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Exploring Therapeutic Approaches for Bruxism: Effective Treatments for Teeth Grinding

Updated: Mar 15

What are the different approaches for Bruxism? Are there any effective treatments for teeth grinding? Bruxism, commonly known as teeth grinding or clenching, is a condition characterized by the grinding of teeth or biting together the upper and lower teeth, often occurs during sleep. It can cause a multitude of dental problems, including tooth damage, jaw disorders, headaches, and facial pain. Fortunately, several therapeutic approaches have proven effective in managing bruxism and alleviating its associated symptoms.

In this article, we will explore some of the most widely used and successful treatments for bruxism, including physical therapy, massage therapy, myofunctional therapy and occlusal splint therapy.


Therapeutic Approaches for Bruxism including physical therapy, massage therapy, myofunctional therapy and occlusal splint therapy


Understanding Bruxism: Causes and Symptoms

Young lady with nightguard for bruxism sleeping peacefully
Courtesy of Colgate

Before delving into the therapeutic approaches for bruxism, it is essential to understand the causes and symptoms of this condition. Bruxism can have multiple underlying factors, such as stress, anxiety, sleep disorders, and malocclusion (improper alignment of the teeth). Symptoms of bruxism often include teeth grinding or clenching sounds during sleep, worn-down tooth surfaces, jaw pain or soreness, headaches, and disrupted sleep patterns. Identifying the causes and recognizing the symptoms is crucial for effective treatment.


Now that we have a better understanding of bruxism, it is time to see how different therapies might help with alleviating this condition. The purpose of these therapies is to provide a more holistic dimension to the approach with which we treat bruxism. Therefore, the patient with bruxism does not feel uncomfortable with lengthy, painful, and expensive procedures. However, it is important to know these therapies only may help as adjunct therapies and are not necessarily a substitute, especially when the condition is in a more destructive stage.


These therapies include occlusal splint therapy, physical therapy, massage therapy, and myofunctional therapy, which we will discuss one by one.



1. Physical Therapy for Bruxism:


physcial therapy for bruxism - fingers massaging exterior jaw line
Courtesy of cacc-pt.com


Physical therapy is another valuable approach in managing bruxism. By focusing on jaw muscle relaxation, stretching, and strengthening exercises, physical therapy aims to alleviate muscle tension and improve jaw function.


Role of Physical Therapy in Bruxism Management:


Physical therapy plays a significant role in bruxism management by addressing the muscular aspect of the condition. Through various techniques, exercises, and modalities, physical therapists can help individuals with bruxism achieve muscle relaxation, reduce pain, and improve jaw mobility.


Exercises and Techniques for Relaxing Jaw Muscles:


Physical therapists employ a range of exercises and techniques to relax the jaw muscles. These may include gentle jaw stretches, massage, heat and cold therapy, and biofeedback training. The specific exercises and techniques used will depend on the individual's needs and the therapist's expertise.



Stretching and Strengthening Exercises for the Jaw:


Practitioner with gloves on showing exercises for strengthening the jaw
Courtesy of fisiobalance.cat

In addition to muscle relaxation techniques, physical therapy for bruxism may involve stretching and strengthening exercises for the jaw. These exercises aim to improve muscle coordination and promote a balanced jaw movement pattern, reducing the likelihood of grinding and clenching.


Incorporating Heat and Cold Therapy:


Heat and cold therapy can provide additional relief for individuals with bruxism. Applying heat packs or warm towels to the jaw muscles helps relax tension and increase blood flow, while cold therapy, such as ice packs, can numb the area and reduce inflammation.



Benefits and Success Rates of Physical Therapy:


Young woman receiving massage by therapy with fingers massaging the TMJ  (temporomandibular joint )
Courtesy of kinetixpt.com

Physical therapy has shown promising results in the management of bruxism. Studies have indicated that physical therapy interventions, when combined with other treatments like occlusal splints, can significantly reduce pain, muscle tenderness, and the frequency of teeth grinding episodes.


The success rates of physical therapy for bruxism vary depending on the individual and the severity of the condition. However, numerous studies have demonstrated the effectiveness of physical therapy in reducing bruxism symptoms and improving overall jaw health.


A study published in the Journal of Oral Rehabilitation conducted a systematic review and meta-analysis of various treatment modalities for bruxism, including physical therapy. The analysis concluded that physical therapy interventions, such as manual therapy, exercises, and stretches, significantly reduced bruxism symptoms compared to control groups [2]. The study highlighted the positive impact of physical therapy in managing bruxism.


Another study published in the Journal of Bodywork and Movement Therapies explored the effectiveness of physical therapy techniques, including myofascial release and trigger point therapy, in treating bruxism. The findings revealed that physical therapy interventions led to a significant reduction in pain, muscle tension, and bruxism episodes among participants [3].


 
 

Combining Physical Therapy with Other Treatments:


In many cases, physical therapy is used in conjunction with other therapeutic approaches for bruxism. Combining physical therapy with occlusal splint therapy, massage therapy, or myofunctional therapy can enhance the overall effectiveness of treatment and provide comprehensive care for individuals with bruxism.


2. Massage Therapy for Bruxism:


Massage therapy offers a holistic approach to treating bruxism by targeting the muscles involved in teeth grinding. Through various techniques, massage therapists can help relieve muscle tension, reduce pain, and promote relaxation.



Role of Massage Therapy in Bruxism Treatment:


Therapist massaging female patient's jaw along the exterior
Courtesy of drninaskin.com

Massage therapy achieves its effects through various mechanisms, including:


Muscle Manipulation: The manual manipulation of muscles and soft tissues during massage therapy helps release tension, knots, and trigger points. This manipulation promotes muscle relaxation, reduces muscle tightness, and relieves muscle soreness. By addressing muscular imbalances and reducing muscle tension, massage therapy can help alleviate the strain on the jaw muscles and decrease the likelihood of teeth grinding.


Activation of the Relaxation Response: Massage therapy activates the body's relaxation response, triggering physiological changes that promote relaxation and reduce stress. This response involves a decrease in the release of stress hormones such as cortisol and an increase in the release of endorphins, which are the body's natural pain-relieving and mood-enhancing chemicals.



Techniques and Approaches for Relieving Jaw Tension:


image male adult receiving different techniques used for relieving jaw
Courtesy of livehealthymag.com

Massage therapists employ a variety of techniques to relieve jaw tension. These may include effleurage (gentle stroking movements), petrissage (kneading and compression), and trigger point therapy. The therapist will tailor the treatment based on the individual's specific needs and areas of muscle tension.


Here are some common techniques used by massage therapists to alleviate jaw tension:


Effleurage: Effleurage involves gentle stroking movements performed with varying pressure. The therapist uses their palms, fingers, or knuckles to apply smooth and continuous strokes along the jawline and surrounding areas. Effleurage helps to increase blood flow, promote relaxation, and reduce muscle tension in the jaw muscles.


Petrissage: Petrissage techniques involve kneading, squeezing, and compression of the muscles. The therapist applies controlled pressure and rhythmic movements to the jaw muscles, targeting specific areas of tension. Petrissage helps to release muscle knots, improve circulation, and relieve muscle tightness in the jaw region.


Trigger Point Therapy: Trigger points are localized areas of muscle tightness and tenderness that can contribute to jaw tension and bruxism. Massage therapists use specialized techniques to identify and treat trigger points in the jaw muscles. This may involve applying sustained pressure or using specific movements to release tension and alleviate discomfort.


Myofascial Release: Myofascial release techniques focus on releasing tension and restrictions in the fascia, the connective tissue surrounding the muscles. The therapist uses gentle pressure and stretching movements to release adhesions and restore optimal tissue mobility. Myofascial release can help relieve jaw tension by addressing underlying fascial restrictions.


Stretching and Range of Motion Exercises: Massage therapists may incorporate stretching and range of motion exercises to improve jaw muscle flexibility and mobility. These exercises aim to gently stretch and lengthen the jaw muscles, promoting relaxation and reducing tension.


Pressure Points and Massage Techniques for Bruxism:


Massage therapists may target specific pressure points and muscle groups associated with bruxism. These points can be located on the face, neck, and shoulders, as tension in these areas can contribute to jaw muscle tightness and teeth grinding. By releasing tension in these points, massage therapy can help alleviate bruxism symptoms.



Benefits of Massage Therapy for Bruxism:


massage therapy used for relaxing muscles which helps in reducing tension
Courtesy of thomsontcm.sg

Massage therapy offers several benefits for individuals with bruxism.


1. Muscle Relaxation:

Massage therapy helps relax the muscles in the face, jaw, and neck, which are often tense and strained in individuals with bruxism. The skilled touch of a massage therapist can release muscle knots and trigger points, easing muscle tension and promoting a state of relaxation. This relaxation response in the muscles can help reduce the frequency and intensity of teeth grinding episodes.


2. Pain and Soreness Relief:

Bruxism can cause pain and soreness in the jaw, face, and neck. Massage therapy can target these areas and provide relief from discomfort. Through various massage techniques such as effleurage, petrissage, and kneading, the therapist can increase blood flow, improve oxygenation, and promote the release of endorphins, which are the body's natural painkillers. This can help alleviate the pain associated with bruxism and enhance overall comfort.


3. Improved Blood Circulation:

Massage therapy improves blood circulation throughout the body, including the orofacial region. By applying gentle pressure and manipulating the soft tissues, massage stimulates the flow of blood, delivering oxygen and nutrients to the muscles and tissues. Enhanced circulation helps reduce inflammation, promote tissue healing, and support overall oral health.


Considerations and Precautions:


While massage therapy is generally safe, certain precautions should be taken for individuals with bruxism. It is essential to consult a qualified massage therapist who has experience in treating bruxism to ensure the appropriate techniques and pressure are applied. Individuals with specific medical conditions or injuries should also seek medical advice before undergoing massage therapy.


Integrating Massage Therapy into a Comprehensive Treatment Plan:


Massage therapy can be integrated into a comprehensive treatment plan for bruxism, alongside other therapeutic modalities. Combining massage therapy with occlusal splint therapy, physical therapy, or myofunctional therapy can provide a well-rounded approach that addresses the physical, muscular, and psychological aspects of bruxism.



3. Myofunctional Therapy for Bruxism:


Female woman demonstrating Myofunctional therapy for bruxism
Courtesy of glenparkdental.com

Myofunctional therapy focuses on the retraining and coordination of the muscles involved in chewing, swallowing, and breathing. By improving muscle function and oral habits, myofunctional therapy aims to reduce bruxism episodes and associated symptoms.


Understanding Myofunctional Therapy:


Myofunctional therapy is a specialized form of therapy that targets the orofacial muscles and their function. It involves exercises and techniques designed to promote proper muscle coordination, strengthen weak muscles, and eliminate harmful oral habits.


How Myofunctional Therapy Addresses Bruxism:


Bruxism is often associated with improper muscle function and oral habits. Myofunctional therapy addresses these underlying issues by retraining the muscles involved in chewing and swallowing, promoting proper tongue posture, and eliminating harmful oral habits like tongue thrusting or mouth breathing.


Exercises and Techniques for Jaw Muscle Coordination:


Myofunctional therapists provide individuals with bruxism specific exercises and techniques to improve jaw muscle coordination. These exercises may involve tongue exercises, lip strengthening exercises, and jaw mobility exercises. The therapist guides the individual through these exercises to ensure proper technique and maximum benefit.


Incorporating Tongue and Facial Exercises:


Tongue and facial exercises are essential components of myofunctional therapy for bruxism. These exercises help strengthen the tongue and facial muscles, promote proper swallowing and chewing patterns, and improve overall muscle coordination in the orofacial region.


The Benefits and Long-term Effects of Myofunctional Therapy:


Myofunctional therapy offers long-term benefits for individuals with bruxism. By addressing the underlying muscle dysfunctions and oral habits, it can significantly reduce the frequency and severity of teeth grinding episodes. It also contributes to improved oral health, proper dental alignment, and enhanced overall well-being.


Therapist and patient seeing themselves in the mirror talking about benefits of myofunctional therapy
Courtesy of tonguesncheeks.com


One of the primary focuses of myofunctional therapy is on tongue exercises. The tongue plays a crucial role in proper jaw positioning and muscle coordination. Through specific exercises, individuals can learn to position their tongue correctly, ensuring that it rests against the roof of the mouth rather than pressing against the teeth. This proper tongue posture helps stabilize the jaw and prevents the grinding and clenching actions associated with bruxism.


Additionally, myofunctional therapy includes exercises to strengthen the facial muscles. Strong facial muscles support the jaw and provide stability, reducing the strain on the temporomandibular joint (TMJ). By incorporating exercises that target the facial muscles, individuals can enhance muscle tone and coordination, leading to improved jaw function and decreased bruxism symptoms.


 
 


Combining Myofunctional Therapy with Other Modalities


In the comprehensive treatment of bruxism, combining myofunctional therapy with other modalities can yield significant benefits and improve overall outcomes. Myofunctional therapy focuses on retraining the muscles involved in chewing, swallowing, and oral habits, while other modalities complement and enhance the effects of this therapy. By integrating multiple approaches, a more holistic and individualized treatment plan can be created.


One common modality that can be combined with myofunctional therapy is occlusal splint therapy. Occlusal splints, also known as nightguards or bite guards, are custom-made oral appliances that help protect the teeth from grinding and clenching. These splints are designed to promote proper jaw alignment, reduce muscle tension, and provide a physical barrier between the upper and lower teeth. When used in conjunction with myofunctional therapy, occlusal splints can help alleviate the immediate symptoms of bruxism while the therapy works on addressing the underlying muscle dysfunctions and habits.


Physical therapy is another modality that can be integrated with myofunctional therapy. Physical therapy focuses on improving muscle function, reducing muscle tension, and promoting overall jaw health. By incorporating specific exercises, stretches, and manual techniques, physical therapy helps individuals with bruxism develop proper muscle coordination, release muscle tension, and improve jaw mobility. Combining physical therapy with myofunctional therapy can provide a synergistic effect, targeting both the muscles and the oral habits associated with bruxism. This comprehensive approach addresses the multifactorial nature of bruxism, leading to improved treatment outcomes and long-term management of the condition.



4. Occlusal Splint Therapy:


Child practicing Occlusal splint therapy process
Courtesy of louisadental.com

Occlusal splint therapy, also known as a nightguard or bite splint, is one of the most commonly prescribed treatments for bruxism. It involves the use of a custom-fitted oral appliance that is worn during sleep to provide a protective barrier between the upper and lower teeth. The main goals of occlusal splint therapy are to reduce teeth grinding forces, protect tooth surfaces from damage, and alleviate jaw muscle tension.


What is an Occlusal Splint?


An occlusal splint is a removable dental appliance made from hard acrylic material. It is custom-designed by a dental professional to fit the patient's upper or lower teeth precisely. The splint is typically worn at night but can also be used during stressful daytime situations.


How Does an Occlusal Splint Work?


By creating a separation between the upper and lower teeth, an occlusal splint redistributes the forces generated during teeth grinding. It reduces the impact on tooth surfaces, preventing further wear and damage. Additionally, the splint helps relax the jaw muscles by providing a stable and comfortable resting position for the jaw.



The Role of Occlusal Splint Therapy in Bruxism Treatment:


 Young lady showing how Occlusal Splint Therapy can help with Bruxism Treatment
Courtesy of everydayhealth.com

Occlusal splint therapy serves multiple purposes in the treatment of bruxism. Firstly, it provides a physical barrier between the upper and lower teeth, preventing them from coming into direct contact. This reduces the abrasive forces that contribute to tooth wear and damage.


Secondly, the splint helps to stabilize the jaw and promote proper alignment. By creating an even and balanced bite, it can alleviate stress on the jaw joints and muscles, reducing muscle tension and discomfort associated with bruxism.


Furthermore, occlusal splint therapy can help break the habit of grinding and clenching by creating a different oral sensation. The splint's presence in the mouth can serve as a sensory reminder, making individuals more aware of their grinding behavior and allowing them to consciously make an effort to avoid it.


The effectiveness of occlusal splint therapy may vary depending on the individual's specific condition and the severity of their bruxism. It is important to note that occlusal splints do not address the root cause of bruxism but rather provide symptomatic relief and protect the teeth from further damage. Therefore, it is often recommended to combine occlusal splint therapy with other treatment modalities for a comprehensive approach to bruxism management.


Benefits and Effectiveness of Occlusal Splint Therapy:


The use of splints has been found to significantly decrease tooth wear, muscle activity, and associated symptoms. Moreover, occlusal splints are non-invasive and relatively inexpensive compared to other treatment options.


Protection of Tooth Structure: Occlusal splints act as a protective barrier between the upper and lower teeth, preventing them from grinding against each other. This helps to minimize the wear and tear on tooth surfaces and reduce the risk of dental damage, such as enamel erosion, fractures, or tooth sensitivity [1].


Prevention of Temporomandibular Joint (TMJ) Disorders: Occlusal splints can help alleviate strain on the temporomandibular joints (TMJ) by promoting proper jaw alignment and reducing excessive pressure on the joints. This can help prevent or reduce the occurrence of TMJ disorders, which are often associated with bruxism.


Cartoon sketch of young brunette lady grimacing from Temporomandibular Joint TMJ pain
Courtesy of leesburgfamily.com

Improved Sleep Quality: Bruxism can disrupt sleep patterns and lead to poor sleep quality. Occlusal splint therapy can contribute to better sleep by reducing the intensity of teeth grinding and its associated noises. This can result in improved sleep for both the individual with bruxism and their sleep partner.


Long-Term Effectiveness: Occlusal splints have demonstrated long-term effectiveness in managing bruxism. They provide consistent protection for the teeth and help break the habit of teeth grinding over time. Regular use of occlusal splints can significantly reduce the frequency and severity of bruxism episodes.


Potential Side Effects and Considerations:


While occlusal splints are generally well-tolerated, some individuals may experience temporary discomfort or changes in their bite alignment when initially using the splint. It is crucial to consult a dental professional for proper fitting and adjustment of the splint to minimize these issues. Regular follow-ups and maintenance of the splint are essential to ensure its continued effectiveness.


Recommendations for Using Occlusal Splints:


To optimize the benefits of occlusal splint therapy, it is important to follow specific recommendations. These include wearing the splint as directed by the dental professional, maintaining proper oral hygiene, storing the splint in a clean and safe container when not in use, and attending regular dental check-ups.



Conclusion:


Bruxism is a common condition that can lead to various dental problems and discomfort. Fortunately, there are several effective therapeutic approaches available to manage bruxism and alleviate its associated symptoms. Occlusal splint therapy, physical therapy, massage therapy, and myofunctional therapy have shown promising results in reducing teeth grinding episodes, relieving muscle tension, and improving overall oral health. It is important to note that each individual's treatment plan should be tailored to their specific needs, and consulting a healthcare professional is crucial for proper diagnosis and therapy selection. With a holistic and individualized approach, individuals with bruxism can find relief and improve their quality of life.


 
 

References:

[1] Deogade, Suryakant. (2013). Occlusal Splint Therapy-Review Article. International Journal Of Dental Practice And Medical Sciences. 1. 73-83.


[2] Amorim, C. S. M., Espirito Santo, A. S., Sommer, M., & Marques, A. P. (2018). Effect of Physical Therapy in Bruxism Treatment: A Systematic Review. Journal of manipulative and physiological therapeutics, 41(5), 389–404. https://doi.org/10.1016/j.jmpt.2017.10.014


[3] Allan Kalamir, Henry Pollard, Andrew L. Vitiello, Rod Bonello (2007). TMD and the problem of bruxism: A review. Journal of Bodywork and Movement Therapies, 11(3). https://doi.org/10.1016/j.jbmt.2006.11.006

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