ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Massage is Beneficial for Managing Temporomandibular Disorder (TMD) Pain in Patients Who Have Sleep Bruxism
Clinical Question Is massage therapy beneficial for TMD symptoms among patients who have sleep bruxism?
Clinical Bottom Line Massage is beneficial for TMD pain management, but professional massages (as used in the study) are expensive and time consuming. A more cost effective manner to manage TMD pain associated with sleep bruxism would be for the patient to wear an occlusal splint at night and use self-massage as an adjunctive therapy to manage the TMD pain.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 26733760Gomes/201578 women diagnosed with sleep bruxismRandomized Controlled Trial
Key resultsMassage therapy decreased the pre-treatment numerical rating scale (NRS) pain score of 7.00 ± 1.32 to a post-treatment NRS pain score of 5.47 ± 1.54 (p value <0.0001). Occlusal splint therapy decreased the pain score from 7.31 ± 0.94 (pre-treatment) to 5.64 ± 1.60 (post-treatment) (p value <0.0001). Combined therapy (massage therapy with occlusal splint therapy) decreased the pain score from 7.73 ± 1.09 (pre-treatment) to 3.69 ± 1.32 (post-treatment) (p value <0.0001). The effect size of the therapies were calculated (with >0.8 signifying a large effect on pain). The effect size was 0.86 for massage therapy, 0.95 for occlusal splint therapy and 2.51 for combined therapy.
Evidence Search ("massage"[MeSH Terms] OR "massage"[All Fields] OR ("massage"[All Fields] AND "therapy"[All Fields]) OR "massage therapy"[All Fields]) AND ("bruxism"[MeSH Terms] OR "bruxism"[All Fields])
Comments on
The Evidence
Validity: The patient groups were similar at the start and the completion rate was greater than 80%. The researchers and evaluators were blinded to the treatment of the patient. The study did not mention any competing interests. Perspective: The study was well structured and thorough. However, all the patients were female. The study could have been expanded to include male patients, to ensure the findings apply to both genders.
Applicability Overall, this study suggests that massage is beneficial for TMD pain management for patients with nighttime bruxism. However, professional massage therapy (as it was performed in the study) of three weekly 30 minute session, is time consuming and costly for the average patient to continue long term. In addition, massage can potentially aggravate symptoms.
Specialty/Discipline (General Dentistry)
Keywords sleep bruxism, complementary therapies
ID# 3017
Date of submission: 03/24/2016spacer
E-mail thomasej@livemail.uthscsa.edu
Author Ernest Thomas
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Edward F. Wright, DDS, MS
Faculty mentor/Co-author e-mail wrighte2@uthscsa.edu
Basic Science Rationale
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Comments on the CAT
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