I'm looking for hard data on the number of people diagnosed with
bruxism per year in the USA and at least one EU country (ideally UK,
Germany, and the Scandinavian countries).
Secondly, I'd like to know how many occlusal splints are prescribed or
sold for bruxism and related conditions in these countries.
Finally, I'd like data on prescriptions or sales of alternative
treatments and screening tools such as the GrindAlert, BiteStrip, and
various biofeedback devices on the market.

---

Request for Question Clarification by nancylynn-ga on 27 Aug 2005 23:34 PDT

Hello ab64-ga:

It appears no truly comprehensive study of bruxism rates has ever been
conducted in the U.S.; there are really only ?guesstimates.?

I did find information about approximately how many of occlusal
splints are prescribed in the U.S. annually, but of course, that
figure likely doesn?t correlate to the number of actual cases, as the
condition appears to be under-diagnosed.

I did find a comprehensive study of patients in three European
countries (along with one study of Italian patients only), which
appears to be the benchmark study on bruxism.

As for sales of the biofeedback devices, it appears the manufacturers,
such as BruxCare, are privately owned, so aren?t required to report
sales data publicly. I could try contacting the companies on Monday to
see if they?ll give me estimates of units sold; if not, you could buy
reports from a service like Hoover?s Online, but those reports *may*
just give you the companies? total sales or revenues, not a breakdown
of data.

If you feel the information I can provide will be satisfactory, let me
know, and I?ll proceed with my research.

Best Regards,

nancylynn-ga
Google Answers Researcher

---

Clarification of Question by ab64-ga on 28 Aug 2005 06:34 PDT

Hi nancylynn,

Yes, please go ahead and give me as much information as you can find
on the number of splints prescribed and results of the European
studies you have found.  Also any guestimates you find for bruxism
incidence in the US.  However, you can skip over the biofeedback
devices.  I agree it seems unlikely that sales figures are publically
available.

Thanks,
ab64

---

Request for Question Clarification by nancylynn-ga on 28 Aug 2005 11:48 PDT

Will do.

I'm going to go ahead and contact the manufacturers of the items you
mentioned, as they may be willing to share some data -- you never
know.

I'll also see if I can find any biofeedback devices made by public
companies that have reported sales/revenue figure.

I'll also contact the ADA tomorrow, as I can't find solid figures even
at their site re: incidence rates.

I was just recently diagnosed with bruxism myself and now wear a
nightguard. I'm a little stumped at the lack of research on this
condition.

I hope to post an answer within a few days.

Regards,
nancylynn-ga
Google Answers Researcher

---

Clarification of Question by ab64-ga on 29 Aug 2005 01:00 PDT

Hi nancylynn,

Thanks for your diligent efforts. I can see that you have a personal
interest in this! But I'm in a bit of a hurry so if you can please
post a partial answer today (with the European data), it will help
tremendously.  You can then fill in the rest of the data later in the
week.

Best regards,
ab64

Here is the information you requested. For future reference, please
note if you are in an extreme hurry when you post your question. (That
doesn?t mean a researcher will be able to assist you immediately.)
Also, posting partial answers is generally frowned upon, but I?ll make
an exception since you do need this right away.

INCIDENCE RATE -- EU:

From the January 2001 issue of the American College of Chest Physicians:

?Risk Factors for Sleep Bruxism in the General Population,? authors: 
Maurice M. Ohayon, MD, DSc, PhD; Kasey K. Li, DDS, MD and Christian
Guilleminault, MD:
  
http://www.chestjournal.org/cgi/content/full/119/1/53

?Participants: Thirteen thousand fifty-seven subjects aged 15 years
(United Kingdom, 4,972 subjects; Germany, 4,115 subjects; and Italy,
3,970 subjects).

? . . .Results: Grinding of teeth during sleep occurring at least
weekly was reported by 8.2% of the subjects, and significant
consequences from teeth grinding during sleep (i.e., muscular
discomfort on awakening, disturbing tooth grinding, or necessity of
dental work) were found in half of these subjects. Moreover, 4.4% of
the population fulfilled the criteria of ICSD sleep bruxism diagnosis.

?Conclusions: Sleep bruxism is common in the general population and
represents the third most frequent parasomnia. . .?

You can read the full study by clicking on ?Full Text (PDF)? in the
menu, top right, or going to:
http://www.chestjournal.org/cgi/reprint/119/1/53  

**********************************************************************

U.S.

This article states up to 50% of the U.S. population may have bruxism:
?A Breakthrough in Occlusal Splints?:
http://www.benchmarkdentallab.com/pdfs/bulletin.pdf#search='occlusal%20splints%20prescribed'

S.L.P., maker of BiteStrip, notes incidence rates of bruxism:
"Prevalence: The prevalence of SB is 14%-20% in children and 8% in the
adult population, thus showing a decline with age."
http://www.bitestrip.com/dynamicPage2P.asp?menuid=68

I have contacted S.L.P. to inquire where they got that data and asking
me to please refer me to that study (studies).


From the April 15, 2005 edition of ?Health Day,? see ?Health Tip: If
You Grind Your Teeth,? by Nancyann Rella: ?As many as 40 million
Americans suffer from bruxism, better known as teeth grinding. Five
percent to 10 percent of them grind their teeth so severely that they
fracture dental fillings or cause other types of tooth damage.?

See that excerpt at KeepMedia.com:
http://www.keepmedia.com/pubs/HealthDay/2005/04/15/814382?extID=10032&oliID=213

 
************************************************************************
SPLINTS PRESCRIBED (U.S.)

This 2000 article ?Unrecommended [Sic] Bruxism Treatments,? by Dr.
Moti Nissani of Wayne State University:
http://www.is.wayne.edu/mnissani/bruxnet/nocures.htm
estimates that 3.6 million splints are prescribed, annually.

---

Request for Answer Clarification by ab64-ga on 29 Aug 2005 10:25 PDT

Thank you nancylynn, I do appreciate you accommodating my request. In
the future I'll make note of any deadlines.  I look forward to your
further findings.

---

Clarification of Answer by nancylynn-ga on 29 Aug 2005 23:02 PDT

INCIDENCE RATES ? U.S.:

I?ve found a variety of estimates for bruxism incidence rates in the
U.S., but most references (maddeningly) don?t contain references to
clinical studies.

For instance: According to the Columbia University of Oral & Dental Surgery:
http://www.dentist-forum.net/dentistry/Some_Bruxism_information__a_little_different_from_our_take_258195.html
? . . .In the United States, bruxism affects an estimated 30 to 40
million children and adults.?

Most studies I found on bruxism concentrate on possible causes
(smoking, stress) rather than prevalence. Overwhelmingly, the study
most often cited re: prevalence is ?Treatment approaches to bruxism,?
by Thompson BA, Blount BW, Krumholtz TS, which was reported in
American Family Physician (Volume 49), May 15, 1994.

The only place I can find to read that study online is at Highbeam Research: 
http://static.highbeam.com/a/americanfamilyphysician/may151994/treatmentapproachestobruxism/index.html

There, you can sign up for a free two-week trial at Highbeam so that
you can read the entire study. You?ll see an excerpt from the opening
of the study:

?The reported incidence of bruxism varies, depending on the population
that is studied, the definition that is used and the diagnostic
criteria that are applied. The incidence of this condition in adults
ranges from 5 to 96 percent and is approximately 15 percent in
children, with equal distribution between the sexes.  . . . The
prevalence in childhood increases up to the age of seven to 10 years.
In children, bruxism is usually transient and resolves with eruption
of the secondary dentition . . . . Since bruxism most frequently
occurs during sleep, only 5 to 20 percent of . . . .?

That?s where the excerpt trails off, but I keep seeing estimates of 5
to 20 percent of Americans have bruxism, so it seems this 1994 study
remains the most comprehensive, definitive study of bruxism prevalence
in the U.S. ? as well as the most frequently cited study.

Btw, the total population of the U.S. as of 2003 was 290,809,777,
according to the U.S. Census Bureau
http://quickfacts.census.gov/qfd/states/00000.html

I have contacted the American Dental Association (ADA) re: more recent
studies on bruxism rates. If I hear back from them, I?ll certainly
update you.

BIOFEEDBACK:
http://members.aol.com/eegspectrm/articles/eegtrain.htm

I have contacted S.L.P. Ltd., which manufactures BiteStrip: 
http://www.bitestrip.com/ourCompanyP.asp
Which is sold by Great Lakes Orthodontics:
http://www.greatlakesortho.com/

And I have also contacted BruxCare:
http://www.bruxcare.com/
maker of GRINDALERT, regarding sales/ units sold.

You also have the option of ordering a $9.99 report on BruxCare from
Hoover?s Online at:
http://smallbusiness.dnb.com/company-information-product-list.asp?referrer=hoovers.com&partner=hoovers&cm_mmc=eLicensing*Hoovers*SIMPLESEARCHRESULTS*Free+Member&key=125290275&bhcd2=1125286990

As far as I can tell, GrindAlert is BruxCare?s only product, so sales
figures in that report should reflect only sales of GrindAlert.

If I hear back from S.L.P./Great Lakes and BruxCare, I will, of
course, update you.

Search Strings

bruxism  +incidence rates
bruxism +statistics
number of occlusal splints prescribed
"American Dental Association" AND bruxism
clinical study AND bruxism
"Thompson, Blount, and Krumholtz" AND 1994
?teeth grinding? OR bruxism

I hope my research is of help to you. You can find more results by
repeating ? or tweaking ? my search strings. If you need help
navigating any of the above links, please post a ?Request For
Clarification.?

Again, I will update you if I hear back from the ADA, and/or from the
biofeedback manufacturers, I will post that information for you.

Best Regards,

nancylynn-ga
Google Answers Researcher

---

Clarification of Answer by nancylynn-ga on 29 Aug 2005 23:11 PDT

I?m sorry; I gave you the incorrect link for the Columbia University
of Oral & Dental Surgery citation. It?s:
http://www.simplestepsdental.com/SS/ihtSS/r.WSIHW000/st.32219/t.25009/pr.3.html

---

Clarification of Answer by nancylynn-ga on 02 Sep 2005 21:32 PDT

Hello again:

I received this reply from Nina Koziol, who is with the ADA?s Division
of Communications.

?The ADA has not published any studies on bruxism or data that relates
to bruxism treatment. I know you have already searched other web
sites, but you may wish to check the National Library of Medicine's
database.  Perhaps they have some bruxism statistics tied to studies
on sleep apnea.  Manufacturers of night guards might also direct you
to studies.?

In my e-mail to S.L.P. (makers of BriteStrip), I did ask them where
they?d found the bruxism incident rates they posted at their Web site:

http://www.bitestrip.com/dynamicPage2P.asp?menuid=68
 "Prevalence: The prevalence of SB is 14%-20% in children and 8% in the
adult population, thus showing a decline with age."

Unfortunately, they never did get back to me.

I also re-checked the National Library of Medicine. Once again, I
mostly got very narrow results, such as bruxism among college
students, or seniors, etc.

I did find one apparent general population study (from 1981) that
matched the keywords ?bruxism AND prevalence AND U.S?:

?J Prosthet Dent. 1981 May;45(5):545-9. Related Articles, Links  

?Incidence of diurnal and nocturnal bruxism.?

Glaros AG.

PMID: 6938686 [PubMed - indexed for MEDLINE?

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?orig_db=PubMed&db=PubMed&cmd=Search&defaultField=Title+Word&term=Glaros+AG.[auth]+AND+Incidence+of+diurnal+and+nocturnal+bruxism

Unfortunately, you can?t read the article online. At the top right of
the above URL click ?Links,? then click ?LinkOut.? That will bring up:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&list_uids=6938686&dopt=ExternalLink
There, click ?Libraries? to bring up a list of libraries that have
this article in their archives. At the next page click ?All? (at the
end of the alphabetical list) to bring up a list of all libraries ?
nearly all are dental school libraries ? that have that issue the May
1981 Journal of Prosthetic Dentistry.

I?m sorry, but I haven?t heard back from the two manufacturers
(BruxCare and S.L.P.) and, at this point, I don?t expect to.

nancylynn-ga

Thank you nancylynn for your dilligent and timely research!

Thanks for the kind words and the generous tip!

Again, I will post an update if I hear back from the manufacturers and the ADA.

I am writing for BruxCare, and would like to say that we were never
contacted by this researcher. We could have helped a lot. Since I
don't have an email address,I will reply here.
Though I won't give sales figures, I am happy to give you some
information.  Biofeedback device sales are incredibly insignificant
compared to the sale of  mouthguards made each year. In 1995, the
American Dental Association reported the U.S. market for
anti-grinding, anti-clenching prescribed nightguards approached $1
billion  (JADA, Vol. 126, Feb. 1995. )  That prediction was based on
3.5 million people seeking treatment per year, which normaly involves
purchasing a custom made $350 nightguard.  More significantly, 10
million Americans are seeking treatment for TMJ disorders each year.
This has a much higher price tag.  We believe that 10% of Americans
are affected in some way by teeth grinding and jaw clenching.

Further research paper summaries of the use of biofeedback to treat
bruxism can be provided on request.

First, I am very glad for BruxCare's response.

I would like to note, however, that I did indeed e-mail BruxCare
co-founder Tom Devlin on August 29, 2005.

Apparently, something went wrong with that transmission and the
company never received my inquiry.

I am sorry for the apparent technical glitch in trying to contact
BruxCare. I also very much appreciate a representative from the
company posting helpful information at this thread.

nancylynn-ga
Google Answers Researcher

Hmm  - $350 for a custom-made nightguard, seems quite expensive,
especially after finding this site that advertises them for 35 pounds
sterling, also custom-made:

http://www.unavida.eu.com/catalog/night-guard-p-41.html

To elaborate on mouthguards, these are made by taking a mold of your
existing teeth, then creating a positive plaster cast of your actual
teeth.  This material is sent to a local lab, where a hard plastic
mold is made to fit your teeth exactly.  The price can be low if your
dentist likes you, maybe $250, or very high if you get it done in a
large city like New York, where they will have no problem charging
$800.

There are inexpensive versions that are made by heating the material,
and biting down.  Many serious bruxers will chew right through these. 
Some can even chew through the expensive versions.  This kind of power
exerted on the jaw can disintegrate teeth, and ruin the jaw joint
(TMJ.)  BruxCare is trying to stop people from grinding in the first
place to prevent this damage.

Mouthguard creation is done by hundreds of labs throughout the U.S.
There is no major player, much like there is no auto repair shop that
dominates the market for fixing cars.  For a bit of perspecitve, from
what I know of our own sales and the sales of other biofeedback
devices, our share of the market is probably no more than the revenue
of ONE of these labs.

Hello, I am writing for SLP, the manufacturer of BiteStrip.
I have only just become aware of this correspondence and i must
comment that we have never received any inquiry from this researcher.
Nevertheless, i am quite agree with most of the info.

I am in the midst of a sabbatical from Google Answers and missed the
Jan. 10, 2006 comment from SLP.

I did indeed contact SLP via this page:
http://www.bitestrip.com/contactusP.asp

Just as with my e-mail to Mr. Devlin at BruxCare, I don't know what
happened, but I never received a response.

Obviously, it was because my e-mails were never received! 

For that I am truly sorry, but I wish to emphasize that I did, in
fact, attempt to contact both companies. Again, I am sorry that the
e-mails -- apparently -- were not properly transmitted.

I would have attempted to call both companies, but the customer was in
an extreme hurry. I am noting this because I strive to be as thorough
as possible.

nancylynn-ga
Google Answers Researcher