BRUXISM

BACKGROUND
Bruxism is the dental term for tooth clenching/teeth grinding
Persistent orofacial pain associated with myalgia and myofascial TMD has
typically been linked to hyperactivity or abnormal contraction of
masticatory muscles such as thisbruxism
Sleep bruxism is a relatively common occurrence
Diagnosis can sometimes be made via questions like:
Have you been told that you grind or clench your jaw?
Have you been told that you grind or clench your jaw while sleeping at night?

STATISTICS
Sleep bruxism was associated with:
Women
Under 60 years old
Greater pain intensity
Greater pain interference with ADLs
Those with TMD affected by both muscular and articular pathology

TAKEUCHI ET AL
Found that:
Prolonged, low level tooth clenching evoked short-lived pain like TMD

Propose
Tooth clenching alone is insufficient to initiate longer lasting and selfperpetuating symptoms of TMD
May require other risk factors

WHAT INTERVENTION WORKED BEST?

Exercise therapy paired with psychological intervention
Numeric rating scale scores were significantly lower compared with other
interventions
Jaw movement improved
This was more effective than just exercise alone to improve craniocervical pain
(without apparent organic abnormalities)

WHAT DID IT CONSIST OF?

Psychological intervention consisting of:
Educated to recognize parafunctional activities and how often they occur throughout the day
Advised to not obsess with avoidance of these parafunctional activities
Instructed to remember what activities they are doing when they do feel pain
Trained to relax jaw, masticatory muscles and tongue
Consists of deep breathing with mouth wide open and closing without clenching

Exercises consisting of:

10 sets of protrusion-retraction jaw movements
Performed by biting on a cotton roll with the front teeth

Lateral jaw movements to both sides

Cotton roll on the left canine for the right movements and on the right canine for the left movements