Applied Psychophysiology and Biofeedback

, Volume 30, Issue 4, pp 333–345 | Cite as

Efficacy of Biofeedback-Based Treatments for Temporomandibular Disorders

  • Andrew Crider
  • Alan G. Glaros
  • Richard N. Gevirtz
Article

Abstract

Bibliographic searches identified 14 controlled and uncontrolled outcome evaluations of biofeedback-based treatments for temporomandibular disorders published since 1978. This literature includes two randomized controlled trials (RCTs) of each of three types of biofeedback treatment: (1) surface electromyographic (SEMG) training of the masticatory muscles, (2) SEMG training combined with adjunctive cognitive-behavioral therapy (CBT) techniques, and (3) biofeedback-assisted relaxation training (BART). A detailed review of these six RCTs, supplemented with information from non-RCT findings, was conducted to determine the extent to which each type of intervention met treatment efficacy criteria promulgated by the Association for Applied Psychophysiology and Biofeedback (AAPB). We conclude that SEMG training with adjunctive CBT is an efficacious treatment for temporomandibular disorders and that both SEMG training as the sole intervention and BART are probably efficacious treatments. We discuss guidelines for designing and reporting research in this area and suggest possible directions for future studies.

Keywords

temporomandibular disorders biofeedback electromyography treatment efficacy 

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References

  1. Brooke, R. I., & Stenn, P. G. (1983). Myofascial pain dysfunction syndrome-how effective is biofeedback-assisted relaxation training? In J. J. Bonica, et al. (Eds.), Advances in pain research and therapy (Vol. 5, pp. 809–812). New York: Raven Press.Google Scholar
  2. Crider, A. B., & Glaros, A. G. (1999). A meta-analysis of EMG biofeedback treatment of temporomandibular disorders. Journal of Orofacial Pain, 13, 29–37.PubMedGoogle Scholar
  3. Crockett, D. J., Foreman, M. E., Alden, L., & Blasberg, B. (1986). A comparison of treatment modes in the management of myofascial pain dysfunction syndrome. Biofeedback and Self-Regulation, 11, 279–291.PubMedCrossRefGoogle Scholar
  4. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New York: Academic Press.Google Scholar
  5. Dahlstrom, L., & Carlsson, S. G. (1984). Treatment of mandibular dysfunction: The clinical usefulness of biofeedback in relation to splint therapy. Journal of Oral Rehabilitation, 11, 277–284.PubMedGoogle Scholar
  6. Dahlstrom, L., Carlsson, S. G., Gale, E. N., & Jansson, T. G. (1984). Clinical and electromyographic effects of biofeedback training in mandibular dysfunction. Biofeedback and Self-Regulation, 9, 37–47.PubMedGoogle Scholar
  7. Dalen, K., Ellertsen, B., Espelid, I., & Gronningsaeter, A. (1986). EMG biofeedback in the treatment of myofascial pain dysfunction syndrome. Acta Odontology Scandinavia, 44, 279–284.Google Scholar
  8. Dohrmann, R. J., & Laskin, D. M. (1978). An evaluation of electromyographic biofeedback in the treatment of myofascial pain-dysfunction syndrome. Journal of the American Dental Association, 96, 656–662.PubMedGoogle Scholar
  9. Dworkin, R. H., Turk, D. C., Farrar, J. T., Haythornthwaite, J. A., Jensen, M. P., Katz, N. P., et al. (2005). Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain, 113, 9–19 .Google Scholar
  10. Dworkin, S. F., & LeResche, L. (Eds.). (1992). Research diagnostic criteria for temporomandibular disorders: Review, criteria, examinations and specifications, critique. Journal of Craniomandibular Disorders: Facial and Oral Pain, 6, 301–355.Google Scholar
  11. Efficacy Task Force. (2002). Template for developing guidelines for the evaluation of the clinical efficacy of psychophysiological interventions. Applied Psychophysiology and Biofeedback, 27, 273–281.Google Scholar
  12. Fricton, J. R., & Schiffman, E. L. (1995). Epidemiology of temporomandibular disorders. In J. R. Fricton & R. Dubner (Eds.), Advances in pain research and therapy: Orofacial pain and temporomandibular disorders (Vol. 21, pp. 1–14). New York: Raven Press.Google Scholar
  13. Funch, D. P., & Gale, E. N. (1984). Biofeedback and relaxation therapy for chronic temporomandibular joint pain: Predicting successful outcomes. Journal of Consulting and Clinical Psychology, 52, 928–935.PubMedGoogle Scholar
  14. Gardea, M. A., Gatchel, R. J., & Mishra, K. D. (2001). Long-term efficacy of biobehavioral treatment of temporomandibular disorders. Journal of Behavioral Medicine, 24, 341–359.PubMedCrossRefGoogle Scholar
  15. Glaros, A. G., & Glass, E. G. (1993). Temporomandibular disorders. In R. J. Gatchel & E. B. Blanchard (Eds.), Psychophysiological disorders: Research and clinical applications (pp. 299–356). Washington, DC: American Psychological Association.Google Scholar
  16. Glaros, A. G., & Lausten, L. (2003). Temporomandibular disorders. In M. S. Schwartz & F. Andrasik (Eds.), Biofeedback: A practitioner's guide (3rd ed., pp. 349–368). New York: Guilford Press.Google Scholar
  17. Greene, C. S., & Laskin, D. M. (2000). Temporomandibular disorders: Moving from a dentally based to a medically based model. Journal of Dental Research, 79, 1736–1739.PubMedCrossRefGoogle Scholar
  18. Hijzen, T. H., Slangen, J. L., & Van Houweligen, H. C. (1986). Subjective, clinical and EMG effects of biofeedback and splint treatment. Journal of Oral Rehabilitation, 13, 529–539.PubMedGoogle Scholar
  19. Kasman, G. S., Cram, J. R., & Wolf, S. L. (1997). Clinical applications in surface electromyography. Gaithersburg, MD: Aspen Publishers.Google Scholar
  20. Lewinsohn, P. M., Antonuccio, D. O., Steinmety, J. L., & Teri, L. (1984). The coping with depression course. Eugene, OR: Castalia.Google Scholar
  21. McNeill, C., Mohl, N. D., Rugh, J. D., & Tanaka, T. T. (1990). Temporomandibular disorders: Diagnosis, management, education, and research. Journal of the American Dental Association, 120, 253–263.PubMedGoogle Scholar
  22. Mishra, K. D., Gatchel, R. J., Gardea, M. A. (2000). The relative efficacy of three cognitive-behavioral treatment approaches to temporomandibular disorders. Journal of Behavioral Medicine, 23, 293–309.PubMedCrossRefGoogle Scholar
  23. Okeson, J. P. (1998). Management of temporomandibular disorders and occlusion (4th ed.). St. Louis: C.V. Mosby.Google Scholar
  24. Olson, R. E., & Malow, R. M. (1987). Effects of biofeedback and psychotherapy on patients with myofascial pain dysfunction who are nonresponsive to conventional treatments. Rehabilitation Psychology, 32, 195–204.CrossRefGoogle Scholar
  25. Rosenthal, R. (1984). Meta-analytic procedures for social research. Beverly Hills, CA: Sage.Google Scholar
  26. Stenn, P. G., Mothersill, K. J., & Brooke, R. I. (1979). Biofeedback and a cognitive behavioral approach to treatment of myofascial pain dysfunction syndrome. Behavior Therapy, 10, 29–36.Google Scholar
  27. Syrop, S. B. (2002). Initial management of temporomandibular disorders. Dentistry Today, 21, 52–57.PubMedGoogle Scholar
  28. Turk, D. C., Dworkin, R. H., Allen, R. R., Bellamy, N., Brandenburg, N., Carr, D. B., et al. (2003). Core outcome domains for chronic pain clinical trials: IMMPACT recommendations. Pain, 106, 337–345.PubMedCrossRefGoogle Scholar
  29. Turk, D. C., Rudy, T. E., Kubinski, J. A., Zaki, H. S., & Greco, C. M. (1996). Dysfunctional patients with temporomandibular disorders: Evaluating the efficacy of a tailored treatment protocol. Journal of Consulting and Clinical Psychology, 64, 136–146.CrossRefGoogle Scholar
  30. Turk, D. C., Zaki, D. S., & Rudy, T. E. (1993). Effects of intraoral appliance and biofeedback/stress management alone and in combination in treating pain and depression in patients with temporomandibular disorders. Journal of Prosthetic Dentistry, 70, 158–164.PubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Andrew Crider
    • 1
  • Alan G. Glaros
    • 2
  • Richard N. Gevirtz
    • 3
  1. 1.Department of PsychologyWilliams CollegeWilliamstown
  2. 2.Kansas City University of Medicine and BiosciencesKansas City
  3. 3.California School of Professional PsychologyAlliant International UniversitySan Diego

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