Somatosensory Training Versus Exercise Therapy in Awake Bruxism: A Randomized Controlled Trial
Awake bruxism (daytime teeth clenching or jaw tension) is a common condition that can cause jaw pain, facial pain, muscle fatigue, and reduced quality of life. Although current treatments often focus on the jaw muscles and posture, recent research suggests that changes in the brain's sensory processing may also play an important role in bruxism-related pain. This randomized controlled trial aims to compare two physiotherapy-based treatment approaches with a wait-list control group in adults with awake bruxism. Participants will be randomly assigned to one of three groups: (1) somatosensory awareness-based training, (2) jaw and posture exercise therapy, or (3) a wait-list control group. The somatosensory training program focuses on improving body awareness and sensory perception of the face and jaw, while the exercise program includes jaw mobility, postural alignment, and cervical exercises. Both active interventions will be delivered over a 4-week period. Participants will be assessed at baseline, immediately after treatment, and during follow-up to evaluate changes over time. The main outcome of this study is orofacial pain intensity. Secondary outcomes include jaw function, sensory processing, muscle structure, oral parafunctional behaviors, and oral health-related quality of life. The results of this study may help improve physiotherapy-based treatment strategies for people with awake bruxism by addressing both physical and sensory aspects of the condition.
• Adults aged 18 to 45 years
• Clinical diagnosis of awake bruxism confirmed using standardized diagnostic criteria (STAB and DC/TMD Axis I)
• Presence of at least one measurable somatosensory alteration confirmed at baseline using digital and clinical assessments
• Self-reported daytime jaw clenching or parafunctional activity
• Baseline orofacial pain intensity of ≥5/10 on a Visual Analog Scale (VAS)
• Chronic pain graded as GCPS Grades I-III according to DC/TMD Axis II (Turkish validated version)
• Willingness to comply with the study protocol and attend scheduled treatment sessions
• Ability to understand the study procedures and provide written informed consent