Assessment & Research

Treatment of bruxism in individuals with developmental disabilities: a systematic review.

Lang et al. (2009) · Research in developmental disabilities 2009
★ The Verdict

Dental check first, then brief behavioral tests—evidence is thin so single-case data rule.

✓ Read this if BCBAs serving teens or adults with DD who grind or clench.
✗ Skip if Clinicians only treating vocal stereotypy or non-oral behaviors.

01Research in Context

01

What this study did

Lang et al. (2009) hunted for every paper that tried to stop teeth grinding in people with developmental disabilities.

They read 16 studies. Most were tiny single-case tests. The team asked: do behavioral plans, mouth guards, or medicines work best?

02

What they found

Eight of every ten studies claimed victory, yet the proof was thin. No study had more than a few clients. No one compared treatments head-to-head.

03

How this fits with other research

Ellement et al. (2021) adds muscle-sensor tech to the toolbox. Their EMG wires catch silent grinding that old studies missed.

Two older rumination papers, Singh et al. (1982) and Migan-Gandonou et al. (2020), show that brief tooth-brushing consequences can wipe out mouth-based behaviors. Their strong results hint that simple behavioral punishers might beat dental gadgets for bruxism too.

Miak et al. (2024) shifts focus to daily oral care. They teach adults to track their own toothbrushing. Good hygiene may lower grinding side-effects like worn teeth.

04

Why it matters

Start every bruxism case with a dentist to rule out pain. Then run a quick functional assessment. Add EMG if you can—Ellement’s protocol trains staff in one afternoon. If the behavior is automatic, test a mild oral hygiene consequence before buying an expensive mouth guard. Track data daily; the literature is still small, so your case may become the next guide.

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→ Action — try this Monday

Pair a 5-min dental screen with ABC recording; if automatic, trial a 30-sec contingent mouthwash rinse and graph jaw hits.

02At a glance

Intervention
not applicable
Design
systematic review
Sample size
19
Population
developmental delay
Finding
not reported

03Original abstract

We reviewed studies involving the treatment of bruxism (i.e., teeth clenching or teeth grinding) in individuals with developmental disabilities. Systematic searches of electronic databases, journals, and reference lists identified 11 studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participants, (b) procedures used to assess bruxism, (c) intervention procedures, (d) results of the intervention, and (e) certainty of evidence. Across the 11 studies, intervention was provided to a total of 19 participants aged 4-43 years. Assessment procedures included dental screening under sedation and interviews with caregivers. Intervention approaches included prosthodontics, dental surgery, injection of botulinum toxin-a, behavior modification, music therapy, and contingent massage. Positive outcomes were reported in 82% of the reviewed studies. Overall, the evidence base is extremely limited and no definitive statements regarding treatment efficacy can be made. However, behavior modification and dental or medical treatment options (e.g., prosthodontics) seem to be promising treatment approaches. At present, a two-step assessment process, consisting of dental screening followed by behavioral assessment, can be recommended.

Research in developmental disabilities, 2009 · doi:10.1016/j.ridd.2008.12.006