Bruxism management during tooth wear rehabilitation: A perspective on the temporary use of contingent electrical stimulation
Year: 2025
Type: article
Abstract: This temporary use of contingent electrical stimulation with the GrindCare ® device may offer a practical, non-invasive solution to reduce bruxism and protect restorations during vulnerable phases of phased dental rehabilitation.Bruxism, whether manifesting during wakefulness or sleep, is a commonly encountered phenomenon in clinical dental practice.It continues to stimulate discussion and research due to its multifactorial nature and diverse clinical implications.Notably, our current understanding suggests that bruxism may not always be a harmful behavior; instead, it can serve as either a risk and/or a protective factor, depending on the individual case and context. 1 This dual nature presents a unique challenge for clinicians tasked with discerning when, and how, to intervene.Bruxism diagnostic tools are currently categorized into 3 diagnostic levels.1,2 They are termed subject-based when they rely solely on patient self-reporting; clinically based when accompanied by clinical signs, such as the linea alba, impressions on the tongue or cheek, or tooth wear; and device-based when confirmed via electromyographic (EMG) or polysomnographic (PSG) recordings.While these definitions aid in structuring clinical evaluation, they do not always clarify whether bruxism is active or residual, further complicating treatment decisions.Importantly, bruxism is no longer regarded as a disorder in itself.Instead, it is understood as a behavior that warrants treatment only when it results in negative outcomes (e.g., tooth wear, pain).One promising approach in such cases is contingent electrical stimulation (CES), where muscle activity is detected and interrupted via mild electrical impulses.2 One of CES tools is Butler ® GrindCare ® (Sunstar Suisse SA, Etoy, Switzerland), a single-channel EMG-based device that exemplifies this approach.2 It records activity from the temporalis muscle and, when in the therapeutic mode, responds to bruxism events with mild electrical stimulation intended to disrupt the event without causing discomfort.The device has utility for both diagnosis -by establishing a baseline level of activity -and therapy, by potentially reducing excessive muscle contractions during sleep.Following a standard protocol, patients wear the device for a two-week assessment phase.If more than 15 episodes per hour are recorded, treatment is recommended.2,3 Cite as
Source: Dental and Medical Problems
DOI: 10.17219/dmp/207388
Language: English
Subfield: Complementary and Manual Therapy
Field: Health Professions
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413412593