The following is an continuation of the overview of the more common reasons for prescribing occlusal appliances. In Part I, I discussed:
- Diagnosing the etiology of pain.
- Treating pain that is muscle, and not TMJ based.
- Treating pain that is TMJ based during excursions.
- Treating pain that is TMJ based during condylar seating.
- Evaluating occlusal changes prior to restoration or equilibration.
Here are three more common reasons:
6. Diagnosing the level of a patient's parafunction following occlusal changes: Many patients present with significant tooth wear from parafunction due to multiple etiologies. It is possible to use an appliance as a way of assessing the patient's current parafunctional activity level. This information can help in predicting a prognosis for restorative treatment but also in making patients aware of the level of parafunction present. This can also aid in determining if investigations into the etiology of the parafunction, such as sleep studies, may be appropriate.
7. Treating snoring or sleep apnea: Dentistry has become much more attuned to the prevalence of sleep related breathing disorders and the opportunity for some occlusal appliances to have significant benefits in their treatment. Unfortunately other appliances may actually make the breathing disorder worse, so the appliance choice is critical.
8. Protecting teeth or restorations from wear or fracture: Many times the reason for prescribing an appliance is simply to protect teeth or restorations from wear or fracture; any occlusal appliance does that, but some are much more easily fabricated, adjusted and worn than others. Additionally, sometimes they may need to be worn at times during the day, as well as at night. This will definitely effect which appliances may be more appropriate.