Massed practice exercises for the elimination of tooth-grinding habits

Abstract

In 1958, Wolpe described a method for the treatment of excessive tooth-grinding habits based on the principle of massed practice. Wolpe placed his patient on a regimen of exercises in which the patient was required to clench his teeth tightly together for 1 min and then to relax his jaws for 1 min. The patient was instructed to do this five times for one block of trials. Six blocks were to be performed each day for a 2-week period. Wolpe reported the successful elimination of the patient's bruxomania. Ayer and Gale (1969) applied Wolpe's technique in the treatment of a student with a severe bruxing problem and reported that it was effective in eliminating the disorder. Ayer and Levin (1973) felt that the 1-min clenching interval was difficult, if not impossible, for the patient to sustain and eventually determined that 5-sec exercise periods with 5-sec relaxation periods were effective. At a 1-month follow-up they reported treatment had been effective in almost 80% of their patients. Those patients who were not successfully treated were teen-age girls who found the exercise schedule too tedious and time consuming and had failed to perform the exercises. Rugh and Solberg (1974) measured nocturnal masseter muscle electrical activity in fifteen bruxist patients, in an effort to evaluate the effectiveness of massed practice therapy. One group was required to clench their teeth vigorously one hundred times, six times daily. Another group was directed to chew gum for 1 1 2 min. six times daily. The placebo group merely clenched the fist and arms one hundred times, six times daily. Nocturnal masseter muscle activity was significantly reduced in both treatment groups as compared to the placebo group, thus permitting the inference that the oral exercises significantly reduced the grinding habits as measured by the electrical activity. Massed practice therapy does appear to be effective for the elimination of tooth-grinding problems. However, the question of long-term effectiveness must still be raised. The present paper reports the results of a year-long follow-up of patients treated with this technique.