Diurnal Bruxism Research Articles

Electromyography of diurnal bruxism during assessment and treatment.

Diurnal bruxism among individuals with intellectual disabilities is often measured on the basis of its auditory products, thereby precluding the contingent presentation of stimuli during silent bruxism events. Electromyography (EMG) offers a technological solution to the identification of all bruxism events. EMG has not been previously evaluated in nonvocal clients with intellectual disabilities in the context of functional analysis and treatment. In the current series of analyses, we suggest a set of methods to implement EMG technology with this population. In Analysis 1, we propose a strategy for systematically identifying bruxism events. In Analysis 2 we evaluate an EMG staff-training package with naïve interventionists without past experience with EMG technology. Finally, Analysis 3 presents a practical example of this method during the functional analysis and treatment of a client with frequent diurnal bruxism.

Oral health care and service utilisation in individuals with Rett syndrome: an international cross-sectional study.

There is a dearth of literature available on the comparative oral health status of those with Rett syndrome (RTT) despite diurnal bruxism being a supportive diagnostic criterion for the disorder. This study was designed to investigate the dental experiences of individuals with RTT in terms of perceived at-home and professional dental care. Using data in the InterRett database, provided by English-speaking families of individuals with a confirmed MECP2 genetic mutation, the study investigated relationships between dental problems, oral care, child factors including bruxism and use of gastrostomy, and socioeconomic indicators. The study also explored relationships between dental presentations and socioeconomic, child, and family-related factors. Individuals with RTT exhibiting bruxism were more likely to access dental treatment. Those who had full oral feeding had a higher incidence rate of dental treatment than those with full tube feeding. A conservative (under) estimation of the overall dental caries progression rate revealed that this may be similar to that of the normal population. Drivers for dental treatment in RTT include bruxism as well as dental caries. Those who have full oral feeding experience more dental treatment than those with full tube feeding. A higher maternal education level may confer a protective effect for oral health outcomes in those with RTT. Nevertheless, families generally tended to value the importance of oral health despite reported difficulties in day-to-day mouth care.

Minimum measurement time of masseteric electromyogram required for assessment of awake bruxism during the daytime

ABSTRACT Objective: Assessments of diurnal awake bruxism (d-AB) using masseteric electromyogram (EMG) during various lengths of measurement time within a day were examined as the first step of research to clarify the minimum measurement time required for assessment of d-AB by subject. Methods: Subjects were 33 outpatients. Assessment of d-AB by EMG during partial measurement time (PMT) with durations ranging from 30 minutes to 6 hours was compared with that during total measurement time (TMT) used as the reference standard. Results: No significant difference was found between TMT data and PMT data. There were significant correlations in all combinations between TMT data and PMT data. Accuracy was 0.909 or more for 2.5 hours or longer. Discussion: The results suggest that the tendency of daytime muscle activity in 1 day can be assessed even by using masseteric EMG data obtained during a relatively short measurement time.

Bruxism as a neurological problem (literature review)

Bruxism is stereotypical movements of the mandibula accompanied by grinding or clenching of teeth. Bruxism has 2 circadian manifestations: during sleep (nocturnal bruxism) and during wakefulness (diurnal bruxism). Etiology of the disease is unclear but occlusal disharmony, stress management, basal ganglia dysfunction, and genetic factors are being discussed. An association between bruxism and other motor disorders such as Parkinson’s disease, oromandibular dystonia, Huntington’s disease, as well as some drugs, is observed. For bruxism diagnosis, questionnaires, clinical examination, polysomnography, electromyography, and brux checkers are used. The leading treatment method for bruxism and accompanying dysfunction of the temporomandibular joint is local administration of botulinum neuroprotein into the temporal, masseter, and lateral pterygoid muscles.

Bruxism in connection with neurocognitive disorders

Diurnal bruxism (teeth grinding) is known as a symptom of neurocognitive disorders. However, the scientific basis regarding underlying mechanisms, influencing factors and treatment options is still scarce and large knowledge gaps exist. According to Kwak et al. (2009) the prevalence of diurnal bruxism in Alzheimer’s patients is 4%. Our review and case report of a patient with Alzheimer’s disease and diurnal bruxism supports the hypothesis that bruxism in neurocognitive disorders is a direct consequence of disturbed neurotransmitter balances. With their inhibitory and activating effects, the interaction of neurotransmitters is very complex and numerous medications have the potency to influence these balances directly or indirectly. Due to progressively reduced compliance and a complex disease pattern, therapeutic measures are difficult to implement in patients with neurocognitive disorders and bruxism. Further- more, good cooperation between dentists and general practitioners is also of high importance.

The clinical management of awake bruxism

BackgroundAwake bruxism is a common clinical condition that often goes undetected, often leading to pain or damaged teeth and restorations. MethodsThe authors searched electronic databases regarding the treatment and effects of awake bruxism compared with those of sleep bruxism. The authors used the search terms diurnal bruxism and oral parafunction. The authors combined information from relevant literature with clinical experience to establish a recommended protocol for diagnosis and treatment. ResultsThe authors found articles regarding the diagnosis and treatment of bruxism. The authors combined information from the articles with a review of clinical cases to establish a treatment protocol for awake bruxism. ConclusionsLiterature and clinical experience indicate a lack of patient awareness and, thus, underreporting of awake bruxism. As a result, myriad dental consequences can occur from bruxism. The authors propose a need for increased awareness, for both patients and professionals, particularly of the number of conditions related to awake bruxism. Practical ImplicationsClinicians should look for clinical signs and symptoms of awake bruxism and use minimally invasive treatment modalities.

BRUXISMO NA INFÂNCIA: PERFIL DE COMPORTAMENTO, CARACTERÍSTICAS DO SONO E SINTOMATOLOGIA

Bruxism is the repetitive motion of chewing muscles characterized by tightening and teeth grinding. That condition is multifactorial, involuntary and parafunctional. Studies on involvement of bruxism in children are scarce and considered a subject little explored in the literature. The aim of this study was to evaluate the association between the child’s behavior profile, as well as the sleep characteristics and symptoms associated with the occurrence of bruxism in children aged 5 to 11 years in the city of Juazeiro do Norte - Ceará. A pilot study, cross-sectional type, was performed with 32 parents and/or guardians that answered a structured questionnaire about the topic. Of the total sample, 56.5% were male. 53.2% reported having gnashing of teeth, 75% complained of headaches and 53.1% said that children were agitated or anxious. The prevalence of bruxism in this study was 53.2% (n = 17). In addition, 34.4% (n = 11) cases were observed during the night. Statistically significant associations were observed between the diurnal bruxism and the occurrence of nightmares (p=0.011) and the habit of talking while sleeping (p = 0.009); additionally, it was observed association between nocturnal bruxism and behavior profile (anxious and/or agitated) of child (p=0.022). The other variables of this study showed not statistical association with the diurnal or nocturnal bruxism (p>0.05). It is concluded through this study that changes in sleep patterns and behavior of the child’s profile, were factors associated with the occurrence of bruxism in children.

BRUXISMO NA INFÂNCIA: PERFIL DE COMPORTAMENTO, CARACTERÍSTICAS DO SONO E SINTOMATOLOGIA

O bruxismo é a movimentação repetitiva dos músculos da mastigação caracterizado por apertar e ranger os dentes. Tal condição é multifatorial, involuntária e parafuncional. Estudos sobre o acometimento de bruxismo em crianças são escassos sendo considerado um tema pouco explorado na literatura. O objetivo do presente estudo foi avaliar a associação entre o perfil de comportamento da criança, bem como as características do sono e a sintomatologia associada à ocorrência de bruxismo em crianças com idade entre 5 e 11 anos na cidade de Juazeiro do Norte – Ceará. Foi realizado um estudo piloto de carácter transversal com um grupo de 32 pais e/ou responsáveis que responderam um questionário estruturado sobre o tema. Do total da amostra, 56,5% eram do gênero masculino. 53,2% relataram apresentar ranger de dentes, 75% se queixaram de dores de cabeça e 53,1% afirmaram que as crianças eram agitadas ou ansiosos. A prevalência de bruxismo no presente estudo foi de 53.2% (n=17), sendo que 34,4% (n=11) dos casos foram observados durante o período noturno. Foram observadas associações estatisticamente significativas entre o bruxismo diurno e a ocorrência de pesadelos (p = 0,011) e do hábito de falar enquanto dorme (p=0,009); além da associação entre bruxismo noturno e o perfil de comportamento ansioso e/ou agitado da criança (p=0,022). As demais variáveis do estudo não apresentaram associação estatística com o bruxismo diurno ou noturno (p>0,05). Conclui-se através do presente estudo que alterações no padrão do sono e no perfil de comportamento da criança, foram fatores associados à ocorrência de bruxismo em crianças.

Specific diurnal EMG activity pattern observed in occlusal collapse patients: relationship between diurnal bruxism and tooth loss progression.

AimThe role of parafunctional masticatory muscle activity in tooth loss has not been fully clarified. This study aimed to reveal the characteristic activity of masseter muscles in bite collapse patients while awake and asleep.Materials and MethodsSix progressive bite collapse patients (PBC group), six age- and gender-matched control subjects (MC group), and six young control subjects (YC group) were enrolled. Electromyograms (EMG) of the masseter muscles were continuously recorded with an ambulatory EMG recorder while patients were awake and asleep. Diurnal and nocturnal parafunctional EMG activity was classified as phasic, tonic, or mixed using an EMG threshold of 20% maximal voluntary clenching.ResultsHighly extended diurnal phasic activity was observed only in the PBC group. The three groups had significantly different mean diurnal phasic episodes per hour, with 13.29±7.18 per hour in the PBC group, 0.95±0.97 per hour in the MC group, and 0.87±0.98 per hour in the YC group (p<0.01). ROC curve analysis suggested that the number of diurnal phasic episodes might be used to predict bite collapsing tooth loss.ConclusionExtensive bite loss might be related to diurnal masticatory muscle parafunction but not to parafunction during sleep.Clinical Relevance: Scientific rationale for studyAlthough mandibular parafunction has been implicated in stomatognathic system breakdown, a causal relationship has not been established because scientific modalities to evaluate parafunctional activity have been lacking.Principal findingsThis study used a newly developed EMG recording system that evaluates masseter muscle activity throughout the day. Our results challenge the stereotypical idea of nocturnal bruxism as a strong destructive force. We found that diurnal phasic masticatory muscle activity was most characteristic in patients with progressive bite collapse.Practical implicationsThe incidence of diurnal phasic contractions could be used for the prognostic evaluation of stomatognathic system stability.

Oral health in a group of patients with Rett syndrome in the regions of Valencia and Murcia (Spain): a case-control study.

Objectives: Rett syndrome (RS) is a rare disease with oral manifestations that have not been described in detail or in a standardized manner in the literature. The present study describes the oral health of the population with RS in two Spanish regions, following the protocol of the World Health Organization for conducting common oral health surveys. Study Design: A prospective, observational case-control study was carried out, involving a group of patients with RS (n1=41) and a mean age of 13.37±3.19 years, and an age- and gender-matched control group without RS (n0=82). The data referred to oral health and habits were recorded by means of a questionnaire and oral examination was used to document caries indicators (prevalence of caries, df(t), df(s), DMF(T), DMF(S) and indices referred to dental loss, morbidity, restoration), the Community Periodontal Index (CPI), and the most characteristic oral manifestations. Results: The most frequent oral habit in the patients with RS was diurnal bruxism, followed by stereotyped tongue movements and oral breathing. The caries scores were lower in the RS population than in the control group, but patients with RS showed greater periodontal alterations and a greater prevalence of drooling, dental wear, high-arched palate and anterior open bite. Conclusions: The population with RS exhibits characteristic and early oral habits and alterations, and periodontal problems that are more notorious than caries disease, so that our efforts should focus on the diagnosis and early correction of the parafunctional habits, promoting restorative treatment, and providing instructions on correct oral hygiene. Key words:Rett syndrome, oral habits, bruxism, caries.

Trial of Metoclopramide on Oro-facial Dyskinesia Following Traumatic Brain Injury: A Case Report

Oro-facial dyskinesia is characterized by involuntary repetitive movements of the tongue, lip, or jaw, which is known to be derived by variable causes. Pre- and post-synaptic dopamine receptor abnormalities by degenerative changes in the brain seem to be the key pathophysiology, but the exact mechanism still remained to be unknown. Metoclopramide can pass the blood-brain barrier, which is known for a selective presynaptic autoregulating dopamine D2 receptor antagonist in the brain, and is usually prescribed for dyspepsia, nausea and vomiting. In particular, it was also reported to improve the symptoms of diurnal bruxism after brain injury. With reviewing some of literatures, we present a case of 27 year old man with traumatic brain injury who showed improvement of oro-facial dyskinesia after taking oral metoclopramide. (Brain & NeuroRehabilitation 2014; 7: 147-150)

Trial of Oral Metoclopramide on Diurnal Bruxism of Brain Injury

Bruxism is a diurnal or nocturnal parafunctional activity that includes tooth clenching, bracing, gnashing, and grinding. The dopaminergic system seems to be the key pathophysiology of bruxism and diminution of dopaminergic transmission at the prefrontal cortex seems to induce it. We report two patients with diurnal bruxism in whom a bilateral frontal lobe injury resulted from hemorrhagic stroke or traumatic brain injury. These patients' bruxism was refractory to bromocriptine but responded to low-dose metoclopramide therapy. We propose that administering low doses of metoclopramide is possibly a sound method for treating bruxism in a brain injury patient with frontal lobe hypoperfusion on positron emission tomography imaging.

Work, Stress, and Diurnal Bruxism: A Pilot Study among Information Technology Professionals in Bangalore City, India

The study assessed the prevalence of diurnal bruxism among information technology (IT) professionals and explored plausible predictors associated with the parafunctional habit. A cross-sectional study was designed and IT professionals were invited to participate. The inclusion criteria composed of participants in service for at least one year, having natural dentition, no history of cervical or facial injury and not undergoing orthodontic therapy. The participants (N = 147) were interviewed by a trained interviewer to record information. A pre-tested questionnaire that included questions related to work, stress symptoms and diurnal bruxism was completed by each participant. The prevalence of self-reported diurnal bruxism was 59%. Bivariate analyses revealed that work (P < 0.05) and work experience (P < 0.05) were significantly associated with self-reported diurnal bruxism. In the binary logistic regression analysis stress (Odds Ratio [OR] = 5.9, 95% Confidence Interval [CI] 2.6–13.3) was identified to be a strong predictor of diurnal bruxism. Professionals with 11 or more years of experience were less likely to report diurnal bruxism (OR = 0.04, 95% CI 0.00–0.43) than those with 1 to 5 years of work experience. The study revealed that stress and less work experience were associated with diurnal bruxism among IT professionals in Bangalore city.

Delayed-onset diurnal bruxism, psychic akinesia and depression after carbon monoxide poisoning: a case report

Diagnosing the delayed neuropsychological sequelae of carbon monoxide (CO) poisoning is a clinical challenge because of its varied presentations. Pallidal lesions, the most common site of involvement in CO poisoning [ Clin Radiol. 2000;55(4):273–80] can cause psychic akinesia [ Mov Disord. 2001;16(5):810–4; J Neurol Neurosurg Psychiatry 1984;47(4):377–85]. We present a patient with diurnal bruxism, psychic akinesia and depression that were delayed manifestations of CO poisoning.

P3-024: Diurnal bruxism in advanced Alzheimer's disease

P3-024: Diurnal bruxism in advanced Alzheimer's disease

Tinnitus: Evaluation of biofeedback and stomatognathic treatment

Thirty-two patients with disabling tinnitus received stomatognathic treatment and biofeedback therapy according to a cross-over design. The evaluation of treatment outcomes showed some improvements at the group level: decrease of tinnitus intensity, mood improvement and reduction of clinical signs of dysfunction in the masticatory system. Qualitative observations indicated numerous positive changes in patients' emotional and cognitive orientation vis à vis tinnitus. Some possible predictors of positive treatment outcome were observed: comparatively low severity of tinnitus, normal hearing or compensated hearing loss, occlusal interferences, jaw fatigue, diurnal bruxism and fluctuations in tinnitus intensity. Left-sided tinnitus seemed to be a negative predictor of stomatognathic and biofeedback treatment outcome. Consequently, stomatognathic and biofeedback treatment seem to have some positive effects on subgroups of tinnitus patients.

A stomatognathic analysis of patients with disabling tinnitus and craniomandibular disorders (CMD)

Forty-two patients with disabling tinnitus and reported symptoms of craniomandibular disorders (CMD) were investigated by means of questionnaire, semistructured interview, stomatognathic examination and 2-week diary with thrice-daily ratings of tinnitus and mood. The findings have been analysed in order to identify symptoms of CMD related to tinnitus, and it was concluded that awareness of diurnal bruxism and feeling of jaw tenderness/fatigue may be related to fluctuating tinnitus, vertigo and hyperacusis.

Prevalence of nocturnal and diurnal bruxism in patients with psoriasis

Prevalence of nocturnal and diurnal bruxism in patients with psoriasis

Teaching the control of diurnal bruxism to two children with autism using a simple cueing procedure

Bruxism is a habit that causes significant dental damage and that has been identified in the literature as occurring more often in handicapped than in normal populations. A nonaversive treatment procedure was developed for two severely developmentally delayed and autistic boys, aged 101/2 and 11 years. The procedure was based on elements of Azrin and Nunn's (1973, 1977) habit reversal technique, and involved a physical cue to open the mouth when the behavior was observed. The study used a multiple baseline design with data collection in two school situations. For both boys, bruxing was nearly continuous during baseline; implementation of the cueing procedure resulted in an immediate decrease in the frequency of the behavior. Little generalization to the second school situation occurred in either case until cueing was instituted directly in those situations. Follow-up data after two years indicated that the rate of bruxing remained low.

Sensory and Motor Integration During Mandibular Function

The subject of pain is intimately related to that of mandibular function. It is now clear that certain types of temporomandibular disorders, particularly myofascial pain dysfunction, result, in part, from rhythmic muscle activity produced by parafunctional oral habits such as diurnal or nocturnal bruxism. Furthermore, in addition to phasic hyperactivity, evidence also suggests that masticatory muscles of patients with MPD are tonically hyperactive. The pain associated with such hyperactive musculature prompts many patients to seek professional help. This article provides an updated historical review of one important aspect of mandibular function and gives insight into the general "state of the art."