Title A Combination of Cognitive Behavioral Therapy and Splint Therapy is More Effective in Reducing Resting Muscle Activity in Adult Bruxers Than Splint Therapy Alone
Clinical Question In an adult with nocturnal bruxism, is cognitive behavioral therapy combined with splint therapy more effective in reducing resting jaw muscle activity compared to splint therapy alone?
Clinical Bottom Line A combination of occlusal splint and cognitive behavioral therapy is more effective at achieving resting jaw muscle relaxation than occlusal splint use alone.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
26325649Trindade/20152 groups of patients with bruxism (11 in each group) Randomized Controlled Trial
Key resultsThis study found that a group of 11 bruxism patients treated with an occlusal splint in combination with cognitive therapy had significantly greater improvement in achieving muscle relaxation than the group treated with an occlusal splint alone (P < 0.05; analysis of variance and Student t tests).
Evidence Search “Bruxism” [All Fields] AND “stress" [All Fields] AND “occlusal splint” [All Fields]
Comments on
The Evidence
Validity: It is assumed that patients were randomized to the two groups, however, it is not clear that this was the case from the methods section of this paper. It is also not known if the examiners were blinded. Although the sample size was small, significant differences were found (P < 0.05; analysis of variance and student t tests). The outcome variable of resting jaw muscle activity used in this study may or may not correlate with other outcomes such as pain and levels of bruxism.
Applicability This study suggests that in treating patients with bruxism, the combination of an occlusal splint with cognitive therapy is more effective in relaxing jaw muscles than the use of an occlusal splint alone, however, the cognitive therapy involved 16, 45 minute sessions. This may not be practical or accepted by many patients. This study did not report any assessment of facial pain or levels of bruxism thus it is not known if these were impacted by the addition of cognitive behavioral therapy to splint therapy.
Specialty (General Dentistry) (Interprofessional CATs)
Keywords bruxism; cognitive behavioral therapy; interdisciplinary treatment; occlusal splint
ID# 3084
Date of submission 04/01/2016
E-mail cernac@livemail.uthscsa.edu
Author Carissa Cerna
Co-author(s) e-mail
Faculty mentor John D. Rugh, PhD
Faculty mentor e-mail rugh@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available