Treatment of bruxism in individuals with developmental disabilities: a systematic review.
Dental check first, then brief behavioral tests—evidence is thin so single-case data rule.
01Research in Context
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?
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.
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.
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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02At a glance
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