Theoretical Basis and Application of Massed Practice Exercises for the Elimination of Tooth Grinding Habits

TRADITIONAL ATTEMPTS to eliminate bruxing and clench­ ing habits have involved the equilibration of the patient's dentition, the wearing of night guards, and in extreme instances referral of the patient for psychiatric treatment. However, these approaches, by and large, have been remarkable for their lack of success in eliminating pathologic grinding habits. Recent efforts by Ayer and Gale 1 and Ayer and Levin 2 appear to offer a promising method for extinguishing these habits based on a psychologic technique known as massed practice therapy. With this approach, the pa­ tient's nocturnal grinding habits were treated by having him repeatedly clench his teeth together during the waking hours. At a 1-month posttreatment appointment, the patients indicated that they were still free of the habit. The recent findings of Rugh and Solberg 3 have provided additional support for the efficacy of this therapeutic modality. The purpose of the present paper is to describe in greater detail the theoretical model on which massed practice is based and also to update the original studies by providing data on the outcome of treatment at 1 year follow-up. This is particularly important in light of the fact that few bruxism studies tend to report long term follow-ups.