Skip to main content
SpringerLink
Log in

Propositions for a cognitive behavioral approach to bruxism management

  • original article
  • Published:
international journal of stomatology & occlusion medicine

Abstract

In dentistry bruxism patients are common during routine daily practice and their situation is difficult to manage. The excessive forms are particularly challenging because severe bruxism leads to major mechanical risks to the survival of dental elements especially artificial crowns or roots. In this case it is probably interesting, perhaps necessary, to try to establish a management procedure to reduce these phenomena. Parafunctional awareness and cognitive behavioral therapy represent a non-invasive and potentially simple approach.

At present the classical therapeutic options pills or splint are deceiving. The aim of this article is to propose to optimize a cognitive behavioral approach for bruxism management. Cognitive behavioral therapy could be beneficial as a simple and effective method when the precise steps of an established protocol are followed: diagnosis, building trust, self-management of stress, awareness of awake bruxism and reprogramming of the automatisms of mandibular resting posture and swallowing. By definition a dentist is a behavioral clinician dedicated to oral dysfunctions related to oral hygiene as well as bruxism. A cognitive behavioral approach is probably a necessary step in a management plan for severe forms. The proposed approach could be tested using a research protocol.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. American Academy of Sleep Medicine. International classification of sleep disorders. 2nd ed. Rochester: Allen; 2005.

    Google Scholar 

  2. De Leeuw R, editor. American Academy of Orofacial Pain. Orofacial pain: guidelines for assessment, diagnosis and management. 4th ed. Chicago: Quintessence; 2008.

    Google Scholar 

  3. Kato T, Thie NMR, Huynh N, Miyawaki S, Lavigne G. Topical review: sleep bruxism and the role of peripheral sensory influences. J Orofac Pain. 2003;17:191–213.

    PubMed  Google Scholar 

  4. Huynh N, Manzini C, Rompre PH, Lavigne GJ. Weighing the potential effectiveness of various treatments for sleep bruxism. J Can Dent Assoc. 2007;73:727–30.

    PubMed  Google Scholar 

  5. Manfredini D, Lobbezoo F. Role of psychosocial factors in the etiology of bruxism. J Orofac Pain. 2009;23:153–66.

    PubMed  Google Scholar 

  6. Manfredini DF, Lobbezoo F. Relationship between bruxism and temporomandibular disorders: a systematic review of literature from 1998 to 2008. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:e26–e50.

    PubMed  Google Scholar 

  7. Lavigne GJ, Kato T, Kolta A, Sessle BJ. Neurobiological mechanisms involved in sleep bruxism. Crit Rev Oral Biol Med. 2003;14:30–46.

    Article  PubMed  CAS  Google Scholar 

  8. Klineberg I. Bruxism: aetiology, clinical signs and symptoms. Aust Prosthodont J. 1994;8:9–17.

    Google Scholar 

  9. Every RG. The teeth as weapons; their influence on behaviour. Lancet. 1965;1(7387):685–8.

    Google Scholar 

  10. Kato T, Thie NM, Huynh N, Miyawaki S, Lavigne GJ. Topical review: sleep bruxism and the role of peripheral sensory influences. J Orofac Pain. 2003;17:191–213.

    PubMed  Google Scholar 

  11. Lopez-Perez R, Lopez-Morales P, Borges-Yanez SA, Maupome G, Pares-Vidrio G. Prevalence of bruxism among Mexican children with Down syndrome. Downs Syndr Res Pract. 2007;12:45–9.

    Article  PubMed  Google Scholar 

  12. Peres AC, Ribeiro MO, Juliano Y, Cesar MF, Santos RC. Occurrence of bruxism in a sample of Brazilian children with cerebral palsy. Spec Care Dentist. 2007;27:73–6.

    Article  PubMed  Google Scholar 

  13. Kreulen C, Van’t Spijker A, Rodriguez J, Bronkhorst E, Creugers N, Bartlett D. Systematic review of the prevalence of tooth wear in children and adolescents. Caries Res. 2010;44:151–9.

    Article  PubMed  CAS  Google Scholar 

  14. Restrepo CC, Vasquez LM, Alvarez M, Valencia I. Personality traits and temporomandibular disorders in a group of children with bruxing behaviour. J Oral Rehabil. 2008;35:585–93.

    Article  PubMed  CAS  Google Scholar 

  15. Olkinuora M. Psychosocial aspects in a series of bruxists compared with a group of non-bruxists. Proc Fin Dent Soc. 1972;68:200–8.

    CAS  Google Scholar 

  16. Ahlberg J, Savolainen A, Rantala M, Lindholm H, Kononen M. Reported bruxism and biopsychosocial symptoms: a longitudinal study. Community Dent Oral Epidemiol. 2004;32:307–11.

    Article  PubMed  CAS  Google Scholar 

  17. Von Onciul J. ABC of work related disorders. Stress at work. BMJ. 1996;313:745–8.

    Article  Google Scholar 

  18. Lavigne GJ, Kato T, Kolta A, Sessle BJ. Neurobiological mechanisms involved in sleep bruxism. Crit Rev Oral Biol Med. 2003;14:30–46.

    Article  PubMed  CAS  Google Scholar 

  19. Winocur E, Uziel N, Lisha T, Goldsmith C, Eli I. Self-reported bruxism—associations with perceived stress, motivation for control, dental anxiety and gagging. J Oral Rehabil. 2011;38:3–11.

    Article  PubMed  CAS  Google Scholar 

  20. Endo H, Kanemura K, Tanabe N, Takebe J. Clenching occurring during the day is influenced by psychological factors. J Prosthodont Res. 2011;55:159–64.

    Article  PubMed  Google Scholar 

  21. Manfredini D, Landi N, Fantoni F, Segù M, Bosco M. Anxiety symptoms in clinically diagnosed bruxers. J Oral Rehabil. 2005;32:584–8.

    Article  PubMed  CAS  Google Scholar 

  22. Manfredini D, Fabbri A, Peretta R, Guarda-Nardini L, Lobbezoo F. Influence of psychological symptoms on home-recorded sleep-time masticatory muscle activity in healthy subjects. J Oral Rehabil. 2011;38:902–11.

    Article  PubMed  CAS  Google Scholar 

  23. Kail K, Slavicek R. Behandlungserfolg bei Kiefergelenksbeschwerden in Abhängigkeit von organischen und psychischen Faktoren in Zusammenarbeit mit Slavicek, Fischer, Formann, Keresztesi, Frohner Grund- und Integrativwiss. Austria: University of Vienna; 1986.

  24. McEwen BS. Stress, adaptation, and disease. Allostasis and allostatic load. Ann N Y Acad Sci. 1998;840:33–44.

    Article  PubMed  CAS  Google Scholar 

  25. Hori N, Lee MC, Sasaguri K, Ishii H, Kamei M, Kimoto K et al. Suppression of stress-induced nNOS expression in the rat hypothalamus by biting. J Dent Res. 2005;84(7):624–8.

    Article  PubMed  CAS  Google Scholar 

  26. Sato S, Slavicek R. The masticatory organ and stress management. Int J Stomatol Occl Med. 2008;1:51–7.

    Article  Google Scholar 

  27. Yoshimi H, Sasaguri K, Tamaki K, Sato S. Identification of the occurrence and pattern of masseter muscle activities during sleep using EMG and accelerometer systems. Head Face Med. 2009;5:7.

    Article  PubMed  Google Scholar 

  28. Sato C, Sato S, Takashina H, Ishii H, Onozuka M, Sasaguri K. Bruxism affects stress responses in stressed rats. Clin Oral Investig. 2010;14:153–60.

    Article  PubMed  Google Scholar 

  29. Ono Y, Yamamoto T, Kobo KY, Onozuka M. Occlusion and brain function: mastication as a prevention of cognitive dysfunction. J Oral Rehabil. 2010;37:624–40.

    PubMed  CAS  Google Scholar 

  30. Sugimoto K, Yoshimi H, Sasaguri K, Sato S. Occlusion factors influencing the magnitude of sleep bruxism activity. Cranio. 2011;29(2):127–37.

    PubMed  Google Scholar 

  31. Lavigne L, Palla S. Transient morning headache: recognizing the role of sleep bruxism and sleep-disordered breathing. J Am Dent Assoc. 2010;141:297–9.

    PubMed  Google Scholar 

  32. Macedo CR, Silva AB, Machado MA, Saconato H, Prado GF. Occlusal splints for treating sleep bruxism (tooth grinding). Cochrane Database Syst Rev. 2007;17(4):CD005514. doi: 10.1002/14651858.CD005514.pub2.

    Google Scholar 

  33. Lobbezoo F, van der Zaag J, van Selms MK, Hamburger HL, Naeije M. Principles for the management of bruxism. J Oral Rehabil. 2008;35:509–23.

    Article  PubMed  CAS  Google Scholar 

  34. Van Der Zaag J, Lobbezoo F, Wicks DJ, Visscher CM, Hamburger HL, Naeije M Controlled assessment of the efficacy of occlusal stabilization splints on sleep bruxism. J Orofac Pain. 2005;19:151–8.

    PubMed  Google Scholar 

  35. Litt MD, Shafer DM, Ibanez CR, Kreutzer DL, Tawfik-Yonkers Z. Momentary pain and coping in temporomandibular disorder pain: exploring mechanisms of cognitive behavioral treatment for chronic pain. Pain. 2009;145:160–8.

    Article  PubMed  Google Scholar 

  36. 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;137:1099–107.

    PubMed  Google Scholar 

  37. Fjellstrom M, Yakob M, Soder B. A modified cognitive behavioural model as a method to improve adherence to oral hygiene instructions—a pilot study. Int J Dent Hygiene. 2010;8:178–82.

    CAS  Google Scholar 

  38. Ohrbach R. Behavioral therapy in TMDs: an evidence based approach to diagnosis and treatment. In: Laskin DM, Greene C, Hylander W, editors. Chicago: Quintessence; 2006. pp. 391–402.

    Google Scholar 

  39. Dworkin SF, Turner JA, Mancl L, Wilson L, Massoth D, Huggins KH, et al. A randomized clinical trial of a tailored comprehensive care treatment program for temporomandibular disorders. J Orofac Pain. 2002;16:259–76.

    PubMed  Google Scholar 

  40. Ommerborn MA, Schneider C, Giraki M, Schafer R, Handschel J, Franz 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.

    Article  PubMed  Google Scholar 

  41. Oakley ME, McCreary CP, Clark GT, Holston S, Glover D, Kashima K. A cognitive-behavioral approach to temporomandibular dysfunction treatment failures: a controlled comparison. J Orofac Pain. 1994;8:397–401.

    PubMed  CAS  Google Scholar 

  42. Restrepo C, Gomez S, Manrique R. Treatment of bruxism in children: a systematic review. Quintessence Int. 2009;40:849–55.

    PubMed  Google Scholar 

  43. Restrepo CC, Alvarez E, Jaramillo C, Velez C, Valencia I. Effects of psychological techniques on bruxism in children with primary teeth. J Oral Rehabil. 2001;28:354–60.

    Article  PubMed  CAS  Google Scholar 

  44. Casas JM, Beemsterboer P, Clark GT. A comparison of stress-reduction behavioral counseling and contingent nocturnal EMG feedback for the treatment of bruxism. Behav Res Ther. 1982;20:9–15.

    Article  PubMed  CAS  Google Scholar 

  45. Lavigne L, Palla S. Transient morning headache: recognizing the role of sleep bruxism and sleep-disordered breathing. J Am Dent Assoc. 2010;141:297–9.

    PubMed  Google Scholar 

  46. Onodera K, Kawagoe T, Protacio-Quismundo C, Sasaguri K, Sato S. The use of a bruxchecker in the evaluation of different occlusal schemes based on individual grinding patterns. J Craniomandib Pract. 2006;24:292–9.

    Google Scholar 

  47. Kawagoe T, Onodera K, Tokiwa O, Sasaguri K, Akimoto S, Sato S. Relationship between sleeping occlusal contact patterns and temporomandibular disorders in the adult Japanese population. Int J Stomatol Occl Med. 2009;2:11–5.

    Article  Google Scholar 

Download references

Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.

Author information

Authors and Affiliations

  1. Unité d’Occlusodontologie, Faculté d’Odontologie de Marseille, Pôle Odontologie – Assistance publique des Hôpitaux de Marseille, Aix-Marseille Université, 27 bd Jean Moulin, 13355, Marseille Cedex 7, France

    Jean-Daniel Orthlieb, Ariane Camoin & Bernard Mantout

  2. Department of Fundamental Dentistry, Faculty of Odontostomatology, Ho Chi Minh University of Medicine and Pharmacy, Ho Chi Minh, Vietnam

    Thi-Nguyen-Ny Tran

Authors
  1. Jean-Daniel Orthlieb
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thi-Nguyen-Ny Tran
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ariane Camoin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bernard Mantout
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean-Daniel Orthlieb.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Orthlieb, JD., Tran, TNN., Camoin, A. et al. Propositions for a cognitive behavioral approach to bruxism management. J. Stomat. Occ. Med. 6, 6–15 (2013). https://doi.org/10.1007/s12548-012-0072-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12548-012-0072-5

Keywords

Search

Navigation