Wassell R W, Verhees L, Lawrence K, Davies S, Lobbezoo F
Department of Restorative Dentistry, The School of Dental Sciences, Framlington Place, Newcastle upon Tyne, NE2 4BW.
TMD Clinic, Dental School, Higher Cambridge Street, Manchester, M15 6FH.
Br Dent J. 2014 Jun 13;216(11):E24. doi: 10.1038/sj.bdj.2014.452.
Some individuals may now be bypassing their dentists for treatment of bruxism. Self-diagnosed, self-adjusted and self-monitored consumers can access over-the-counter (OTC) bruxism splints via the Internet. While some may regard this market as benefiting consumers there are potential pitfalls that need to be highlighted. These include unevidenced claims of efficacy.
To survey OTC bruxism splints available to individuals in the UK via the Internet, categorise their characteristics, and determine any web-based claims or safety warnings.
An Internet search was made of OTC bruxism splints available in the UK. The following information was recorded for each OTC splint: the name of the manufacturer, name of the device, its UK price and any claims and safety warnings made either on a major UK retail website or via other UK web retail outlets. In addition, a note was made of any web-based mention of 'CE marking', indicating compliance with the EC Medical Devices Directive's requirements for safety, quality and performance.
Safety information is notable for its paucity and is totally lacking on many Internet sites. However, manufacturers are not obliged to display safety information on the Internet, but it must be provided with the product. A search of the MAUDE database showed a number of potentially serious adverse events associated with these splints including choking hazards, tissue damage and occlusal changes. None of the splint designs assure full occlusal coverage.
As with any partial coverage appliance, if worn for protracted periods there may be a risk of unwanted tooth movement. Dentists should report or assist patients with reporting suspected adverse events with OTC splints to the relevant competent authority. In the UK this is the Medicines and Healthcare Products Regulatory Agency (MHRA).
现在一些人可能绕过牙医自行治疗磨牙症。自我诊断、自我调整和自我监测的消费者可以通过互联网购买非处方(OTC)磨牙症矫治器。虽然有些人可能认为这个市场对消费者有益,但也有一些潜在的问题需要强调。这些问题包括未经证实的疗效宣称。
调查英国个人可通过互联网获得的非处方磨牙症矫治器,对其特征进行分类,并确定任何基于网络的宣称或安全警告。
在互联网上搜索英国市场上的非处方磨牙症矫治器。记录每个非处方矫治器的以下信息:制造商名称、产品名称、英国价格以及在英国主要零售网站或其他英国网络零售渠道上的任何宣称和安全警告。此外,记录任何基于网络提及的“CE标志”,表明符合欧盟医疗器械指令对安全性、质量和性能的要求。
安全信息明显匮乏,许多网站上完全没有。然而,制造商没有义务在互联网上展示安全信息,但必须随产品提供。对MAUDE数据库的搜索显示了一些与这些矫治器相关的潜在严重不良事件,包括窒息风险、组织损伤和咬合变化。没有一种矫治器设计能确保完全覆盖咬合面。
与任何部分覆盖的矫治器一样,如果长期佩戴,可能存在牙齿意外移动的风险。牙医应报告或协助患者向相关主管当局报告非处方矫治器的疑似不良事件。在英国,相关主管当局是药品和医疗产品监管局(MHRA)。