The night guard: its uses and dangers of abuse

Adverse events of acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders

Occlusal splint therapy and acupuncture have been found to provide positive treatment in a number of studies. As with other therapies, adverse events may occur. In this paper, adverse event refers to any reaction to a treatment besides the intended treatment effect--irrespective of any correlation between the treatment and the reaction. This reaction can be positive, as well as negative, to the patient. In the present study, 61 patients with craniomandibular dysfunction (CMD) were treated with acupuncture or occlusal splint therapy and the adverse events were carefully recorded. The results show that the profile of the adverse events differed between the two treatment modes. Acupuncture seemed to have adverse events of a more general nature, e.g., relaxed feeling, improved sleep, temporarily increased pain; whereas, adverse events of occlusal splint therapy seemed to be more locally related to the orofacial region, e.g., increased/decreased salivation and tension in the teeth. The majority of the patients responded positively to both treatment modalities. Only in a few cases did the patients consider the treatment uncomfortable. No serious adverse event or complication was observed in this study.

A critical evaluation of orthopedic interocclusal appliance therapy: design, theory, and overall effectiveness

Orthopedic interocclusal appliances have been evaluated in a number of research papers and clinical reports over the years. Various theories have been proposed about the method of action of the different appliances, but at present no conclusive controlled testing of these theories has occurred. Certainly, when the potential influence of the nonspecific treatment factors is considered, as well as those cognitive awareness factors common to all appliances, the use of "symptom improvement" as the definitive proof of the need for mandibular realignment or repositioning must be questioned. Specific, well-controlled research using more quantifiable measures of the treatment effect is necessary to make valid comparisons between the different therapeutic approaches. The full-arch occlusal stabilizing appliance is the design that has the most valid evidence about its effectiveness. Partial coverage interocclusal appliances have significant irreversible complications with tooth intrusion or eruption when used on an extended basis. There is little or no experimental support at present about repositioning, realignment, and pivot appliances and their effectiveness. Therefore, these appliances must be considered experimental treatments. When used to treat TM dysfunction in a program along with other methods, such as occlusal adjustments, and prosthetic care, the effectiveness of this treatment method is between 70% and 90%. As a general approach to managing TM pain and dysfunction, interocclusal appliances appear to be a highly effective, commonly used method.