Music Modulates Awake Bruxism in Chronic Painful Temporomandibular Disorders

Abstract

Objective In this experimental study, we aimed to determine whether guided music listening (GML) – a music intervention based on models of mood mediation and attention modulation – modulates masticatory muscle activity and awake bruxism in subjects with chronic painful muscular temporomandibular disorders (TMD myalgia, mTMD), a condition causing a significant burden to patients, their families, and healthcare systems. Background Awake bruxism – a stress behavior characterized by clenching of the teeth – is a strong contributor to chronic mTMD. GML modulates psychological stress and motor responses and could thus reduce muscle activity in chronic musculoskeletal conditions, including mTMD. Methods We recorded the electromyographic (EMG) activity in the right masseter of 14 women with chronic (>6 months) mTMD (median [IQR] = 39.5.3 [24.3] years) and 15 pain‐free women (median [IQR] = 30.0 [3.5] years) during a GML session, including 3 music (stressful, relaxing, and participants' favorite music) and a no‐music (pink noise) control blocks, each lasting 15 minutes. We measured the motor effort of the right masseter relative to the participants' maximum voluntary contraction (MVC), the muscular effort to maintain mandibular posture (EMGposture), and to produce spontaneous awake bruxism episodes (EMGbruxism), and the duration and frequency of spontaneous awake bruxism episodes. We tested between‐group and within‐group (between blocks) differences, as well as the effect of the interaction group by experimental block on these outcome measures. Results In both groups, EMGposture was significantly affected by the interaction group by experimental block (P < .001). Compared to pink noise [mean (95% CI); mTMD: 2.2 (1.6‐2.8) %MVC; Controls: 1.1 (0.5‐1.7) %MVC], EMGposture increased during the stressful music block [contrast estimate (95% CI); mTMD: +0.8 (0.7‐0.8) %MVC; Controls: +0.3 (0.3‐0.4) %MVC; both P < .001], and decreased during the relaxing [mTMD: −0.4 (−0.5 to −0.4) %MVC; Controls: −0.3 (−0.4 to −0.3) %MVC; both P < .001] and favorite [mTMD: −0.5 (−0.6 to −0.5) %MVC; Controls: −0.5 (−0.5 to −0.4) %MVC; both P < .001] music blocks. EMGposture was greater in mTMD individuals than controls during the favorite music [contrast estimate (95% CI): +1.1 (0.2‐1.9) %MVC; P = .019] and the pink noise [+1.1 (0.2‐2.0) %MVC; P = .014] blocks. EMGbruxism was significantly affected by the interaction group by experimental block (P < .001). In mTMD participants, compared to the pink noise block [mean (95% CI); 23.8 (16.0‐31.6) %MVC], EMGbruxism increased during the stressful music block [contrast estimate (95% CI); +10.2 (8.6‐11.8) %MVC], and decreased during the relaxing [−6.2 (−8.1 to −4.3) %MVC; P < .001] and favorite [−10.2 (−12.2 to −9.1) %MVC; P < .001] music blocks. These effects were not observed in the control group [mean (95% CI); pink noise: 19.3 (10.9‐27.6); stressful: 21.2 (12.9‐29.4) %MVC; relaxing: 21.6 (13.3‐29.9) %MVC; favorite: 24.2 (15.8‐32.7) %MVC; all P > .05]. EMGbruxism was significantly greater in mTMD partici...

The association between sleep bruxism and awake bruxism: Polysomnographic and electromyographic recordings in women with and without myofascial pain

“…Stress has a role as a contributing factor for AB 12–15 . Tooth clenching induced by guided music listening increased when listening to stressful music 16 . However, the changes in tooth clenching after listening to stressful music were different between high and low parafunctional groups 17 .…”

“…[12][13][14][15] Tooth clenching induced by guided music listening increased when listening to stressful music. 16 However, the changes in tooth clenching after listening to stressful music were different between high and low parafunctional groups. 17 AB would play a part in stress coping that may differ between individuals.…”

Identification of central amygdala and trigeminal motor nucleus connectivity in humans: An ultra‐high field diffusion MRI study

“…There is evidence that awake‐bruxism plays a crucial role in the onset and maintenance of myogenic temporomandibular disorders (mTMD), which are characterized primarily by spontaneous pain or pain associated with jaw function (Schiffman et al, 2014; Slade et al, 2016). Importantly, experimental interventions aiming at improving mood by reducing stress and anxiety have been shown to modulate (i.e., increase or decrease) awake bruxism based on the emotional valence of the stimulus (Imbriglio et al, 2020), and that this effect is present in individuals with chronic mTMD but not healthy controls. Therefore, it is highly probable that amygdala plays an important role in modulating jaw motor function in individuals with chronic mTMD.…”

A novel neuromotor reprogramming treatment modality for temporomandibular disorders: a pilot retrospective observational study

“…Additionally, patients with TMD seem to be associated with increased activity in brain areas involved in emotional processing (Weissman-Fogel et al, 2011), suggesting that individuals with this pathology may be more sensitive to music. Among the different technics that can be used for TMD, Imbriglio et al recently demonstrated if adequate music is selected, passive music listening might have positive effects in TMD (Imbriglio et al, 2020). Interestingly, there is evidence of a link between auditory and motor systems in the brain (Chen et al, 2008).…”