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Title |
Relief Of TMD Pain In Patients Diagnosed With PTSD: Modifications Of Traditional Occlusal Appliances |
Clinical Question |
In a patient diagnosed with post-traumatic stress disorder who reports of night time clenching activity during during PTSD nightmares, and has found no relief via psychiatric/psychologic means, what is the best dental treatment? |
Clinical Bottom Line |
Severe nocturnal tooth clenching activity is commonly observed with nightmares related to PTSD, and serves as a primary contributing factor for their TMD symptoms. A non-pharmaceutical approach for managing the TMD symptoms among these patients is to provide a maxillary acrylic appliance worn at night. If this traditional appliance does not adequately resolve the symptoms, the addition of an opposing mandibular soft appliance may provide additional benefit. |
Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
#1) 15119679 | Wright/2004 | 1 patient diagnosed with PTSD reporting of tooth pain | Case Study | Key results | A maxillary acrylic appliance provided some relief, while addition of a subsequent soft occlusal appliance opposing on the mandibular provided additional relief. | |
Evidence Search |
"Stress Disorders, Post-Traumatic"[Mesh] AND "Bruxism"[Mesh] |
Comments on
The Evidence |
This was a case report covering the diagnosis, treatment, and management of a patient diagnosed with PTSD reporting bilateral tooth pain and night time clenching activity. There was no evidence of competing interest. As with all case reports, it is deficient in control groups, however, it offers insight to a potential solution for patients presenting with similar symptoms. More research is needed to assess alternative and best methods of treatment. |
Applicability |
PTSD patients often present much different than the average TMD patient. This case represents successful dental pain management in the complex PTSD presenting patient. Correct diagnosis and management of tooth pain in PTSD patients is critical in successful dental treatment. |
Specialty/Discipline |
(General Dentistry) (Behavioral Science) |
Keywords |
PTSD, Bruxism, Tooth Pain, Appliance
|
ID# |
2212 |
Date of submission: |
04/26/2012 |
E-mail |
Moers@uthscsa.edu |
Author |
Emily L. Moers |
Co-author(s) |
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Co-author(s) e-mail |
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Faculty mentor/Co-author |
Edward F. Wright, DDS, MS |
Faculty mentor/Co-author e-mail |
wrightE2@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
None available | |
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