A recent study (c.Manzini, J Prosth Dent 2006 vol19 P21) shows that the short -term use of dental splint was the treatment presenting the most important reduction in sleep bruxism. Two types of dental splints were tried, one an upper splint and the other a mandibular anterior positioning device (MAD) that actually reduced bruxism more than just the upper splint. An through evaluation by a dentist trained in occlusion and cosmetic dentistry will determine which device should be used. A MAD device is mainly used for sleep apnea and although it has definite benefits but dental devices, including MAD, is not as effective as CPAP therapy, but patients may be more satisfied with them. They do have side effects, however. For example, the following problems are reported with MAD devices:
Side effects of MAD can include nighttime pain, dry lips, tooth discomfort, and excessive salivation. In general, these side effects are mild, although over the long term, nearly half of patients stop using them. Devices made of softer materials may produce fewer side effects. In some cases of long-term use, permanent changes in the position of the teeth or jaw have occurred. Periodic check-ups with a health professional are advised. In a small percentage of patients, the treatment may worsen apnea.
Also the effect of Clonidine (alpha 2 cardioactive drug) was evaluated and it seemed like this medication had an important effect in reducing sleep bruxism but this result was hampered by severe morning hypotension in %25 of subjects. Bromocriptine (dopaminergic agonist) increased the sleep bruxism in this study while propranilol (antihypertensive) decreased it just slightly
