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Comparative Effects of Dental Treatment and Two Different Physical Therapy Interventions in Individuals with Bruxism: A Randomized Clinical Trial

Objective: To compare the efficacy of dental treatment and two different physical therapy interventions in individuals with bruxism. 

Methods: A total of 72 individuals with bruxism were randomly allocated to the massage (massage with stretching exercises), relaxation (relaxation with imagination therapy) groups (n=24 each; biweekly 40-min sessions over 6 weeks) or the dental group (n=24; direct restoration; two 2-h sessions 1 week apart). Primary outcomes included muscle pain and symptoms, and mandibular opening. Secondary outcomes included anxiety, stress, depression, oral health and sleep quality. Outcomes were evaluated at baseline, 6 weeks and 2 months post-initial intervention by a blinded assessor. Physical therapy interventions included individual sessions that lasted 40 min biweekly for 6 weeks and dental treatment, two 2-h individual sessions conducted a week apart. The level of significance established was α=5%. RESULTS: After 6 weeks, the improvement with difference among massage and relaxation groups and dental group was observed in muscle pain, symptoms, anxiety, stress, depression and sleep quality (p<0.001). Relaxation group exhibited significantly greater improvement in oral health than dental group (p<0.001). These effects were sustained for up to 2 months. 

Conclusion: Therefore, two physical therapy interventions are superior to dental treatment in the improvement of muscle pain, symptoms, anxiety, stress, depression and sleep quality in individuals with bruxism. Oral health improves more with relaxation with imagination therapy than with dental treatment.