JEFF WYSCARVER
TRIAGING THE
Tooth wear causes are numer-
ous requiring more informa-
tion than just its presence to
manage. Significant prog-
ress is being made treating
patients with the signs and
symptoms associated with
bruxism. Most notably, the
Bruxism Triad originally de-
scribed by Jeff Rouse, DDS
talks about airway dysfunc-
tion along with other types
of EEG arousals triggering a
cascade of events including
parafunctional EMG activity
and bruxism.
Historically speaking, manag-
ing any type of sleep issue is
difficult because we find our-
selves asking patients about
behavior that occurs while
asleep. For example, how
many times have you heard a
patient say, “I DO NOT grind
my teeth” yet the patient has
8 teeth with exposed dentin.
Triaging the triggers causing
tooth wear is the challenge
when managing the Bruxism
Triad. In many cases, manag-
ing the bruxism\tooth wear
can be surprisingly simple
when the triggers are identi-
fied.
For example, if a subtle air-
way issue is triggering brux-
ism, something as simple as
changing the sleep position
can dramatically reduce
parafunction, as seen in the
diagram below. This example
demonstrates the alleviation
of oxygen desaturations, snor-
ing and parafunctional activi-
ty while sleeping on their side.