Sensory trick splint as a multimodal therapy for oromandibular dystonia

Abstract

Purpose: Many patients with oromandibular dystonia, which is characterized by involuntary masticatory, lower facial, and/or tongue muscle contractions, experience relief of symptoms through sensory tricks such as eating chewing gum or candy. The aim of this study was to identify the factors influencing the effects of splints in patients with oromandibular dystonia. Methods: Occlusal splints were inserted in 128 patients (89 women, 39 men) with oromandibular dystonia (102 with jaw closing dystonia, 20 with lingual dystonia, 5 with jaw deviation dystonia, 4 with jaw opening dystonia, 3 with lip dystonia, and 2 with jaw protrusion dystonia). Patients who showed improvement with the use of splints and continued to wear them for at least 3 months were defined as responders. In contrast, patients who showed little or no effect and/or were unable to insert splints were defined as non-responders. Differences in demographic and clinical data were statistically compared between responders and non-responders. Results: Ninety-eight patients (76.6%) were responders (subjective improvement: 30.5%). Thirty patients (23.4%) were non-responders (subjective improvement: 7.2%). The responders were significantly older than the non-responders (53.8 years vs 47.0 years; p < 0.05). Patients with jaw closing dystonia showed the most favorable results. The proportion of patients with sensory tricks was significantly higher in responders than in non-responders (66.3% vs 26.7%; p < 0.05). Conclusions: The sensory trick splint is especially helpful for patients with jaw closing dystonia. It is useful, although partially effective, as an alternative therapy in patients for whom other therapies have been unsatisfactory.