Key Points
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Addresses the need for increased awareness of unintended occlusal changes which may be associated with night guard use.
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Highlights examples of cases demonstrating occlusal changes related to night guard use.
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Provides clinical advice on how to minimise the risks of occlusal changes with night guard use
Abstract
A review of the literature on night guards left questions unanswered about the risk and possible causes of occlusal derangement linked to night guard design and use. Cases are presented where night guard use resulted in anterior open bite and associated occlusal derangement. The aetiology of the occlusal changes observed is discussed. It is concluded that adverse occlusal effects linked to the use of night guards may be found to be more common than anticipated from existing literature. Patient follow-up is essential to monitor the use and effects of night guards, and regardless of appliance type, unintended occlusal changes may result. The use and effects of partial coverage appliances require very careful monitoring. Suggestions are provided for information and written instructions to be given to patients provided with night guards and removable orthodontic retainers.
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References
Capp N J . Occlusion and Splint Therapy. Br Dent J 1999; 186: 217–222.
Stapelmann H, Turp J C . The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – where do we stand? A qualitative systematic review of the literature. BMC Oral Health 2008; 8: 1–23.
Okeson J P . The effects of hard and soft occlusal splints on nocturnal bruxism. J Am Dent Assoc 1987; 114: 788–791.
Stohler C S . Clinical decision-making in occlusion: a paradigm shift. In McNeill C (editor) Science and Practice of Occlusion. pp. 294–305. Chicago: Quintessence, 1997.
Wassell R W, Verhees L, Lawrence K, Davies S, Lobbezoo F . Over-the-counter (OTC) bruxism splints available on the Internet. Br Dent J 2014; 216: E24.
Lobbezoo F, Ahlberg D, Manfredini D, Winocur E . Review article: are bruxism and the bite causally related? J Oral Rehabil 2012; 39: 489–501.
Van der Zaag J, Lobbezoo F, Wicks D J, Visscher C M, Hamburger H L, Naeije M . Controlled assessment of the efficacy of occlusal stabilization splints on sleep bruxism. J Orofac Pain, 2005; 19: 151–158.
Moufti M A, Lilico J T, Wassell R W . How to make a well-fitting stabilization splint. Dent Update 2007; 34: 398–400, 402–394, 407–398.
Chate R A, Falconer D T . Dental appliances with inadequate occlusal coverage: a case report. Br Dent J 2011; 210: 109–110.
Magdaleno, Fernando, and Eduardo Ginestal. Side effects of stabilization occlusal splints: a report of three cases and literature review. Cranio 2010; 28: 128.
Fricton J, Look J O, Wright E et al. Systematic review and meta-analysis of randomized controlled trials evaluating intraoral orthopedic appliances for temporomandibular disorders. J Orofac Pain 2010; 24: 237–254.
Brown D T, Gaudet E L, Jr., Phillips C . Changes in vertical tooth position and face height related to long term anterior repositioning splint therapy. Cranio 1994; 12: 19–22.
Poyser N J, Porter R W, Briggs P F, Chana H S, Kelleher M G . The Dahl Concept: Past, Present and Future. Br Dent J 2005; 198: 669–676.
Clark G T, Minakuchi H . Oral appliances. In Laskin D M, Greene C S, Hylander WL (editors) TMDs: An Evidence-Based Approach to Diagnosis and Treatment. pp. 377–390. Chicago: Quintessence, 2006.
Dawson P E . Functional occlusion: from TMJ to smile design. First edition. Edinburgh: Elsevier Mosby, 2006.
Badel T, Simonić-Kocijan S, Lajnert V, Dulčić N, Zdravec D . Michigan splint and treatment of temporomandibular joint. Medicina Fluminensis 2013; 49: 112–120.
Widmalm S E, Use and abuse of bite splints. Comp Cont Ed in Dent 1999; 20: 249–254: 256, 258–259.
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Bereznicki, T., Barry, E. & Wilson, N. Unintended changes to the occlusion following the provision of night guards. Br Dent J 225, 715–722 (2018). https://doi.org/10.1038/sj.bdj.2018.869
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DOI: https://doi.org/10.1038/sj.bdj.2018.869
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