Statement of Principles concerning bruxism (Reasonable Hypothesis) (No. 91 of 2016) (Cth)

Statement of Principles concerning BRUXISM (Reasonable Hypothesis) (No. 91 of 2016) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

Dated 28 October 2016

The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:

Professor Nicholas Saunders AO Chairperson

Contents 1 Name 2 Commencement 3 Authority 4 Application 5 Definitions 6 Kind of injury, disease or death to which this Statement of Principles relates 7 Basis for determining the factors 8 Factors that must exist 9 Relationship to service 10 Factors referring to an injury or disease covered by another Statement of Principles Schedule 1 - Dictionary 1 Definitions

1 Name This is the Statement of Principles concerning bruxism (Reasonable Hypothesis) (No. 91 of 2016). 2 Commencement This instrument commences on 28 November 2016. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Application This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies. 5 Definitions The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument. 6 Kind of injury, disease or death to which this Statement of Principles relates (1) This Statement of Principles is about bruxism and death from bruxism. Meaning of bruxism (2) For the purposes of this Statement of Principles, bruxism means a disorder of jaw muscle activity characterised by repetitive, involuntary clenching or grinding of the teeth or by bracing or thrusting of the mandible, occurring during wakefulness or sleep. Death from bruxism (3) For the purposes of this Statement of Principles, bruxism, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's bruxism. Note: terminal event is defined in the Schedule 1 – Dictionary. 7 Basis for determining the factors The Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that bruxism and death from bruxism can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA. Note: relevant service is defined in the Schedule 1 – Dictionary. 8 Factors that must exist At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting bruxism or death from bruxism with the circumstances of a person's relevant service: (1) experiencing a moderate to severe traumatic brain injury within the 30 days before the clinical onset of bruxism; (2) having a clinically significant neurological condition as specified at the time of the clinical onset of bruxism; Note: clinically significant neurological condition as specified is defined in the Schedule 1 - Dictionary. (3) having a clinically significant disorder of mental health as specified at the time of the clinical onset of bruxism; Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary. (4) experiencing a category 2 stressor at the time of the clinical onset of bruxism; Note: category 2 stressor is defined in the Schedule 1 - Dictionary. (5) taking a drug or a drug from a class of drugs from the specified list of drugs, at the time of the clinical onset of bruxism; Note: specified list of drugs is defined in the Schedule 1 - Dictionary. (6) smoking at least one-half pack-year of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of bruxism, and where smoking has ceased, the clinical onset of bruxism has occurred within one year of cessation; Note: pack-year of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary. (7) consuming an average of at least 30 grams of alcohol per day in the six months before the clinical onset of bruxism; Note: alcohol is defined in the Schedule 1 - Dictionary. (8) consuming an average of at least six cups of caffeinated coffee per day in the six months before the clinical onset of bruxism; (9) having gastro-oesophageal reflux disease at the time of the clinical onset of bruxism; (10) experiencing a moderate to severe traumatic brain injury within the 30 days before the clinical worsening of bruxism; (11) having a clinically significant neurological condition as specified at the time of the clinical worsening of bruxism; Note: clinically significant neurological condition as specified is defined in the Schedule 1 - Dictionary. (12) having a clinically significant disorder of mental health as specified at the time of the clinical worsening of bruxism; Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary. (13) experiencing a category 2 stressor at the time of the clinical worsening of bruxism; Note: category 2 stressor is defined in the Schedule 1 - Dictionary. (14) taking a drug or a drug from a class of drugs from the specified list of drugs, at the time of the clinical worsening of bruxism; Note: specified list of drugs is defined in the Schedule 1 - Dictionary. (15) smoking at least one-half pack-year of cigarettes, or the equivalent thereof in other tobacco products, before the clinical worsening of bruxism, and where smoking has ceased, the clinical worsening of bruxism has occurred within one year of cessation; Note: pack-year of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary. (16) consuming an average of at least 30 grams of alcohol per day in the six months before the clinical worsening of bruxism; Note: alcohol is defined in the Schedule 1 - Dictionary. (17) consuming an average of at least six cups of caffeinated coffee per day in the six months before the clinical worsening of bruxism; (18) having gastro-oesophageal reflux disease at the time of the clinical worsening of bruxism; (19) inability to obtain appropriate clinical management for bruxism.