eISSN: 2299-551X
ISSN: 0011-4553
Journal of Stomatology
Current issue Archive About the journal Editorial board Subscription Contact Instructions for authors
SCImago Journal & Country Rank
vol. 71
Review paper

The most commonly used methods of treatment for bruxism – a literature review

Paulina Wilmont, Klara Saczuk, Łukasz Pawlak, Monika Łukomska-Szymańska

J Stoma 2018; 71, 4: 350-355
Online publish date: 2019/01/28
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Bruxism is referred to as grinding and clenching of the teeth. It is a disorder affecting an increasing number of patients. This disease causes severe ailments that negatively influencing the daily functioning and manifesting, among the others, as toothaches, masticatory muscle pain, headaches, and tooth hypersensitivity.

The aim of the work is to analyse the contemporary treatment methods and methods of alleviating the effects of the disease. In addition, it evaluates the usefulness of these methods in daily dental practice. The article shows the contemporary view of treatment, including the multidisciplinary approach. The authors present treatment methods of bruxism, such as: splints, physiotherapy, psychotherapy, biofeedback, and pharmacological treatment. The variety of methods currently used and the lack of clear guidelines for treatment of bruxism should be emphasised. The article also draws attention to the need to modify the daily behaviour of the patient through relaxation exercises or biofeedback, in order to eliminate bruxism and not just alleviate its symptoms.

A multidirectional approach and treatment of bruxism can produce satisfactory and lasting results.

bruxism, treatment, physiotherapy, biofeedback, psychotherapy

Lobbezoo F, Ahlberg J, Glaros AG, et al. Bruxism defined and graded: an international consensus. J Oral Rehabil 2013; 40: 2-4.
Behr M, Hahnel S, Faltermeier A, et al. The two main theories on dental bruxism. Ann Anat 2012; 194: 216-219.
Alkan A, Bulut E, Arici S, Sato S. Evaluation of treatments in patients with nocturnal bruxism on bite force and occlusal contact area: a preliminary report. Eur J Dent 2008; 2: 276-282.
Gomes CAF de P, El Hage Y, Amaral AP, et al. Effects of massage therapy and occlusal splint therapy on electromyographic activity and the intensity of signs and symptoms in individuals with temporomandibular disorder and sleep bruxism: a randomized clinical trial. Chiropr Man Therap 2014; 22: 43.
Reddy SV, Kumar MP, Sravanthi D, et al. Bruxism: a literature review. J Int Oral Health 2014; 6: 105-109.
Bader G, Lavigne G. Sleep bruxism; an overview of an oromandibular sleep movement disorder. Sleep Med Rev 2000; 4: 27-43.
Bernhardt O, Imhoff B, Lange M, Ottl P. Bruxism: etiology, diagnosis and treatment. J Craniomand Func 2015; 7: 71-74.
Gomes CAF de P, El-Hage Y, Amaral AP, et al. Effects of massage therapy and occlusal splint usage on quality of life and pain in individuals with sleep bruxism: a randomized controlled trial. J Jpn Phys Ther Assoc 2015; 18: 1-6.
Vieira e Silva CA, da Silva MA, Melchior M de O, et al. Treatment for TD with occlusal splint and electromyographic control: application of the FARC protocol in a Brazilian population. Cranio 2012; 30: 218-226.
Dubé C, Rompré PH, Manzini C, et al. Quantitative polygraphic controlled study on efficacy and safety of oral splint devices in tooth-grinding subjects. J Dent Res 2004; 83: 398-403.
Okkerse W, Brebels A, De Deyn PP, et al. Influence of a bite-plane according to Jeanmonod, on bruxism activity during sleep. J Oral Rehabil 2002; 29: 980-985.
Saueressig AC, Mainieri VC, Grossi PK, et al. Analysis of the influence of a mandibular advancement device on sleep and sleep bruxism scores by means of the BiteStrip and the Sleep Assessment Questionnaire. Int J Prosthodont 2010; 23: 204-213.
Karakis D, Dogan A, Bek B. Evaluation of the effect of two different occlusal splints on maximum occlusal force in patients with sleep bruxism: a pilot study. J Adv Prosthodont 2014; 6: 103-108.
Singh PK, Alvi HA, Singh BP, et al. Evaluation of various treatment modalities in sleep bruxism. J Prosthet Dent 2015; 114: 426-431.
Landry ML, Rompré PH, Manzini C, et al. Reduction of sleep bruxism using a mandibular advancement device: an experimental controlled study. Int J Prosthodont 2006; 19: 549-556.
Wright E, Anderson G, Schulte J. A randomized clinical trial of intraoral soft splints and palliative treatment for masticatory muscle pain. J Orofac Pain 1995; 9: 192-199.
Pettengill CA, Growney MR Jr, Schoff R, Kenworthy CR. A pilot study comparing the efficacy of hard and soft stabilizing appliances in treating patients with temporomandibular disorders. J Prosthet Dent 1998; 79: 165-168.
Scopel V, Alves da Costa GS, Urias D. An electromyographic study of masseter and anterior temporalis muscles in extra-articular myogenous TMJ pain patients compared to an asymptomatic and normal population. Cranio 2005; 23: 194-203.
Giannakopoulos NN, Katsikogianni EN, Hellmann D, et al. Comparison of three different options for immediate treatment of painful temporomandibular disorders: a randomized, controlled, pilot trial. Acta Odontol Scand 2016; 74: 480-486.
Truelove E, Huggins KH, Mancl L, Dworkin SF. The efficacy of traditional, low-cost and nonsplint therapies for temporomandibular disorder: a randomized controlled trial. J Am Dent Assoc 2006; 137: 1099-1107; quiz 1169.
Weggen T, Schindler HJ, Kordass B. Hugger A. Clinical and electromyographic follow-up of myofascial pain patients treated with two types of oral splint: a randomized controlled pilot study. Int J Comput Dent 2013; 16: 209-224.
Zhang FY, Wang XG, Dong J, et al. Effect of occlusal splints for the management of patients with myofascial pain: a randomized controlled, double-blind study. Chin Med J 2013; 126: 2270-2275.
Magdaleno F, Ginestal E. Side effects of stabilization occlusal splints: a report of three cases and literature review. Cranio 2010; 28: 128-135.
Naikmasur V, Bhargava P, Guttal K, Burde K. Soft occlusal splint therapy in the management of myofascial pain dysfunction syndrome: a follow-up study. Indian J Dent Res 2008; 19: 196-203.
Villalón P, Arzola JF, Valdivia J, Miralles R. The occlusal appliance effect on myofascial pain. Cranio 2013; 31: 84-91.
Harada T, Ichiki R, Tsukiyama Y, Koyano K. The effect of oral splint devices on sleep bruxism: a 6-week observation with an ambulatory electromyographic recording device. J Oral Rehabil 2006; 33: 482-488.
Nascimento LL, Amorim CF, Giannasi LC, et al. Occlusal splint for sleep bruxism: an electromyographic associated to Helkimo Index evaluation. Sleep Breath 2008; 12: 275-280.
Dalewski B, Chruściel-Nogalska M, Frączak B. Occlusal splint versus modified nociceptive trigeminal inhibition splint in bruxism therapy: a randomized, controlled trial using surface electromyography. Aust Dent J 2015; 60: 445-454.
Roark Al, Glaros AG, O’Mahony AM. Effects of interocclusal appliances on EMG activity during parafunctional tooth contact. J Oral Rehabil 2003; 30: 573-577.
Amorim CF, Giannasi LC, Ferreira LMA, et al. Behavior analysis of electromyographic activity of the masseter muscle in sleep bruxers: J Bodyw Mov Ther 2010; 14: 234-238.
Fricton J. Current evidence providing clarity in management of temporomandibular disorders: summary of a systematic review of randomized clinical trial for intra-oral appliances and occlusal therapies. J Evid Based Dent Pract 2006; 6: 48-52.
Abekura H, Yokomura M, Sadamori S, Hamada T. The initial effects of occlusal splint vertical thickness on the nocturnal EMG activities of masticatory muscles in subjects with a bruxism habit. Int J Prosthodont 2008; 21: 116-120.
Baad-Hansen L, Jadidi F, Castrillon E, et al. Effects of a nociceptive trigeminal inhibitory splint on electromyographic activity in jaw closing muscles during sleep. J Oral Rehabil 2007; 34: 105-111.
Gawriołek K, Piotrowski P. Assessment of temporomandibular dysfunction therapy progress based upon mandibular velocity measurement. J Stoma 2012; 65: 395-403.
Amorim CSM, Firsoff EFO, Vieira GF, et al. Effectiveness of two physical therapy interventions, relative to dental treatment in individuals with bruxism: study protocol of a randomized clinical trial. Trials 2014; 15: 8.
Visscher CM, Lobbezoo F, Naeije M. Treatment of bruxism: physiotherapeutic approach. Ned Tijdschr Tandheelkd 2000; 107: 293-296.
Knutson GA. Vectored upper cervical manipulation for chronic sleep bruxism, headache, and cervical spine pain in a child. J Manipulative Physiol Ther 2003; 26: E16.
Ommerborn MA, Schneider C, Giraki M, et al. Effects of an occlusal splint compared with cognitive-behavioral treatment on sleep bruxism activity. Eur J Oral Sci 2007; 115: 7-14.
Rajpurohit B, Khatri SM, Metgud D, Bagewadi A. Effectiveness of transcutaneous electrical nerve stimulation and microcurrent electrical nerve stimulation in bruxism associated with masticatory muscle pain – a comparative study. Indian J Dent Res 2010; 21: 104-106.
Watanabe A, Kanemura K, Tanabe N, Fujisawa M. Effect of electromyogram biofeedback on daytime clenching behavior in subjects with masticatory muscle pain. J Prosthodont Res 2011; 55: 75-81.
Dallanora LJ, Faltin PP, Inoue RT, Santos VM. Accupuncture use in the treatment of patients with bruxism. Rev Gaúcha Odontol 2004; 52: 333-339.
Quintero Y, Restrepo CC, Tamayo V, et al. Effect of awareness through movement on the head posture of bruxist children. J Oral Rehabil 2009; 36: 18-25.
Treacy K. Awareness/relaxation training and transcutaneous electrical neural stimulation in the treatment of bruxism. J Oral Rehabil 1999; 26: 280-287.
McNeely ML, Armijo Olivo S, Magee DJ. A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders. Phys Ther 2006; 86: 710-725.
Michelotti A, Steens MH, Farella M, Parisini F. Short-term effects of physiotherapy versus counselling for the treatment of myofascial pain of the jaw muscles. J Oral Rehabil 2002; 29: 874.
Jadidi F, Castrillon E, Svensson P. Effect of conditioning electrical stimuli on temporalis electromyographic activity during sleep. J Oral Rehabil 2008; 35: 171-183.
Albertin A, Kerppers II, Amorim CF, et al. The effect of manual therapy on masseter muscle pain and spasm. Electromyogr Clin Neurophysiol 2010; 50: 107-112.
Núñez SC, Garcez AS, Suzuki SS, Ribeiro MS. Management of mouth opening in patients with temporomandibular disorders through low-level laser therapy and transcutaneous electrical neural stimulation. Photomed Laser Surg 2006; 24: 45-49.
Rodrigues D, Siriani AO, Bérzin F. Effect of conventional TENS on pain and electromyographic activity of masticatory muscles in TMD patients. Braz Oral Res 2004; 18: 290-295.
Santana JM, Lauretti GR. Possíveis mecanismos de ação da estimulação elétrica nervosa transcutânea no controle da dor. Rev Dor 2006; 7: 716-728.
Grossmann E, Tambara JS, Grossmann TK, Tesseroli JT de S. Transcutaneous electrical nerve stimulation for temporomandibular joint disorder. Rev Dor 2012; 13: 271-276.
Shanavas M, Chatra L, Shenai P, et al. Transcutaneous electrical nerve stimulation therapy: An adjuvant pain controlling modality in TMD patients – A clinical study. Dent Res J 2014; 11: 676-679.
Kato MT, Kogawa EM, Santos CN, Conti PCR. TENS and low-level laser therapy in the management of temporomandibular disorders. J Appl Oral Sci 2006; 14: 130-135.
Moger G, Shashikanth MC, Sunil MK, Shambulingappa P. Transcutaneous electrical nerve stimulation therapy in temporomandibular disorder: A clinical study. J Indian Acad Oral Med Radiol 2011; 23: 46-50.
Moraes Ada R, Sanches ML, Ribeiro EC, Guimarães AS. Therapeutic exercises for the control of temporomandibular disorders. Dental Press J Orthod 2013; 18: 134-139.
Clark GT. Classification, causation and treatment of masticatory myogenous pain and dysfunction. Oral Maxillofac Surg Clin North Am 2008; 20: 145-157.
De Leeuw R (ed.). Orofacial pain: Guidelines for assessment. Diagnosis and management. 4th ed. Quintessence, Chicago 2008, 179-185.
Fricton J. Myogenous temporomandibular disorders: diagnostic and management considerations. Dent Clin North Am 2007; 51: 61-83.
Fjellström M, Yakob M, Söder B. A modified cognitive behavioural model as a method to improve adherence to oral hygiene instructions – a pilot study. Int J Dent Hyg 2010; 8: 178-182.
Ohrbach R. Behavioral therapy in TMDs: an evidence based approach to diagnosis and treatment. Laskin DM, Greene C, Hylander W (eds.). Temporomandibular Disorders: An Evidence-Based Approach to Diagnosis and Treatment. Quintessence, Chicago 2006; 391-402.
Orthlieb JD, Tran TNN, Camoin A, Mantout B. Propositions for a cognitive behavioral approach to bruxism management. J Stomat Occ Med 2013; 6: 6-15.
Frank DL, Khorshid L, Kiffer JF, et al. Biofeedback in medicine: who, when, why and how? Ment Health Fam Med 2010; 7: 85-91.
Ilovar S, Zolger D, Castrillon E, et al. Biofeedback for treatment of awake and sleep bruxism in adults: systematic review protocol. Syst Rev 2014; 3: 42.
Molina OF, Santos ZC, Scotta P, et al. Somatisation and dissociation: a comparison study in bruxers subgroups. Rev Neuroscienc 2013; 21: 77-84.
Wieselmann-Penkner K, Janda M, Lorenzoni M, Polansky R. A comparison of the muscular relaxation effect of TENS and EMG-biofeedback in patients with bruxism. J Oral Rehabil 2001; 28: 849-853.
Lobbezoo F, van der Zaag J, van Selms MK, et al. Principles for the management of bruxism. J Oral Rehabil 2008; 35: 509-523.
Shedden Mora MC, Weber D, Neff A, Rief W. Biofeedback-based cognitive-behavioral treatment compared with occlusal splint for temporomandibular disorder: a randomized controlled trial. Clin J Pain 2013; 29: 1057-1065.
Glaros AG. Temporomandibular disorders and facial pain: a psychophysiological perspective. Appl Psychophysiol Biofeedback 2008; 33: 161-171.
Veiga N, Ângelo T, Ribeiro O, Baptista A. Bruxism – literature review. Int J Dent Oral Health 2015; doi: http://dx.doi.org/ 10.16966/2378-7090.134.
Strausz T, Ahlberg J, Lobbezoo F, et al. Awareness of tooth grinding and clenching from adolescence to young adulthood: a nine-year follow-up. J Oral Rehabil 2010; 37: 497-500.
Sutin AR, Terracciano A, Ferrucci L, Costa PT. Teeth grinding: is emotional stability related to bruxism? J Res Pers 2010; 44: 402-405.
Tsai CM, Chou SL, Gale EN, McCall WD Jr. Human masticatory muscle activity and jaw position under experimental stress. J Oral Rehabil 2002; 29: 44-51.
Huynh N, Lavigne GJ, Lanfranchi PA, et al. The effect of 2 sympatholytic medications – propranolol and clonidine – on sleep bruxism: experimental randomized controlled studies. Sleep 2006; 29: 307-316.
Moosavi SM, Setareh J, Ahmadi M, et al. Treatment of bruxism with trihexiphenidyl, a case series. Am J Psych Neurosc 2015; 3: 108-110.
Raigrodski AJ, Christensen LV, Mohamed SE, Gardiner DM. The effect of four-week administration of amitriptyline on sleep bruxism. A double-blind crossover clinical study. Cranio 2001; 19: 21-25.
Sabuncuoglu O, Ekinci O, Berkem M. Fluoxetine-induced sleep bruxism in an adolescent treated with buspirone: a case report. Spec Care Dentist 2009; 29: 215-217.
Lu DW, Lippitz J. Complications of botulinum neurotoxin. Dis Mon 2009; 55: 198-211.
Archana MS. Toxin yet non toxic: botulinum toxin in dentistry. Saudi Dent J 2016; 28: 63-69.
Dressler D, Benecke R. Autonomic side effects of botulinum toxin type B treatment of cervical dystonia and hyperhidrosis. Eur Neurol 2003; 49: 34-38.
Srivastava S, Kharbanda S, Pal US, Shah V. Applications of botulinum toxin in dentistry: a comprehensive review. Natl J Maxillofac Surg 2015; 6: 152-159.
Kim HS, Yun PY, Kim YK. A clinical evaluation of botulinum toxin – a injections in the temporomandibular disorder treatment. Maxillofac Plast Reconstr Surg 2016; 38: 5.
Meunier FA, Schiavo G, Molgó J. Botulinum neurotoxins: from paralysis to recovery of functional neuromuscular transmission. J Physiol Paris 2002; 96: 105-113.
Sidebottom AJ, Patel AA, Amin J. Botulinum injection for the management of myofascial pain in the masticatory muscles. A prospective outcome study. Br J Oral Maxillofac Surg 2013; 51: 199-205.
Guarda-Nardini L, Manfredini D, Salamone M, et al. Efficacy of botulinum toxin in treating myofascial pain in bruxers: a controlled placebo pilot study. Cranio 2008; 26: 126-135.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe