PubMed · 8409019
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T J Ceschi. 1993. Receding gums.. https://doi.org/10.14219/jada.archive.1993.0188
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We describe a 51-year-old man who developed awake bruxism during the course of multiple system atrophy. Electromyographic studies revealed side-to-side amplitude asymmetry of the bursts of motor activity. The bruxism responded favourably to low-dose levodopa-carbidopa therapy. Possible mechanisms of this rare association are discussed.
As one of the dental differentiations in The Netherlands, temporomandibular disorders (TMD) focuses on the diagnosis and treatment of pain and dysfunction of the masticatory system. Bruxism (i.e. tooth clenching and/or grinding) is thought to play an important aetiological role in TMD. Among others, bruxism may result in TMD pain and dental attrition. The close relationship between TMD, bruxism, and attrition necessitates an integrated approach to these clinical problems. This could be achieved through the multidisciplinary differentiation 'oral kinesiology', that covers not only the diagnosis and treatment of TMD and bruxism but also the restoration of worn dentitions. This article focuses on the background of oral kinesiology, as well as on the rationale to develop a curriculum for the postgraduate training of dentist-kinesiologists in the Netherlands. Further, the oral kinesiology curriculum of the Academic Centre for Dentistry Amsterdam will be introduced. This curriculum will ensure that specialized professionals, who are able to approach the different aspects of oral kinesiology in an integrated manner, are available not only for general dental practice but also for centres for special dental care and university departments. This will lead to improved care for patients, whose management is until now dispersed between various dental specialists.
A dental patient with post-traumatic stress disorder (PTSD) may present with greater dental and behavioral challenges than most dental patients. The background review of PTSD's initiating factors, diagnostic criteria, and medical management should help practitioners better understand and manage these challenges. Many of the challenges the clinician may encounter and managing recommendations are described. A case report of a PTSD patient complaining of constant bilateral tooth pain of the maxillary and mandibular bicuspids and molars is presented. Recommended techniques for identifying the tooth pain source and contributing factors are provided. The primary contributing factor for the patient's tooth pain was determined to be his severe tooth clenching activity. A maxillary acrylic appliance provided some pain reduction and a subsequent mandibular soft occlusal appliance worn opposing the maxillary appliance provided additional relief.