Biofeedback vs Mouthguards for Treating Bruxism

With new research strengthening the case of teeth grinding or bruxism as a behavior that can be treated and corrected, traditional treatment of bruxism methods is getting a hard second, third, or fourth look by the medical community.

And mouthguards are the top treatment for bruxism method being scrutinized. Mouthguards have long been the go-to solution for alleviating symptoms of teeth grinding. At the same time, biofeedback therapy now emerges as a novel treatment of bruxism, offering a different approach to tackling this condition.

The question arises: Can biofeedback therapy truly outshine the tried-and-tested efficacy of mouthguards in addressing bruxism?

Let’s  dive into biofeedback vs mouthguards and explore these contrasting treatments to shed light on the optimal path toward managing this prevalent issue.

Defining Bruxism or Teeth Grinding


Bruxism, commonly known as teeth grinding, is a condition characterized by the involuntary clenching, grinding, or gnashing of teeth that is consistent enough to become a disorder or harmful habit. 


A new consensus has developed in recent years that increasingly recognizes this as a risky behavior that can lead to various clinical consequences or disorders, including tooth wear, jaw pain, headaches, and other related issues, as highlighted by this 2018 paper published in the Journal of Oral Rehabilitation.


Awake Bruxism and Sleep Bruxism


Bruxism itself can be divided into two types, based on the time of day and how they occur: Awake bruxism and sleep bruxism.

Awake bruxism or daytime bruxism happens while conscious, often during stressful situations, and sleep bruxism occurs during sleep, sometimes without the individual even realizing it.


Both daytime bruxism and sleep bruxism share the aspect of uncontrolled or unintentional teeth grinding or jaw clenching, but both can have distinct root causes and are considered different conditions.

Nonetheless, both types can lead to dental issues, jaw pain, and headaches if left untreated.


What Causes Sleep Bruxism? 


During sleep, the unconscious grinding and clenching of the teeth, known as sleep bruxism or nocturnal bruxism, can be triggered by various factors but is mostly attributed to such as stress, anxiety, or misaligned teeth. These nighttime teeth grinding and clenching are often associated with an underlying sleep disorder, like problems with gastroesophageal reflux disease (GERD) or obstructive sleep apnea.


The exact causes of sleep bruxism are not fully understood, but research suggests a combination of physical, psychological, and genetic factors may play a role. Stress and anxiety are common triggers for bruxism, as individuals may clench their jaw in response to emotional tension.


Additionally, misaligned teeth or an abnormal bite can contribute to the development of bruxism during sleep, along with sleep disorders, as already mentioned.


Sleep Bruxism Symptoms and Effects


Sleep bruxism symptoms manifest through involuntary and repetitive jaw muscle contractions during sleep. These actions can lead to various effects, including jaw muscle discomfort, headaches, crooked teeth, damaged teeth, tooth sensitivity, and patterns of sleep disruption. Over time, severe or even moderate teeth grinding can result in permanent damage, such as worn-down teeth, fractured enamel, or even tooth loss.


The constant strain on the jaw muscles can also contribute to temporomandibular joint disorders (TMJ,) leading to further pain and limited jaw movement. 


Understanding the potential causes and symptoms of sleep bruxism is essential for effective treatment and management of this condition.


Traditional Bruxism Treatment Methods


Traditional bruxism treatment methods encompass a range of approaches that seek to both treat the immediate symptoms and harm to your oral health while looking to address some of the root causes.


Mouthguards, Splints, Night Guards


The most common and traditional treatment method for treating bruxism often involves the use of mouthguards, splints, or night guards. These oral appliances are designed to protect the teeth from grinding and clenching during sleep, reducing the associated symptoms such as jaw pain, headaches, and tooth damage.


Mouthguards (or mouth guards) are typically made from soft or hard materials and are customized to fit the individual’s teeth, providing a protective barrier. Another name for them is splints or occlusal splints. 


Their sleep bruxism counterpart is night guards, which specifically aim to cushion the teeth and reduce the impact of grinding your teeth at night, offering a conservative approach to managing grinding and clenching.


A dentist will traditionally recommend a custom-made mouth guard or soft custom night guard for patients with bruxism, but some over-the-counter guards can be enough for mild cases of bruxism. Nonetheless, custom-made splints will always be preferable to generic dental appliances.


Muscle Relaxants


Muscle relaxants have long been utilized as a traditional approach to addressing the underlying muscle tension that contributes to teeth grinding and clenching during sleep. Muscle relaxants work by reducing the hyperactivity of jaw muscles, which can help alleviate jaw pain associated with bruxism and temporomandibular disorders.


These medications are commonly prescribed to individuals suffering from bruxism-related disorders to relax the muscles involved in grinding and clenching, providing relief from discomfort and preventing further damage to the teeth. While muscle relaxants can be an effective method for managing bruxism symptoms, it is essential to consult with a healthcare professional to determine the most suitable treatment approach based on individual needs and medical history.


Stress Management and Relaxation Techniques


Effective stress-reduction techniques and management play a crucial role in addressing stress, which is a common trigger for bruxism, and managing stress levels can help alleviate its symptoms.


By integrating practices such as deep breathing, mindfulness, meditation, and progressive muscle relaxation, individuals can effectively address the underlying stress and tension contributing to this condition. Deep breathing exercises help to calm the mind and body, reducing overall stress levels that may manifest as teeth grinding.


Mindfulness techniques encourage individuals to be present at the moment, promoting awareness of jaw-clenching habits and enabling them to consciously relax the jaw muscles. Meditation aids in relaxation, promoting a state of inner peace and reducing the likelihood of teeth-grinding episodes.


Progressive muscle relaxation involves systematically tensing and then releasing different muscle groups, helping to alleviate muscle tension in the jaw area.


By incorporating these relaxation methods into a daily routine, the hope is that individuals can minimize stress, manage bruxism, and improve their overall oral health.



What’s Biofeedback Therapy? 


Biofeedback therapy is a non-invasive method that aims to enhance awareness and control of physiological processes. When it comes to the management of bruxism, understanding different treatment options is essential, with biofeedback therapy being particularly crucial in this regard.


In adults with bruxism, biofeedback therapy specifically targets the monitoring of muscle activity, especially the masseter muscle, which is commonly involved in nighttime teeth grinding and clenching.


Biofeedback treatment sessions will consist of sensors set on the facial muscles or masseter muscles to measure muscle tension levels. Patients receive real-time feedback, such as visual or auditory cues, to help them recognize and manage muscle tension associated with bruxism behavior. This process enables individuals to consciously relax the masseter muscle, thereby reducing the frequency and intensity of episodes of bruxism events.


While biofeedback therapy has been used in both nighttime and daytime bruxism cases, recent emphasis has been on applying biofeedback devices to patients with sleep bruxism.


Sleep bruxism events are challenging to address, as many individuals are unaware of their behavior. Therefore, utilizing biofeedback in patients with sleep bruxism has been identified as a promising application of this technology.


Focusing on biofeedback for sleep bruxism has emerged as a key aspect of this innovative therapeutic approach. It can play a significant role in a dental professional’s comprehensive treatment plan for bruxism in adults.


How Most Biofeedback Devices Work


A biofeedback device is engineered to provide individuals with immediate feedback on their muscle activity during sleep, alerting them to teeth grinding and clenching.


While there are various types of biofeedback devices on the market and in clinical trials, most of these new holistic technologies typically function through these three steps:


    1. Monitoring Jaw Muscle Activity: A biofeedback device can identify and measure muscle contractions in the jaw region, notifying the user when excessive muscle activity linked to bruxism occurs.
    2.  Real-Time Feedback: By delivering instant feedback, these devices help individuals identify the specific times when a bruxism event occurs, enabling them to develop strategies to prevent or halt jaw muscle activity in sleep bruxism.
    3. Behavior Modification: Through consistent use, a biofeedback device supports individuals in altering their sleep behaviors by encouraging relaxation techniques and muscle activity retraining, leading to improved management of sleep bruxism and treatment outcomes.

A prevalent form of biofeedback technology presently includes devices like biofeedback headbands, headphones, and other similar tools that, unlike night guards, monitor muscle motor activity during sleep.


Benefits of Biofeedback Over Other Treatment for Sleep Bruxism Options


Biofeedback therapy offers a non-invasive alternative to traditional treatment options like mouthguards, night guards, and muscle relaxants for bruxism. Its focus on self-regulation and stress management techniques can address the root cause of teeth grinding, providing a holistic approach to treatment.


Additionally, biofeedback therapy can empower individuals by giving them real-time information about their body’s responses, promoting self-awareness and long-term behavior change.


Mouthguards or Night Guards


Utilizing mouthguards, night guards, and oral splints has long been a common approach to managing bruxism. 

While mouth guards, night guards, and oral splints help protect the teeth from damage caused by grinding and clenching during sleep, they do not address the underlying muscle tension and habitual patterns associated with bruxism.


However, devices like the biofeedback headband or other types of biofeedback tech offer a unique advantage by providing real-time feedback to help individuals become more aware of their clenching and grinding behaviors. This awareness allows for targeted interventions to retrain muscle function and reduce bruxism activity, leading to more effective and sustainable long-term results in managing bruxism.


Muscle Relaxants


In comparison to conventional treatments like muscle relaxants, biofeedback therapy stands out for its efficacy in addressing the underlying muscle tension and habitual patterns associated with bruxism.


While muscle relaxants may provide temporary relief by reducing muscle activity, they do not target the root cause of bruxism.


Biofeedback therapy, on the other hand, offers a more comprehensive approach by helping individuals become more aware of their muscle tension levels and providing techniques to manage and reduce this tension over time. This proactive method can lead to long-term improvements in bruxism symptoms, unlike the temporary relief provided by muscle relaxants.


Massage Therapy


When exploring alternative treatment options beyond muscle relaxants for addressing bruxism, the effectiveness of biofeedback therapy becomes even more apparent when compared to massage therapy.


While massage therapy can help relieve muscle tension and promote relaxation, it may only offer temporary relief for individuals with bruxism.


By utilizing biofeedback to teach patients how to control muscle activity, individuals can learn to recognize and change the harmful muscle patterns associated with bruxism.


Stress Management Techniques


Of all the traditional treatment of bruxism methods, stress management is the one that continues to prove its efficacy, even compared to biofeedback therapy. But this is because stress management techniques or relaxation techniques are complementary to biofeedback therapy, not a replacement. A true, holistic approach to bruxism will require biofeedback therapy to be combined with stress reduction techniques and lifestyle changes that will prevent the habit from resurfacing once more, even with the proven efficacy of biofeedback therapy to eliminate the behavior.


Is Biofeedback Really Effective?


Numerous research studies have showcased the effectiveness of biofeedback therapy, particularly in addressing sleep bruxism, by offering individuals valuable real-time feedback on their muscle activity during sleep.


For example, one study published in the Journal of Oral Rehabilitation in 2018 demonstrated that biofeedback therapy can serve as a successful treatment for bruxism. Through a systematic review and meta-analysis, it was shown that individuals undergoing biofeedback treatment experienced significant reductions in teeth grinding and clenching compared to those not undergoing biofeedback therapy after five sessions.


A more recent study from 2023 titled ‘Effectiveness of Biofeedback in Individuals with Awake Bruxism Compared to Other Types of Treatment: A Systematic Review’ reported a decrease in ‘phasic events of the masticatory muscles’ both during nighttime and daytime teeth grinding when auditory biofeedback was administered for two or more consecutive days per week. In addition, visual biofeedback was found to reduce electromyographic or motor activity in the jaw muscles (both left masseter and temporalis) when applied once a week for three weeks.


Moreover, a 2014 study conducted in Japan utilized a longitudinal analysis to assess the long-term efficacy of tonic biofeedback in managing bruxism. Over a span of three weeks, the study monitored 12 individuals with bruxism disorder and discovered sustained enhancements in muscle relaxation, along with a reduction in bruxism-related myofascial pain and dental damage in those who underwent biofeedback therapy.


These studies underscore the favorable results and benefits of biofeedback therapy in mitigating bruxism symptoms and enhancing the overall well-being of impacted individuals.


Consult With Your Dental Health Provider if Biofeedback is Right for You


Considering the potential benefits of biofeedback therapy in managing bruxism, it is advisable to consult with your dental health provider to determine if this treatment approach is suitable for your individual needs.

Your dental health provider can assess the severity of your bruxism, evaluate the condition of your jaw joint, and consider factors such as facial pain and overall health when recommending a treatment plan. They can guide you on how to incorporate biofeedback therapy into your overall bruxism management strategy effectively. Your healthcare provider may also discuss the option of using occlusal splints in conjunction with biofeedback therapy to optimize results.

In closing, the comparison of biofeedback vs mouthguards for bruxism management illuminates two distinct yet complementary approaches to addressing this common condition. Nevertheless, it is very important to note that consulting with a professional will ensure that the chosen treatment aligns with your specific requirements and health considerations. By seeking expert advice, you can make informed decisions regarding your oral health and well-being, ultimately leading to a more tailored and successful treatment outcome.

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