Dr. Gordon Christensen did an excellent review and explanation of bruxism and clenching ("Treating Bruxism and Clenching," February JADA).
I am an orthodontist who believes in early treatment. I start a large number of cases in the mixed dentition. Dr. Christensen states that patient education should be the main objective at this age. In the same paragraph, he talks about placing an occlusal splint.
I believe he is referring a young patient to a prothodontist (not an orthodontist). To prevent any misunderstandings, I would like to add a few thoughts.
Placing an occlusal-coverage splint in the mixed dentition would alter tooth eruption patterns. This in turn could lead to growth modification and to altered skeletal relationships. Occlusal-coverage appliances should not be placed in a growing individual without a complete orthodontic evaluation.
Often, if there is a skeletal discrepancy, a functional appliance, such as a bionator, is an excellent treatment modality. This appliance disoccludes the teeth, preventing enamel loss. At the same time, it can correct skeletal malrelationships.
Other combinations could include headgear with a bite plate. Further evaluation of airway and other functional problems are indicated. Patient education, as Dr. Christensen recommends, should be instituted.
In developing Class III malocclusions, early intervention may be necessary to prevent excess wear on the incisors. This can be a serious esthetic and functional problem that could be prevented.
In conclusion, placement of occlusal splints in the growing individual should not be considered except in conjunction with a complete orthodontic evaluation.
