An investigation into the management of awake bruxism: a systematic literature review

Abstract

Awake Bruxism (AB) covers a number of varied oral activities and behaviours all of which have the potential to be damaging to teeth, oral soft tissues, masticatory muscles and the temporomandibular joint. The purpose of this systematic review is to answer the following question: -“For teenage and adult humans (aged 13 and above), how effective is the most frequently evaluated form of management to reduce awake bruxism behaviour compared to other interventions?”

The results of the search were imported into Covidence and subjected to inclusion criteria: Randomised Control Trials (RCTs), non RCTs, reports or trials, case series reports.

Each of the included studies in this literature review only looked at a single type of management technique without comparing with any other mode of management. All these forms of management showed a significant decrease in AB activity, it is not possible to make direct comparison and say one management technique is more effective than the other. Habit-reversal maintained the decreases over 6 month and 12 month follow up. With biofeedback the treatment period lasted 3 weeks, but there is no mention of later follow up. The email reminders ran for 20 days. This study also had a third group who used sticky notes strategically placed around home and place of work. This was the only study with a comparator. The sticky note group achieved better results than the control group but not as good as the email group.

Assessment of quality/risk of bias was done for all the included studies. In the Counselling and Self-Management study the results were evaluated over 2 months. This is the only one of the included studies achieving a good quality/risk of bias rating, is the study with the simplest management technique (i.e. not requiring EMG biofeedback, guided music listening or an email reminder system) and in addition is the study with the most immediate application for general practice.