Sleep Bruxism and OSA… Dentists Be Aware!

dentistWhy Are You Prescribing Bruxism Appliances?

Bruxism is a very common dental problem which is reported in one out of every three patients visiting the dentist’s practice. Bruxism is closely associated with migraines, headaches, temporomandibular disorders (TMD), and orofacial pain in the head and neck. However, bruxism is the least understood dental problem.

Dental professionals who do not have adequate information about bruxism has led to many patients being prescribed with bruxism appliances. Many dentists will often prescribe the same bruxism appliance irrespective of the severity of the condition and the presentation of symptoms. The devices may be an anterior bite plane, a posterior plane or a full arch coverage appliance.

A study by the American Academy of Facial Esthetics (AAFE) in September 2013 interviewed nine hundred and forty six dental professionals. It found that most dentists used only one type of bruxism appliance 95% of the time irrespective of the bruxism problem. It was further reported by 86% of the same group of dentists that the patient's condition is not satisfactorily resolved by the bruxism appliance. 

Dental sleep medicine has been a rapidly growing area of dentistry and is changing the treatment of bruxism. Bruxism is a condition related to obstructive sleep apnoea. OSA is a large problem affecting about 40 million people in the US alone with most people remaining undiagnosed. It is estimated that 90% of OSA sufferers go untreated.

An apnoea is characterized by the OSA patient stopping breathing for a minimum of 10 seconds during sleep. A hypopnoea where the OSA patient has significantly reduced airflow because of a partially blocked airway for at least 10 seconds while sleeping. Patients with OSA will have multiple apnoeas/hypopnoeas every night while they sleep.

OSA is associated with adverse health effects which include the incidence and severity of stroke, diabetes, hypertension, and heart attacks in patients. We should be screening for OSA with simple tests as part of a patient’s medical history. 

Advancements in the dental sleep medicine niche and especially bruxism have made it simpler for dental clinicians who can objectively measure bruxism and OSA. An example of technology used to measure and diagnose bruxism is the STATDDS Bruxism and Sleep Monitor, a home test kit worn at night. The device gives a report of the patient’s bruxism episodes index (BEI) and the apnoea/hypopnoea index (AHI). BEI gives the number of bruxism episodes per sleep hour and the AHI gives how many apnoea/hypopnoeas per sleep hour.

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Image courtesy of patrisyu /

Somnowell Inventor - Visiting Professor Simon Ash FDS MSc MOrth BDS

Prof. Ash is the inventor of the highly successful SOMNOWELL Chrome device for snoring and sleep apnoea.

The Somnowell Chrome is made to exacting standards in the Somnowell laboratory under the supervision of Visiting Professor Simon Ash. Prof. Ash and his master technicians create each Somnowell Chrome device using their wealth of experience and expertise.

Prof. Ash works at the forefront of his profession. He is a Consultant and Specialist Orthodontist with over 30 years clinical experience, with a special interest in sleep related breathing disorders, TMJD, and bruxism. He currently works in Harley Street London and two private hospitals in London as part of a multi-disciplinary team managing snoring and sleep apnoea, and is Visiting Professor of Orthodontics at the BPP University.