Is there a role for biofeedback to treat sleep bruxism?

toddler-girl-grinding-teethSleep bruxism (nocturnal tooth grinding) causes hypersensitive teeth, aching jaw muscles, and headaches. There may even be tooth damage and loss.

Researchers at Sichuan University, Chengdu, People’s Republic of China, reviewed the evidence.

First, the details.

  • 7 studies involving 240 participants were included.
    • 3 had moderate risk of bias.
    • 4 had high risk of bias.
  • The authors were interested in studies using the following techniques.
    • Contingent electrical stimulation (CES): pulse stimulation of the mechano-receptors in the skin
    • Electromyography (EMG): a technique for evaluating and recording the electrical activity produced by skeletal muscles
  • The diversity of biofeedback modalities (auditory, electrical, and visual stimulus) and controls (splint, occlusal adjustment, etc.) in 5 studies limited the evaluation to a qualitative description.

And, the results.

  • Meta-analysis showed no significant difference between CES and control.

The bottom line?

The authors concluded, “There is no powerful evidence to support the use of biofeedback technology on sleep bruxism treatment.

Insight into why these studies fail, as a group, to show significant benefit is found in a study by researchers at Aarhus University, in Denmark

Yes, CES reduced EMG activity.

However, patients treated with CES experienced no difference in pain, muscle tension, or average duration of sleep hours compared with placebo.

The use of biofeedback to treat buxism appears to be a case where causing a change in physiologic response is not necessarily associated with a significant positive clinical effect.

6/21/13 00:23 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.