Bracha, H. Stefan

Lenze, Stacy M.

Shelton, Jessica

English

Cognitive Sciences ePrint Archive

H. Stefan Bracha
Stacy M. Lenze
Jessica M. Shelton
Bruxism and autonomic
activity
Published online:
j Key words posttraumatic stress
disorder Æ evidence-based treat-
ment Æ sympathetic activation Æ
war veterans Æ warzone exposure
Sirs: Marthol and colleagues [3]
make an important contribution
to the neglected interface between
chronic-stress-induced sympa-
thetic activation and subsequent
teeth-clenching and grinding
(bruxism). Their findings are
consistent with both the clinical
and basic science literature. Re-
views of this large empirical liter-
ature conclude that sympathetic
activation is the precursor of
bruxism (and not the other way
around) (e.g. [1]). Propranolol
and prazosin have shown promise
in preventing progression from
jaw-clenching and teeth-grinding
to chronic musculofacial pain.
Research is sorely needed to study
the efficacy of alpha and beta
blockers for stress-induced brux-
ism in young individuals with
posttraumatic stress disorder or
following warzone exposure,
among which bruxism and related
symptoms are observed with
alarming frequency [1].
Importantly, a 2003 Cochrane
meta-analysis and an NIH tech-
nology assessment conference
both state that the invasive (and
often costly) dental procedures
currently used for bruxism
(including braces and other treat-
ments for dental malocclusion) are
not evidence-based and in some
cases contraindicated [2, 4].
References
1. Bracha HS, Ralston TC, Williams AE,
Yamashita JM, Bracha AS (2005) The
clenching-grinding spectrum and fear
circuitry disorders: clinical insights from
the neuroscience/paleoanthropology
interface. CNS Spectr: Int J Neuropsy-
chiatric Med 10:311–318
2. Koh H, Robinson PG (2003) Occlusal
adjustment for treating and preventing
temporomandibular joint disorders.
Cochrane Database Syst Rev CD003812
3. Marthol H, Reich S, Jacke J, Lechner KH,
Wichmann M, Hilz MJ (2006) Enhanced
sympathetic cardiac modulation in
bruxism patients. Clin Auton Res
16:276–280
4. NIH Consensus (1996) Management of
temporomandibular disorders. National
Institutes of Health Technology Assess-
ment Conference Statement. J Am Dent
Assoc 127:1595–1606
H.S. Bracha, MD (&) Æ S.M. Lenze
J.M. Shelton
National Center for PTSD
Dept. of Veterans Affairs
Pacific Islands Health Care System
Spark M. Matsunaga Medical Center
3375 Koapaka Street, Suite I-560
Honolulu (HI), 96819, USA
E-Mail h.bracha@med.va.gov
H.S. Bracha MD
Asia-Pacific Center for Biosecurity
Disaster & Conflict Research
John A. Burns School of Medicine
University of Hawaii
Honolulu (HI), USA
LETTER TO THE EDITOR
Clin Auton Res (2006) xx:1
DOI 10.1007/s10286-006-0380-1
C
A
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