Background Electromyography (EMG) biofeedback (BF) training is potentially an effective cognitive‐behavioural approach to regulate bruxism. Objective This study examined sleep bruxism regulation by daytime clenching control using a single‐channel auditory EMG BF device. Methods Seventeen male subjects (mean age, 24.4 ± 3.1 years; mean ± SD) with self‐reported awake/sleep bruxism were recruited and divided into a BF (n = 10) and a control (CO) group (n = 7). All subjects underwent four EMG recording sessions during both daytime and sleep over 3 weeks. During the daytime, in week 2, the BF group received feedback alert signals when excessive EMG activity with certain burst duration was detected while the subjects performed regular daily activities. The CO group underwent EMG recording sessions without receiving any alerts of parafunctional activity. The number of phasic burst events during sleep was compared between the BF and CO groups. Results While the number of phasic EMG events was not significantly different between the BF and CO groups at baseline, significantly smaller phasic events were observed in the BF compared to the CO group at the follow‐up session (week 3) (P = .006, Tukey's HSD). Since daytime BF training is aimed at raising awareness of awake bruxism, it does not interrupt the sleep sequence or involve associated side effects. Conclusion The present results suggest that EMG BF targeting for tonic EMG events during the daytime can be an effective method to regulate phasic EMG events during sleep.

Bruxism contributes to the development of temporomandibular disorders as well as causes dental problems. Although it is an important issue in clinical dentistry, no treatment approaches have been proven effective. This study aimed to use electromyogram (EMG) biofeedback (BF) training to improve awake bruxism (AB) and examine its effect on sleep bruxism (SB). Twelve male participants (mean age, 26·8 ± 2·5 years) with subjective symptoms of AB or a diagnosis of SB were randomly divided into BF (n = 7) and control (CO, n = 5) groups to undergo 5-h daytime and night-time EMG measurements for three consecutive weeks. EMG electrodes were placed over the temporalis muscle on the habitual masticatory side. Those in the BF group underwent BF training to remind them of the occurrence of undesirable clenching activity when excessive EMG activity of certain burst duration was generated in week 2. Then, EMGs were recorded at week 3 as the post-BF test. Those in the CO group underwent EMG measurement without any EMG BF training throughout the study period. Although the number of tonic EMG events did not show statistically significant differences among weeks 1-3 in the CO group, events in weeks 2 and 3 decreased significantly compared with those in week 1, both daytime and night-time, in the BF group (P < 0·05, Scheffé's test). This study results suggest that EMG BF to improve AB tonic EMG events can also provide an effective approach to regulate SB tonic EMG events.

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Abstract:Although daytime clenching is believed to be one of the oral parafunctions leading to dental problems, a treatment strategy has not yet been devised. Electromyogram (EMG) biofeedback (BF) training was performed to ascertain its effect on regulating daytime clenching behavior. However, the long-term effects remain unknown. Therefore, the purpose of this study was to determine the learning effect concerning one month after EMG-BF training.Twelve subjects (7 males, 5 females: mean age; 31.5 ± 6.3 years) who had mild masticatory muscle pain with daytime clenching behavior were divided into the BF group (n=6) and control (CO) group (n=6) in a random fashion.Subjects were fitted with a hearing-aid-shaped EMG biofeedback apparatus, which was used to record EMG data under natural conditions from the temporal muscle, continuously for five hours on four consecutive days and 1 month after (1 Mo). EMG data on Days 1, 4 and 1 Mo were recorded without biofeedback as the pre-test, post-test, and follow-up test, respectively. On Days 2 and 3, subjects in the BF group were alerted to their clenching behaviors via an alert sound from the EMG biofeedback apparatus. No alert sound was given to the CO group throughout the recording sessions.No significant difference was observed in the number of clenching events for five hours between the BF group (7.3 ± 5.1) and CO group (7.5 ± 2.1) on Day 1; however, significant decreases were found in the BF group between Day 1 (7.3 ± 5.1) and Day 4 (2.3 ± 1.5; p < 0.05), and Day 1 and 1 Mo (2.0 ± 1.1; p < 0.05; Wilcoxon with Bonferroni's

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