Masticatory muscle stretching for the management of sleep bruxism: A randomised controlled trial.

Abstract

Sleep bruxism is a phenomenon associated with masticatory muscle hyperactivity. While stretching of limb and trunk muscles has been extensively studied for musculoskeletal disorders, little is known about the effectiveness of stretching of masticatory muscles in the management of bruxism. The aim of this study is to determine the effectiveness of stretching of the masticatory muscles for sleep bruxism. Twenty four pain-free individuals with sleep bruxism were randomly assigned to either an intervention group or a control group. Both groups were given sleep hygiene advice and the intervention group additionally received muscle-stretching exercises for 10days. Primary outcome measures, bruxism bursts and episodes per hour of sleep, were measured by ambulant polysomnography. Secondary outcome measures were among others pain-free active maximum mouth opening (MMO) and masseter pressure pain threshold (PPT). The number of bruxism episodes per hour of sleep increased more in the intervention group than in the control group (by 1.1 episodes, P=0.066), as did the number of bruxism bursts per hour of sleep (by 8.6 bursts, P=0.049). MMO and PPT increased significantly more in the intervention group (by 3.2mm, P=0.020; and by 1.0kg/cm2 , P=0.036, respectively). Static stretching of the masticatory muscles resulted in a minor increase in sleep bruxism episodes (not significant) and bursts (significant). It also led to a significant increase in MMO and PPT. Therefore, masticatory muscle stretching was not effective in reducing sleep bruxism in the absence of pain and/or dysfunction.