Modulation of Jaw Muscle Motor Response and Wake-Time Parafunctional Tooth Clenching with Music

Aims: To evaluate the effects of Guided Music Listening (GML) on masticatory muscles and on the amplitude of wake-time tooth clenching in individuals with higher vs lower frequency of clenching episodes. Methods: The electromyographic (EMG) activity of the right masseter was recorded during three 20-minute music (relaxing, stress/tension, and favorite) tasks and a control no-music task in 10 (mean age ± standard deviation [SD] = 21.4 ± 3.0 years) and 11 (22.6 ± 2.9 years) healthy volunteers with higher (HP) vs lower (LP) frequency of tooth-clenching episodes, respectively. EMG episodes greater than 10% of the maximum voluntary contraction (EMG activity of the masseter during tooth clenching) and below 10% (EMG activity during rest) were analyzed. Nonparametric tests were used to assess between-group and within-group (between-task) differences in primary outcome measures. Results: In both groups, EMG activity during rest was the greatest during the stress/tension task, and it was the lowest during the favorite task in the LP group and the relaxing task in the HP group (all P < .001). In the HP group, the amplitude of clenching episodes was significantly lower during the favorite and stress/tension tasks than during the relaxing task (all P < .05), while in the LP group, it was significantly lower during the stress/tension task than during the control task (P = .001). The experiment did not affect the frequency or duration of clenching episodes. Conclusion: GML modulates masticatory muscle activity. The response to GML depends on the frequency of clenching and the type of music.

bruxism;guided music listening;oral behaviors;surface electromyography;temporomandibular joint disorders

1. Slade GD, Ohrbach R, Greenspan JD, et al. Painful temporo- mandibular disorder: Decade of discovery from OPPERA studies. J Dent Res 2016;95:1084–1092.

2. John MT, Reissmann DR, Schierz O, Wassell RW. Oral health-related quality of life in patients with temporomandibular disorders. J Orofac Pain 2007;21:46–54.

3. Cioffi I, Perrotta S, Ammendola L, et al. Social impairment of individuals suffering from different types of chronic orofacial pain. Prog Orthod 2014;15:27.

4. Almoznino G, Zini A, Zakuto A, et al. Oral health-related qual- ity of life in patients with temporomandibular disorders. J Oral Facial Pain Headache 2015;29:231–241.

5. Greene CS. The etiology of temporomandibular disorders: Implications for treatment. J Orofac Pain 2001;15:93–105.

6. Suvinen TI, Reade PC, Kemppainen P, Könönen M, Dworkin SF. Review of aetiological concepts of temporomandibular pain disorders: Towards a biopsychosocial model for integra- tion of physical disorder factors with psychological and psy- chosocial illness impact factors. Eur J Pain 2005;9:613–633.

7. Huang GJ, LeResche L, Critchlow CW, Martin MD, Drangsholt MT. Risk factors for diagnostic subgroups of painful temporo- mandibular disorders (TMD). J Dent Res 2002;81:284–288.

8. Michelotti A, Cioffi I, Festa P, Scala G, Farella M. Oral para- functions as risk factors for diagnostic TMD subgroups. J Oral Rehabil 2010;37:157–162.

9 Ohrbach R, Markiewicz MR, McCall WD Jr. Waking-state oral parafunctional behaviors: Specificity and validity as assessed by electromyography. Eur J Oral Sci 2008;116:438–444.

10. Koutris M, Lobbezoo F, Sümer NC, Atis¸ ES, Türker KS, Naeije M. Is myofascial pain in temporomandibular disorder patients a manifestation of delayed-onset muscle soreness? Clin J Pain 2013;29:712–716.

11. Ohrbach R, Bair E, Fillingim RB, et al. Clinical orofacial charac- teristics associated with risk of first-onset TMD: The OPPERA prospective cohort study. J Pain 2013;14(suppl):T33–T50.

12. Chen CY, Palla S, Erni S, Sieber M, Gallo LM. Nonfunctional tooth contact in healthy controls and patients with myogenous facial pain. J Orofac Pain 2007;21:185–193.

13. Cioffi I, Landino D, Donnarumma V, Castroflorio T, Lobbezoo F, Michelotti A. Frequency of daytime tooth clenching epi- sodes in individuals affected by masticatory muscle pain and pain-free controls during standardized ability tasks. Clin Oral Investig 2017;21:1139–1148.

14. Farella M, Soneda K, Vilmann A, Thomsen CE, Bakke M. Jaw muscle soreness after tooth-clenching depends on force level. J Dent Res 2010;89:717–721.

15. Milosevic A, Lennon MA, Fear SC. Risk factors associated with tooth wear in teenagers: A case control study. Community Dent Health 1997;14:143–147.

16. Pigno MA, Hatch JP, Rodrigues-Garcia RC, Sakai S, Rugh JD. Severity, distribution, and correlates of occlusal tooth wear in a sample of Mexican-American and European-American adults. Int J Prosthodont 2001;14:65–70.

17. Manfredini D, Lobbezoo F. Role of psychosocial factors in the etiology of bruxism. J Orofac Pain 2009;23:153–166.

18. Endo H, Kanemura K, Tanabe N, Takebe J. Clenching occur- ring during the day is influenced by psychological factors. J Prosthodont Res 2011;55:159–164.

19. Winocur E, Uziel N, Lisha T, Goldsmith C, Eli I. Self-reported bruxism—Associations with perceived stress, motivation for control, dental anxiety and gagging. J Oral Rehabil 2011; 38:3–11.

20. Michelotti A, Cioffi I, Landino D, Galeone C, Farella M. Effects of experimental occlusal interferences in individuals report- ing different levels of wake-time parafunctions. J Orofac Pain 2012;26:168–175.

21. Cioffi I, Michelotti A, Perrotta S, Chiodini P, Ohrbach R. Effect of somatosensory amplification and trait anxiety on ex- perimentally induced orthodontic pain. Eur J Oral Sci 2016; 124:127–134.

22. Thoma MV, La Marca R, Brönnimann R, Finkel L, Ehlert U, Nater UM. The effect of music on the human stress response. PLoS One 2013;8:e70156.

23. Crawford C, Lee C, Bingham J, Active Self-Care Therapies for Pain (PACT) Working Group. Sensory art therapies for the self-management of chronic pain symptoms. Pain Med 2014; 15(suppl):s66–s75.

24. Thoma MV, Zemp M, Kreienbühl L, et al. Effects of Music Listening on pre-treatment anxiety and stress levels in a dental hygiene recall population. Int J Behav Med 2015;22:498–505.

25. Michaelis K, Wiener M, Thompson JC. Passive listening to pre- ferred motor tempo modulates corticospinal excitability. Front Hum Neurosci 2014;8:252.

26. Stupacher J, Hove MJ, Novembre G, Schütz-Bosbach S, Keller PE. Musical groove modulates motor cortex excitability: A TMS investigation. Brain Cogn 2013;82:127–136.

27. Mizumori T, Kobayashi Y, Inano S, Sumiya M, Murashima F, Yatani H. No effect of conscious clenching on simple arithmetic task in healthy subjects. J Prosthodont Res 2011;55:189–192.

28. Markiewicz MR, Ohrbach R, McCall WD Jr. Oral behaviors checklist: Reliability of performance in targeted waking-state behaviors. J Orofac Pain 2006;20:306–316.

29. Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: Recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache 2014;28:6–27.

30. Spielberger CD, Gorsuch RL, Lushene RE. STAI Manual for the State-Trait Anxiety Inventory (“Self-Evaluation Questionnaire”). Palo Alto: Consulting Psychologists, 1970.

31. Barsky AJ, Goodson JD, Lane RS, Cleary PD. The amplification of somatic symptoms. Psychosom Med 1988;50:510–519.

32. Ohrbach R, Gale EN. Pressure pain thresholds in normal mus- cles: Reliability, measurement effects, and topographic differ- ences. Pain 1989;37:257–263.

33. Castroflorio T, Farina D, Bottin A, Piancino MG, Bracco P, Merletti R. Surface EMG of jaw elevator muscles: Effect of electrode location and inter-electrode distance. J Oral Rehabil 2005;32:411–417.

34. Templeton GF, Burney LL. Using a two-step transformation to address non-normality from a business value of information technology perspective. J Inform Syst 2017;31:149–164.

35. Cioffi I, Farella M, Festa P, Martina R, Palla S, Michelotti A. Short- term sensorimotor effects of experimental occlusal interferenc- es on the wake-time masseter muscle activity of females with masticatory muscle pain. J Oral Facial Pain Headache 2015; 29:331–339.

36. Roark AL, Glaros AG, O’Mahony AM. Effects of interocclusal appliances on EMG activity during parafunctional tooth con- tact. J Oral Rehabil 2003;30:573–577.

37. Michelotti A, Farella M, Stellato A, Martina R, De Laat A. Tactile and pain thresholds in patients with myofascial pain of the jaw muscles: A case-control study. J Orofac Pain 2008; 22:139–145.

38. Al-Harthy M, Ohrbach R, Michelotti A, List T. The effect of cul- ture on pain sensitivity. J Oral Rehabil 2016;43:81–88.

39. Lee JH. The effects of music on pain: A meta-analysis. J Music Ther 2016;53:430–477.

40. Bradt J, Dileo C, Shim M. Music interventions for preoperative anxiety. Cochrane Database Syst Rev 2013;(6):CD006908.

41. Bengtsson SL, Ullén F, Ehrsson HH, et al. Listening to rhythms activates motor and premotor cortices. Cortex 2009;45:62–71.

42. Wilson EM, Davey NJ. Musical beat influences corticospi- nal drive to ankle flexor and extensor muscles in man. Int J Psychophysiol 2002;44:177–184.

43. Droit-Volet S, Ramos D, Bueno JL, Bigand E. Music, emotion, and time perception: The influence of subjective emotional va- lence and arousal? Front Psychol 2013;4:417.

44. McCraty R, Barrios-Choplin B, Atkinson M, Tomasino D. The effects of different types of music on mood, tension, and men- tal clarity. Altern Ther Health Med 1998;4:75–84.

45. Bonin T, Smilek D. Inharmonic music elicits more negative affect and interferes more with a concurrent cognitive task than does harmonic music. Atten Percept Psychophys 2016; 78:946–959.

46. Mayfield C, Moss S. Effect of music tempo on task perfor-mance. Psychol Rep 1989;65:1283–1290.