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Controlling bruxism through automated aversive conditioning
Bchav.
Res. k Therap),
1973. Vol.
I I. pp.327
CASE HISTORIES
to 329. Pergamon
Press. Printed
AND SHORTER
in England
COMMUNICATIONS
a non-functional gnashing and grinding of the teeth, occurring commonly during frequently leading to serious tooth disorders and tissue damage (Ramjford. 1961; Molin, 1066). of has been characterized as pervasive. Reding (1966) found that 5. I
the night and This disorder
328
CASE HISTORIES
AND SHORTER
COMMUNICATIONS
FIG. 1. A record of tooth grinding rate as influenced by the conditioning therapy: Baselinebefore conditioning; First Conditioning-use of conditioned avoidance; Reversal-removal of conditioned avoidance; Second Conditioning-reinstatement of conditioned avoidance.
DISCUSSION The results strongly suggest that bruxism can be controlled through the use of ak’erslve condttioning therapy admimstered in an automated manner. As the figure depicts, however. while we were able to reduce the frequency of the behavior greatly, we were not able to extinguish it completely. As sessions progressed, it became increasingly apparent that the subject was adjusting the intensity of his grinding as well as the frequency. Thus, in several instances, the taping device recorded low amplitude grinds that were below the ‘tripping’ threshold of the voice operated relay. Corrections for this shortcoming will be made in future applications where a miniature pressure-sensitive transducer will be affixed to that portion of the subject’s jaw in proximity to the masticatory muscles. Contraction of these muscles during the grinding behavior will operate the transducer, thus affording the system with an input of such sensitivity that total extinction of the behavior should be achievable. From the verbal reports of the subject, neither symptom substitution nor daytime fatigue accompanied the use of the aversive conditioning. Finally, regarding practical aspects pertaining to future use, it should be noted that the automated system was highly portable, relatively inexpensive to construct, and could be used in applications where other persons could sleep undisturbed in close proximity to a patient. Also the interval tape monitoring device will be unnecessary in future applications as the pressure-sensitive transducer will afford an accurate input for both frequency tabulation and the administration of intervention. University of Virginia, Charlorresrille, Virginia,
RORERT F. HELLER HAROLD R. STRANG*
U.S.A.
l Reprints may be obtained from Harold R. Strang, Department Education, University of Virginia, Charlottesville, Virginia 22903.
of Foundations
of Education,
School of
CASE HISTORIES AND
SHORTER
COMMUNICATIONS
329
REFERENCES AYERW. A. and GALE E. N. (1969) Extinction of bruxism by massed practice therapy. J. Can. Dcnr. Ass. 35, 492-494. BERNALM. E., GILI~OND. M., WILLIAMS D. E. and PESSESD. I. (1971) A device for automatic audio tape recording. J. Appl. Beh. Anal. 4, 151-156. BLJNDG~RD-JORGENSEN F. (1950) Afsplapningsovelser som led i behandlingen of habituelle dysfunktioner i mastikationsapparetet. Odont. Tidskr. 58, 448-454. GELBERDM. B. (1958) Treatment of bruxism. J. of Hypnosis ondf’s~~chol. in Dent. 1, 18. MOLIN C. and JONESR. W. (1966) A psychodontologic investigation of patients with bruxism. Acta Odont. &and. 24, 373-391. MOWRER0. H. (1938) Apparatus for the study and treatment of enuresis. Am. J. Psychol. 45.61-91. PO~~ELTU. cited by OLKINIJORAM. (1969) Bruxism-a review of the literature. . . Suom. Hunursluok Sew. Toim. 65.312-324. RAMJFORDS. P. (1961) A clinical and electromyographic study. .I. Am. Denf. Ass. 62, 214. REDINGG. R., RUBRIGHTW. C. and ZIMMERMAN S. 0. (1966) Incidence of bruxism. J. Dent. Res. 45, 11981204.
Res. k Therap),
1973. Vol.
I I. pp.327
CASE HISTORIES
to 329. Pergamon
Press. Printed
AND SHORTER
in England
COMMUNICATIONS
a non-functional gnashing and grinding of the teeth, occurring commonly during frequently leading to serious tooth disorders and tissue damage (Ramjford. 1961; Molin, 1066). of has been characterized as pervasive. Reding (1966) found that 5. I
the night and This disorder
328
CASE HISTORIES
AND SHORTER
COMMUNICATIONS
FIG. 1. A record of tooth grinding rate as influenced by the conditioning therapy: Baselinebefore conditioning; First Conditioning-use of conditioned avoidance; Reversal-removal of conditioned avoidance; Second Conditioning-reinstatement of conditioned avoidance.
DISCUSSION The results strongly suggest that bruxism can be controlled through the use of ak’erslve condttioning therapy admimstered in an automated manner. As the figure depicts, however. while we were able to reduce the frequency of the behavior greatly, we were not able to extinguish it completely. As sessions progressed, it became increasingly apparent that the subject was adjusting the intensity of his grinding as well as the frequency. Thus, in several instances, the taping device recorded low amplitude grinds that were below the ‘tripping’ threshold of the voice operated relay. Corrections for this shortcoming will be made in future applications where a miniature pressure-sensitive transducer will be affixed to that portion of the subject’s jaw in proximity to the masticatory muscles. Contraction of these muscles during the grinding behavior will operate the transducer, thus affording the system with an input of such sensitivity that total extinction of the behavior should be achievable. From the verbal reports of the subject, neither symptom substitution nor daytime fatigue accompanied the use of the aversive conditioning. Finally, regarding practical aspects pertaining to future use, it should be noted that the automated system was highly portable, relatively inexpensive to construct, and could be used in applications where other persons could sleep undisturbed in close proximity to a patient. Also the interval tape monitoring device will be unnecessary in future applications as the pressure-sensitive transducer will afford an accurate input for both frequency tabulation and the administration of intervention. University of Virginia, Charlorresrille, Virginia,
RORERT F. HELLER HAROLD R. STRANG*
U.S.A.
l Reprints may be obtained from Harold R. Strang, Department Education, University of Virginia, Charlottesville, Virginia 22903.
of Foundations
of Education,
School of
CASE HISTORIES AND
SHORTER
COMMUNICATIONS
329
REFERENCES AYERW. A. and GALE E. N. (1969) Extinction of bruxism by massed practice therapy. J. Can. Dcnr. Ass. 35, 492-494. BERNALM. E., GILI~OND. M., WILLIAMS D. E. and PESSESD. I. (1971) A device for automatic audio tape recording. J. Appl. Beh. Anal. 4, 151-156. BLJNDG~RD-JORGENSEN F. (1950) Afsplapningsovelser som led i behandlingen of habituelle dysfunktioner i mastikationsapparetet. Odont. Tidskr. 58, 448-454. GELBERDM. B. (1958) Treatment of bruxism. J. of Hypnosis ondf’s~~chol. in Dent. 1, 18. MOLIN C. and JONESR. W. (1966) A psychodontologic investigation of patients with bruxism. Acta Odont. &and. 24, 373-391. MOWRER0. H. (1938) Apparatus for the study and treatment of enuresis. Am. J. Psychol. 45.61-91. PO~~ELTU. cited by OLKINIJORAM. (1969) Bruxism-a review of the literature. . . Suom. Hunursluok Sew. Toim. 65.312-324. RAMJFORDS. P. (1961) A clinical and electromyographic study. .I. Am. Denf. Ass. 62, 214. REDINGG. R., RUBRIGHTW. C. and ZIMMERMAN S. 0. (1966) Incidence of bruxism. J. Dent. Res. 45, 11981204.