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Bruxism is a normal activity; the pathology is psychological/sociological
Scientific Programme (On Demand)
Session Description
Bruxism is a normal activity; the pathology is psychological/sociological
In nearly all animals that have anterior dentition, its primary evolutionary advantage is as defence against predation, a defensive weapon; to enable the individual of the species to survive in an otherwise harsh environment. The only other core advantage of a species to survive is the ability to procreate. In those animals that have opposing blades, the gnashing of the teeth activity is to sharpen their blades, the dental aspect of the Fight/Flight Mechanism, which appears with concomitant anxiety (psychological stress). The dentist's role is to give a causal diagnosis which requires an accurate social history in addition to the usual history. Anecdotes will describe use of the causal diagnosis, along with non-invasive symptomatic therapies to remove the symptoms. Splint making is a last resort and rarely needed, and as for Botox....!. These concepts arise from the Thegotic paradigm (from Thegosis; to sharpen) which is a candidate paradigm challenging the current ‘parafunctional habit’ paradigm.
Learning Outcomes
In nearly all animals that have anterior dentition, its primary evolutionary advantage is as defence against predation, a defensive weapon; to enable the individual of the species to survive in an otherwise harsh environment. The only other core advantage of a species to survive is the ability to procreate. In those animals that have opposing blades, the gnashing of the teeth activity is to sharpen their blades, the dental aspect of the Fight/Flight Mechanism, which appears with concomitant anxiety (psychological stress). The dentist's role is to give a causal diagnosis which requires an accurate social history in addition to the usual history. Anecdotes will describe use of the causal diagnosis, along with non-invasive symptomatic therapies to remove the symptoms. Splint making is a last resort and rarely needed, and as for Botox....!. These concepts arise from the Thegotic paradigm (from Thegosis; to sharpen) which is a candidate paradigm challenging the current ‘parafunctional habit’ paradigm.
Learning Outcomes
There are a multitude of learning outcomes within the Thegotic paradigm; I have here endeavoured to reduce those to the most significant key outcomes for the improvement of the practise of Dentistry. 1, 3, & 5 are the most pertinent to TMD.
- Bruxism, termed Thegosis by Dr Ronald Gresham Every (Lancet 1965), is a normal instinctive activity, highly significant to the evolution of the species, particularly, in this paper, to hominins (humans). Its prime advantage is to sharpen the edges of opposing teeth. It is normal therefore, not ‘parafunctional’ nor a ‘habit’, as is the resultant wear. With regard to TMD it is inappropriate to treat a normal entity.
- Further, the accommodation of this wear is highly pertinent to the occlusal mechanics of dental restoration; without that accommodation dental restorations can cause iatrogenic contribution to TMD symptoms
- Learn to, through accurate social history taking, make an accurate causal diagnosis of TMD for each individual.
- Learn why there is such a variety of symptoms in Temporo-Mandibular Disorders.
- And therefore learn to apply the ‘Medicine 101’ approach to therapy, removal of cause.
- To prescribe symptomatic relief therapies other than the use of occlusal splints and/or the use of Botox.