotional stress may trigger, or exacerbate,
bruxism.  On the other hand, the popular belief that stress is the leading
cause of bruxism (and not merely one aggravating factor among many) is, in
all likelihood, mistaken.  Still, negative stress is bad for one's health
anyway, regardless of its effects on bruxism.  It may be worth while
therefore to try to reduce stress levels (with such things as yoga,
hypnosis, changed lifestyle, or autosuggestion tapes).

Recommendation:  Stress reduction is easier said than done.  Besides, it's
unlikely to prevent bruxism, even if successful.   So, while of great value
in its own right, stress reduction will, in most cases, need to be
complemented by other treatment modalities.

Counteracting Trauma. In some cases, bruxism may commence shortly after such
dental procedures as fillings, crowns, or bridges; after an injury to the
mouth; or after a prolonged operation in or through the mouth. To be sure,
at times bruxism may be caused by the psychological stress of the treatment
or injury (and not by the injury itself).  In other cases, coincidence may
play a key role (that is, bruxism starts after trauma but is not traceable
to it).  Nevertheless, it may be still worth while looking into a causal
connection and taking remedial actions right away, before the new bruxing
habit becomes entrenched. A new high crown may be ground down a bit, for exa
mple, to reduce any possible interferences.

Recommendation:  In those comparatively rare instances when bruxism seems to
immediately follow dental manipulation, mouth surgery, or injury, correction
may succeed.  In this case, the corrective procedure should be undertaken as
soon as possible, to prevent entrenchment of the bruxing habit.

Bruxism as a Side Effect of Drugs and Medications.  In some cases, bruxism
may be traceable to drugs. Smoking (Madrid et al., 1998) and alcohol
(Hartmann, 1994) may cause, or at least exacerbate, the condition.
Antidepressant and antipsychotic medications may trigger bruxism in
non-bruxers (reviewed in Brown & Hong, 1999; Gerber & Lynd, 1998). For
example, within a few days of initiating velafaxine therapy for depression,
a man with a bipolar disorder developed bruxism. In another study (Ellison &
Stanziani, 1993), daily intake of the antidepressants fluoxetine (=prozac)
or sertraline triggered sleep bruxism in four non-bruxers.

The effect of anti-depressants is still uncertain (Stein, Van Greunen, &
Niehaus, 1998). Still, clinicians should bear in mind the theoretical
possibility that drugs or medications may induce or exacerbate bruxism.

Recommendation: Clinicians should routinely inquire about their patients'
habits of consuming tobacco, alcohol, and antidepressants. Cutting down on
smoking or drinking may help in some cases to reduce bruxing. If bruxism
developed shortly after the beginning of antidepressant therapy, the
prescribing clinician should be notified and consulted about the
desirability of reducing the dose of the antidepressant, switching to
another antidepressant, or prescribing a drug which will counteract the
bruxism-inducing effect of the antidepressant. Thus, the effects of
venlafaxine may be counteracted with gabapentin; while the effects of
fluoxetine and sertraline may be neutralized with buspirone.

Sleep Feedback: Human Alarms.  One long-term experiment (Watson, 1993)
involved a 28-year-old man with a six-month history of sleep grinding and a
24-year-old woman with a three-month history of sleep grinding. The
treatment only involved the first two hours of sleep and consisted of the
following sequence: 1. Baseline: during the first few nights, the spouses of
both grinders were instructed to merely record grinding noises. 2. Waking:
For the next few nights, they woke their bruxing spouses when grinding
noises were heard. 3. Baseline. 4. Waking. 5. Baseline. 6. Waking plus
overcorrection (an enforced wakeful period-performing a series of
meaningless activities, e.g., face washing for ten minutes before going back
to sleep). 7. Baseline. 8. Follow-up recordings taken at intervals of up to
18 months post-treatment. In both individuals, almost complete cessation of
grinding occurred.

In a similar study (Blount, Drabman, Wilson, and Stewart, 1982), ice was
applied to the cheeks of two profoundly retarded wakeful grinders when they
were heard bruxing, leading to significant long-term reductions in the
incidence of bruxism.

Along with the magnesium therapy discussed below, such little-used
behavioral approaches deserve further study.  Yet, even if these approaches
are shown to be effective in a large-scale study, they suffer from obvious
shortcomings. They are inapplicable to clenchers. Moreover, the four
individuals in these two studies may have simply learned to grind inaudibly,
clench, or shift grinding behavior to periods when feedback was unavailable.
Such approaches depend on the presence of another individual nearby, and on
the willingness of that individual to lose sleep and provide the needed
feedback over a period of many months.

Recommendation:  If you are a grinder (and not a silent clencher), if you
don't sleep alone, and if your sleep partner is willing and able to provide
the needed feedback, you may wish to try this approach for a while.  If it
works, your problem is fairly painlessly solved.  If it doesn't, move on to
something else.

A Taste-Based Approach to the Prevention of Bruxism.

Here, a mildly aversive, safe liquid (e.g., sea water), is inserted into,
and sealed in, small  plastic capsules. Two capsules are attached to a
specially-designed dental appliance which comfortably and securely places
them between the lower and upper teeth. The appliance and capsules are worn
at night or at other times when bruxism is suspected to occur. Whenever
bruxism is attempted, the capsule(s) rupture and the liquid is released into
the mouth. The liquid then draws the bruxer's conscious attention to, and
forestalls, any attempt of teeth clenching or grinding.  After the  capsules
are replaced, sleeping patients then resume sleep while awake patients
resume their normal activities.

This approach is described in greater detail in the accompanying article.
On the positive side, it involves wearing a comfortable dental appliance
similar to a child's retainer; hence (unlike the splint), it is probably not
associated with any worrisome side effects.  It is based on the known
effectiveness of taste stimuli in aversive conditioning (click here to find
out more about the theoretical promise of the taste approach, as opposed to
any other biofeedback modality), and on documented research that the
sleeping brain is capable of learning.  It is less costly and cumbersome
than sound alarms, and, unlike sound alarms, it virtually precludes
habituation (not waking when the alarm sounds).  When worn, it eliminates
(not just reduces) bruxing behavior.  Moreover, this appliance (attached to
wax capsules) can be used to diagnose bruxism and to assess the
effectiveness of all other treatment modalities.  On the negative side, the
first couple of weeks of wearing this appliance are trying.   Also, as in
the case of all other bruxism therapies, a large scale, double-blind,
experiment confirming the effectiveness of this approach has yet to be
carried out.  One chronic clencher who has used this approach for the past
four years says:

I've tried just about everything over the years, and yet my condition
continued to get worse.  Dentures, hearing aids, and TMJ were waiting for me
just around the corner. The taste-based approach worked wonders for me.   It
saved my ever-flattening teeth. It totally stopped my earaches, hearing
loss, splitting headaches, and clicking jaws.  I still wear the device very
night, so for me this approach only provided an effective treatment, not a
cure.  The appliance is far more comfortable than the splint though, and is
not associated with any side effects.  About once every two weeks now a bag
breaks, but that's all right, given all the other alternatives!
Half-asleep, I remove it, replace it with the spare appliance which is
always ready on my nightstand, and go back to sleep.

Recommendation:   Read the attached article and decide for yourself.
However, despite its great promise, this approach is not yet commercially
available (the average time lag between invention and adoption of an
effective medical treatment is 12 years-click here if you want to read about
this lamentable aspect of science and medicine).  In the meantime, if you
are technically proficient, you may wish to try this approach on your own:
click here for technical advice.

Nutritional Supplements. Magnesium's vital role in nerve and muscle function
led at least two researchers to the suspicion that bruxism may be traceable
to insufficient consumption, or inefficient utilization, of this metal.
Magnesium-deficient diet is said to cause frequent teeth grinding in both
sleeping and awake pigs (cf. Lehvila, 1994, p. 219). In humans, the
suggested treatment involves magnesium supplements. According to Ploceniak
(1990),  for instance, prolonged magnesium administration nearly always
provides a cure for bruxism. This confirms the earlier report of Lehvila
(1974), which claimed remarkable reductions (and sometimes even
disappearance) in the frequency and duration of grinding episodes in six
patients who took, once a day, a tablet of assorted vitamins and minerals
(which included 25 mg {in children} or 100 mg {in adults} of magnesium), for
at least five weeks. When the supplements intake stopped, the symptoms
returned.

Earlier, a similar logic led Cheraskin & Ringsdorf (1970) to study the
effects of nutritional supplements on teeth grinders or clenchers. Of these,
16 took calcium, vitamin A, vitamin C, Vitamin B5 (pantothenic acid),
iodine, and vitamin E. When surveyed a year later, they reported that
bruxism vanished. In contrast, the 15 bruxers who only took vitamins A, C, E
and iodine showed no improvement. It seemed reasonable to conclude that the
active agents were calcium and pantothenic acid (vitamin B5).

More research is clearly needed in this area. Indeed, if such claims apply
to even a small proportion of bruxers, they merit a close look because
taking these supplements is comparatively convenient, safe, and free of side
effects.

Recommendation:  Until such claims are confirmed, narrowed down, or refuted
in a large-scale, double-blind study, the best strategy may involve taking
the following on a daily basis: magnesium (approximately 100 mg), calcium
(150 mg), and pantothenic acid (50 mg), combined with at least the
following: vitamins A (1,000 IU), C (300 mg), E (60 mg), and iodine (0.1
mg=100 mcg). If bruxism subsides, patients should be advised to continue
taking these pills. If no improvement is observed after 8 weeks or so, the
approach should be given up.

Notes:

In these nutritional studies, bruxers typically take a number of vitamins
and minerals, not just one; thus, it is not yet possible to pinpoint the
effective nutritional agent. Moreover, these supplements often work
synergistically or cooperatively, so a few minerals and vitamins need to be
taken to correct a deficiency in one. That is why, until we know more about
the subject, all the supplements above should be taken, not just magnesium
or calcium.
The available evidence tells us little about optimal dosages, so there is an
element of uncertainty in deciding how much to take.
Children should take proportionately less. For instance, an eight-year-old
weighing about 70 lbs. should take about half the recommended dosage.
Magnesium should be avoided in cases of renal impairment and acute
dehydration. It should not be taken if it causes diarrhea, other adverse
reactions, or if it interferes with other medicines. One should refrain from
prescribing more than 100 mg a day, as taking too much, or prolonged
treatment, may cause fatigue and respiratory problems. Taking too much
magnesium may even cause hypermagnesaemia, leading to nausea, vomiting,
lethargy, and blockage of the bladder. As in the case of most drugs, dosage
should be roughly determined by weight. In my view, roughly 0.7 mg a day per
pound of body weight is all that should be taken (so a person weighing 143
lbs. needs to take no more than 100 mg of magnesium).
A large-scale experiment on the effectiveness of nutritional supplements is
long overdue.
Vacuum Prevention. Dr. Long (1998) believes that "to clench the jaw for a
long time, an intraoral vacuum must be formed and maintained."  To prevent
the formation of such vacuum, one may construct the simple, stainless steel
wire appliance shown below.  Over this appliance two plastic straws are
fitted, which are in turn held in place with two rubber washers aimed at
preventing the creation of vacuum.

It remains to be seen just how effective this approach is.  In view of its
simplicity, low cost, and few probable side effects, technical improvements
and further experimental and clinical evidence would be of interest.  In the
meantime, some reservations come to mind.

The appliance itself may often float in the mouth of a sleeping patient, or
even be expelled.  The evidence that a vacuum is required for sustained
clenching is sketchy, at best.  The appliance is said to prevent prolonged
clenching, not to prevent clenching of short duration, nor to prevent
grinding.   Thus, it may merely lead to a change in the pattern of bruxing,
with more numerous bouts of shorter durations, so that the total amount of
bruxing remains the same. The total effect may be equivalent to breathing
through the mouth, which is not as healthy or comfortable as breathing
through the nose.  Indeed, it is difficult to see how the same effect could
not be achieved by the simpler means of plugging one's nose before going to
sleep. The appliance cannot serve as a cure; it must be worn to mitigate
clenching. Apart from subjective patient reports, it would be difficult to
know whether this treatment is effective.

Recommendation: If this claim strikes you as sound, and if the idea doesn't
bother you, you may plug your nostrils for a few nights to check the vacuum
prevention claim.  Alternatively, look up Long's paper and either construct
his device yourself or take his paper to your dentist and ask her to
construct it for you.  Try it for a few days.  If it works for you
(unlikely, but one never knows), you are home free.

The NTI Clenching Suppression Device.  The inventor of this mini-splint, Dr.
Jim Boyd, describes it as "a patented pre-fabricated, easily retro-fitted
anterior-point-stop device which suppresses clenching intensity in all
excursive and protrusive movements."   The device is said to effectively
reduce clenching behavior.  To find out more about this device, go to Dr.
Jim Boyd's web page.

According to Dr. Boyd, the device may cause an annoying anterior open bite
(this link contains a photo of a severe open bite).  As well, as in the case
of all other bruxism claims, a systematic, large-scale, double-blind study
remains to be carried out.  All the same, here are the independent
testimonials of two chronic bruxers:

I have been wearing Dr. Jim Boyd's NTI appliance three and a half weeks and
it does suppress clenching. My sore muscles are healing and I haven't felt
better in two and a half years. It feels so good to go to bed and know that
I will not be beating up my muscles, nerves, joints, etc. with clenching I
cannot control.  As for cost. I went to California to a dentist there who
charged me an outrageous price that is not typical. In addition, the NTI was
not correctly fitted.   Dr. Boyd had met me in Las Vegas and  modified it to
correctly fit at no charge. To give you a better idea of cost, my adult
daughter also clenches, so we called her dentist.  His total cost is $190.
There are no lab costs because the NTI can be fitted right in the office.
Also, no dental impressions or molds are needed. It takes approximately half
an hour to fit the appliance. (Note: Dr. Boyd has kindly provided links to
dentists' testimonials).

I checked out Dr. Boyd's device from your website link.  I have been using
his NTI-TSS device for about 2 months now.  It has helped keep me off the
big jaw muscles and seemed to be effective.  But lately I have been
developing heavier TM joint and temporalis pain again, even with the device
in at night. I wanted to try this device first . . .  I am concluding, now,
though, that maybe because I tend to "chatter" and clench, the device's
efficacy is suspect.

Recommendation:  Visit Dr. Boyd's web site, compare his approach to others
in this page, and decide for yourself.

A Parting Word:  If you are a clinician, you may wish to consult all links
and references in this hypertext before prescribing a splint to one more
bruxer.  If you are a bruxer, I hope this hypertext helps you take charge of
your health and confront your bruxism problem now.

Good Luck!

References

Note: Double-click underlined titles for either a summary of the article or
the article itself.

Blount, R. L., Drabman, N. W., Wilson, W., & Stewart, D. (1982). Reducing
severe diurnal bruxism in two profoundly retarded females. Journal of
Applied Behavior Analysis, 15, 565-71.

Brown. E. S., & Hong, S. C.  (1999).  Antidepressant-induced bruxism
successfully treated with gabapentin. Journal of the American Dental
Association, 130(10):1467-9.

Bubon, M. S. (1995).  Documented instance of restored conductive hearing
loss. Functional Orthodontist,12, 26-9.

Carlsson GE, Egermark I, Magnusson T.  (2003).  Predictors of bruxism, other
oral parafunctions, and tooth wear over a 20-year follow-up period.  Journal
of  Orofacial Pain, 17(1), 50-7.
Cheraskin E., & Ringsdorf, W. M. Jr. (1970).  Bruxism: a nutritional
problem? Dental Survey,  46(12), 38-40.

Ellison J. M., & Stanziani P. (1993).  SSRI-associated nocturnal bruxism in
four patients.  J Clin Psychiatry, 54: 432-4.

Gerber P. E., & Lynd, L. D. (1998). Selective serotonin-reuptake
inhibitor-induced movement disorders.  Ann Pharmacother, 32(6):692-8.

Goldman, J. R.  (1991).  Soft Tissue Trauma. In Kaplan, A. S. and Assael, L.
A. Temporomandibular Disorders. Philadelphia: Saunders, pp. 191-223 (Note:
Still one of the best and most accessible books on TMD's).

Hartmann E. (1994).   Bruxism. In: Kryger M. H. & Roth T, Dement W. C.
(eds). Principles and Practice of Sleep Medicine, 2nd ed. Philadelphia: W.
B. Saunders, pp. 598-601.

Kieser J. A., & Groeneveld, H. T. (1998). Relationship between juvenile
bruxing and craniomandibular dysfunction. Journal of Oral
Rehabilitation,(Sep), 25(9): 662-5.

Lehvila, P. (1994). Bruxism and magnesium: Literature Review and Case
Reports. Proceedings of the Finnish Dental Society, 70, 217-224.

Long, J. H. Jr.  (1998). A device to prevent jaw clenching. Journal of
Prosthetic Dentistry, 79(3), 353-4.

Madrid G., Madrid S., Vranesh J. G., & Hicks R. A. (1998). Cigarette smoking
and bruxism. Perceptual and Motor Skills, 87:898.

Matthews E. (1942).  A treatment for the teeth-grinding habit. Dental
Record, 62, 154-5.

Nissani, M. (2000).   Can Taste Aversion Prevent Bruxism?   Applied
Psychophysiology and Biofeedback, 25 (#1), 43-54.

Nissani, M.  (2001).  A bibliographical survey of bruxism with special
emphasis on non-traditional treatment modalities.  Journal of Oral Science,
43 (2): 73-83  (2001).

Ploceniak, C. (1990).  Bruxism and magnesium, my clinical experiences since
1980. Revue de Stomatologie et de Chirurgie Maxillo-Faciale, (French;
English abstract in Medline-a full translation of the article is given in
the accompanying link), 91 Suppl. 1:127.

Reynolods, Burt.  (1994).  My Life (Chapters 49, 50).

Stein, D. J., Van Greunen, G., & Niehaus, D. (1998). Can bruxism respond to
serotonin reuptake inhibitors? Clinical Psychiatry, 59 (3), 133.

Thompson, B. H., Blount, B. W., & Krumholtz, T. S. (1994). Treatment
approaches to bruxism. American Family Physician,  49, 1617-22.

Watson, T. S. (1993). Effectiveness of arousal and arousal plus
overcorrection to reduce nocturnal bruxism. Journal of Behavior Therapy and
Experimental Psychiatry 24, 181-185.

Wright, E. F.  1999.  Using soft splints in your dental practice.  General
Dentistry 47, 506-510.

Clickable Table of Contents:  I1. Educate Yourself  2.  Consult a Specialist
3. Uncertainty about bruxism  4. Bruxism and TMJ (TMDs)  5. "Cures" to avoid
6. Wait & See?  7. Stress?  8. Trauma  9. Drugs  10. Human Alarms  11. Taste
Biofeedback  12.  Nutritional Supplements  13. Vacuum Prevention  13. NTI
14. Works Cited

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