Quantification of jaw reflexes evoked by natural tooth contact in human subjects

Abstract Inhibitory jaw reflexes are believed to be important for protecting the teeth and temporo-mandibular structures from damage during sudden or forceful biting or mastication. Accordingly, alterations in these reflexes are sometimes implicated in aetiologies proposed for oro-facial pain syndromes, although the association is not well-established. We now aim to develop a method for quantifying objectively inhibitory jaw reflexes evoked by natural tooth contact. In the longer term, this may provide a new approach to examining the association of altered reflexes and clinical conditions. Eighteen subjects gave their written, informed consent, and were recruited to participate in this study. They were instructed to clench their teeth together in response to visual cues. They performed two such tasks twenty times: from the jaw postural position and from a more open position with the jaws set 10 mm apart. Both tasks produced a rapid rise then stabilisation in electromyographic activity in the masseter muscle. This was always interrupted by a large inhibitory reflex starting 11.1 ± 1.5 ms (mean ± SD) after tooth contact. The inhibitions produced during the second task were similar but of significantly longer duration (24.3 ± 6.4 vs 18.4 ± 6.5 ms, P  = 0.0003, paired t -test) and greater magnitude (measured as an integral of the waveform: 1577 ± 478 vs 1279 ± 425%.ms, P  = 0.007, paired t -test). Interestingly, in a minority (13%) of the tasks, a second inhibition with a longer latency (50.9 ± 0.9 ms) was also observed. Thus reflex responses in the masseter muscle to natural tooth contact usually consist of single inhibitory periods. In this respect they are like those induced by externally applied tooth pushing although occasionally there is a second inhibition, reminiscent of that seen with externally applied tooth taps.