Stres ve Parafonksiyonel Alışkanlıkların Yönetiminde Klinik Hipnoz: Bruksizm Örneği
Özet
Klinik hipnoz, stresle ilişkili oral durumların ve parafonksiyonel alışkanlıkların yönetiminde tamamlayıcı bir terapötik yaklaşım olarak giderek daha fazla ilgi görmektedir. Bruksizm; diş sıkma veya gıcırdatma ile karakterize, sıklıkla stres ve anksiyete gibi psikolojik faktörlerle ilişkili çok faktörlü bir durumdur. Süreklilik gösteren bruksizm; diş dokusu kaybı, restorasyon kırıkları, temporomandibular eklem bozuklukları ve çiğneme kası ağrısı gibi çeşitli klinik komplikasyonlara yol açabilmektedir. Bu bölümde hipnozun nörobiyolojik ve bilişsel temelleri ele alınmakta ve özellikle protetik diş tedavisi bağlamında diş hekimliğindeki potansiyel kullanım alanları değerlendirilmektedir. Hipnozun stres yanıtının düzenlenmesi, otonom sinir sistemi aktivitesinin modülasyonu ve aşırı çiğneme kası aktivitesinin azaltılması üzerinde olumlu etkiler sağlayabileceği bildirilmektedir. Ayrıca hipnotik teknikler, dental anksiyetenin azaltılması, hasta iş birliğinin artırılması ve protezlere adaptasyon sürecinin desteklenmesine katkıda bulunabilir. Bruksizm yönetiminde hipnoterapinin, oklüzal splint gibi konvansiyonel mekanik yaklaşımlarla birlikte kullanılması daha bütüncül ve multidisipliner bir tedavi stratejisi sunabilir.
Clinical hypnosis has increasingly been recognized as a complementary therapeutic approach in the management of stress-related oral conditions and parafunctional habits, particularly bruxism. Bruxism is a multifactorial condition characterized by involuntary clenching or grinding of the teeth and is frequently associated with psychological factors such as stress and anxiety. Persistent bruxism may lead to significant complications, including tooth wear, fracture of dental restorations, temporomandibular disorders, and masticatory muscle pain. This chapter discusses the neurobiological and cognitive foundations of hypnosis and examines its potential role in dental practice, especially within prosthodontic treatment. Hypnosis may contribute to the regulation of stress responses, modulation of autonomic nervous system activity, and reduction of excessive masticatory muscle activity. In addition, hypnotic techniques can support patient cooperation, reduce dental anxiety, and facilitate adaptation to prosthetic appliances. In the context of bruxism management, hypnotherapy may serve as a supportive behavioral intervention targeting underlying psychological and neuromuscular mechanisms. Integrating hypnosis with conventional mechanical approaches such as occlusal splints may therefore provide a more comprehensive and multidisciplinary strategy for managing bruxism and improving long-term prosthetic outcomes.
Referanslar
Cahn BR, Polich J. Meditation states and traits: EEG, ERP, and neuroimaging studies. Psychol Bull. 2006;132(2):180–211
Vayne-Bossert P. Hypnosis for Symptom Management in Adult Cancer Patients: What is the Evidence? Curr Treat Options Oncol. 2024 Mar;25(3):364-375. doi: 10.1007/s11864-023-01168-y. Epub 2024 Jan 4. PMID: 38236333; PMCID: PMC10894763.
Phillips W, Price J, Molyneux PD, et al. HypnosisPractical Neurology 2022;22:42-47.
Allison N. Hypnosis in modern dentistry: Challenging misconceptions. FDJ 2015;6:172-5.
Andrick JM. Cultivating a “chairside manner”: dental hypnosis,patient management psychology, and the origins of behavioraldentistry in America, 1890-1910. J Hist Behav Sci 2013; 49: 235-258.
Abdeshahi SK, Hashemipour MA, Mesgarzadeh V, ShahidiPayam A, Halaj Monfared A. Effect of hypnosis on induction oflocal anaesthesia, pain perception, control of haemorrhage andanxiety during extraction of third molars: a case-control study.J Craniomaxillofac Surg 2013; 41: 310-315.
Facco E, Zanette G, Casiglia E. The role of hypnotherapy indentistry. SAAD Dig 2014; 30: 3-6.
Eli I. Oral Psychophysiology: Stress, Pain, and Behavior in Dental Care.Boca Raton, FL: CRC Press, Inc.; 1992.
Morse, D. R., Hancock, R. R., & Cohen, B. B. (1984). In vivo desensitization using meditation-hypnosis in the treatment of tactile-induced gagging in a dental patient. International Journal of Psychosomatics, 31(3), 20–23.
Kirsch, I., Montgomery, G., & Sapirstein, G. (1995). Hypnosis as an adjunct to cognitive-behavioral psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 63(2), 214–220. https://doi.org/10.1037/0022-006X.63.2.214
Beri A Jr, Pisulkar SG, Bansod AV, Dahihandekar C. Alternative Prosthodontic Therapies: A Multifaceted Approach. Cureus. 2022 Sep 20;14(9):e29363. doi: 10.7759/cureus.29363. PMID: 36284813; PMCID: PMC9584032.
Chiappelli F, Iribarren FJ, Prolo P. Salivary biomarkers in psychobiological medicine. Bioinformation. 2006 Dec 29;1(8):331-4.
Cawson RA, Odell EW, Porter SR. Cawson’s Essentials of Oral Pathology and Oral Medicine. 7th ed. Edinburgh, New York:Churchill Livingstone, 2002:364-6
Emodi-Perlman A, Eli I, Friedman-Rubin P, Goldsmith C, Reiter S, Winocur E. Bruxism, oral parafunctions, anamnestic and clinical findings of temporomandibular disorders in children. J Oral Rehabil. 2012 Feb;39(2):126-35
Eli I. Self-reported bruxism - associations with perceived stress, motivation for control, dental anxiety and gagging. J Oral Rehabil. 2011 Jan;38(1):3-11.
Koyano K, Tsukiyama Y, Ichiki R, Kuwata T. Assessment of bruxism in the clinic. J Oral Rehabil.2008; 35: 495-508.
Klasser G, Greene C. Role of Oral Appliances in the Management of Sleep Bruxism andTemporomandibular Disorders. Alpha Omegan. 2007; 100: 111-9.
Pop-Jordanova N, Loleska S. On Psychosomatic Problems in Dentistry. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2020 Jun 1;41(1):57-63. doi: 10.2478/prilozi-2020-0023. PMID: 32573480.
Nisar H, Srivastava R. Fundamental concept of psychosomatic disorders: a review. International Journal of Contemporary Medicine Surgery and Radiology. 2018; 3(1): 12–18.
Shetty S, Pitti V, [...], and B. C. Deepthi. Bruxism: A Literature Review. J Indian Prosthodont Soc. 2010 Sep; 10(3): 141–148.
Laat A, Macaluso GM. Sleep bruxism as a motor disorder. Mov Disord. 2002; 17: S67–S69. doi:10.1002/mds.10064.
Ohayon MM, Li KK, Guilleminault C. Risk factors for sleep bruxism in the general population. Chest. 2001; 119: 53–61. doi: 10.1378/chest.119.1.53
Lobbezoo F, Van der Zaag J, Van Selms MK, Hamburger HL, Naeije M. Principles for themanagement of bruxism. J Oral Rehabil. 2008 Jul;35(7):509-23.
Beddis H, Pemberton, M, Davies S. Sleep bruxism: an overview for clinicians. Br Dent J. 2018 Sep28;225(6):497-501.
Fernández-Núñez T, Amghar-Maach S, Gay-Escoda C. Efficacy of botulinum toxin in the treatmentof bruxism: Systematic review. Med Oral Patol Oral Cir Bucal. 2019 Jul 01;24(4):416-424.
Yanıkoğu N. Bruksizm, edi; Taştan K. Bilinmeyen Yönleriyle Hipnoz ve Hipnoterapi. 1. Baskı,Erzurum. Zafer Yayınevi. 2019;955-978.
Clarke JH, Reynolds PJ. Suggestive hypnotherapy for nocturnal bruxism: A pilot study. Am J Clin Hypn 1991; 33:248-253.
Clark JH. (1997) The role of hypnosis in treating bruxism. In: Hypnosis in Dentistry. Hypnosis International Monographs No.3. Germany: M.E.G. Stiftung, pp.79-85.
Simon EP, Lewis DM. Medical hypnosis for temporomandibular disorders: treatment efficacy and medical utilization outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Jul;90(1):54-63. doi: 10.1067/moe.2000.106692. PMID: 10884636.
E. Thomas Dowd (2013) Nocturnal Bruxism and Hypnotherapy: A Case
Study , International Journal of Clinical and Experimental Hypnosis, 61:2, 205-218, DOI:10.1080/00207144.2013.753832
Minakuchi H, Fujisawa M, Abe Y, et al. Managements of sleep bruxism in adult: A systematic review. Japanese Dental Science Review. 2022;58:124-136.
Yanıkoğlu N, Yılmaz AB, Taştan K. Bruksizmi Olan Hastaların Hipnoterapi ile Rehabilitasyonu: 3 Vaka Sunumu. Anadolu Tıbbı Dergisi. 2022; 2: 1-5.
Tandon A, Singh BP, Shanker R, Agrawal KK, Mahour P, Tripathi S. Efficacy of occlusal splint versus sleep hygiene and progressive muscle relaxation on perceived stress and sleep bruxism: A randomized clinical trial. Journal of Prosthodontics. 2024. doi: 10.1111/jopr.13917.
Kent, Gerry. “HARTLAND'S MEDICAL AND DENTAL HYPNOSIS, 4TH EDITION.” Contemporary Hypnosis, vol. 21, no. 1, Jan. 2004, pp. 46–47.
Hammond, D. Corydon, ed. Handbook of Hypnotic Suggestions and Metaphors. New York: W. W. Norton & Company, 1990.
Terhune, D. B., Cleeremans, A., Raz, A., & Lynn, S. J. (2017). Hypnosis and top-down regulation of consciousness. Neuroscience & Biobehavioral Reviews, 81, 59-74.
Referanslar
Cahn BR, Polich J. Meditation states and traits: EEG, ERP, and neuroimaging studies. Psychol Bull. 2006;132(2):180–211
Vayne-Bossert P. Hypnosis for Symptom Management in Adult Cancer Patients: What is the Evidence? Curr Treat Options Oncol. 2024 Mar;25(3):364-375. doi: 10.1007/s11864-023-01168-y. Epub 2024 Jan 4. PMID: 38236333; PMCID: PMC10894763.
Phillips W, Price J, Molyneux PD, et al. HypnosisPractical Neurology 2022;22:42-47.
Allison N. Hypnosis in modern dentistry: Challenging misconceptions. FDJ 2015;6:172-5.
Andrick JM. Cultivating a “chairside manner”: dental hypnosis,patient management psychology, and the origins of behavioraldentistry in America, 1890-1910. J Hist Behav Sci 2013; 49: 235-258.
Abdeshahi SK, Hashemipour MA, Mesgarzadeh V, ShahidiPayam A, Halaj Monfared A. Effect of hypnosis on induction oflocal anaesthesia, pain perception, control of haemorrhage andanxiety during extraction of third molars: a case-control study.J Craniomaxillofac Surg 2013; 41: 310-315.
Facco E, Zanette G, Casiglia E. The role of hypnotherapy indentistry. SAAD Dig 2014; 30: 3-6.
Eli I. Oral Psychophysiology: Stress, Pain, and Behavior in Dental Care.Boca Raton, FL: CRC Press, Inc.; 1992.
Morse, D. R., Hancock, R. R., & Cohen, B. B. (1984). In vivo desensitization using meditation-hypnosis in the treatment of tactile-induced gagging in a dental patient. International Journal of Psychosomatics, 31(3), 20–23.
Kirsch, I., Montgomery, G., & Sapirstein, G. (1995). Hypnosis as an adjunct to cognitive-behavioral psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 63(2), 214–220. https://doi.org/10.1037/0022-006X.63.2.214
Beri A Jr, Pisulkar SG, Bansod AV, Dahihandekar C. Alternative Prosthodontic Therapies: A Multifaceted Approach. Cureus. 2022 Sep 20;14(9):e29363. doi: 10.7759/cureus.29363. PMID: 36284813; PMCID: PMC9584032.
Chiappelli F, Iribarren FJ, Prolo P. Salivary biomarkers in psychobiological medicine. Bioinformation. 2006 Dec 29;1(8):331-4.
Cawson RA, Odell EW, Porter SR. Cawson’s Essentials of Oral Pathology and Oral Medicine. 7th ed. Edinburgh, New York:Churchill Livingstone, 2002:364-6
Emodi-Perlman A, Eli I, Friedman-Rubin P, Goldsmith C, Reiter S, Winocur E. Bruxism, oral parafunctions, anamnestic and clinical findings of temporomandibular disorders in children. J Oral Rehabil. 2012 Feb;39(2):126-35
Eli I. Self-reported bruxism - associations with perceived stress, motivation for control, dental anxiety and gagging. J Oral Rehabil. 2011 Jan;38(1):3-11.
Koyano K, Tsukiyama Y, Ichiki R, Kuwata T. Assessment of bruxism in the clinic. J Oral Rehabil.2008; 35: 495-508.
Klasser G, Greene C. Role of Oral Appliances in the Management of Sleep Bruxism andTemporomandibular Disorders. Alpha Omegan. 2007; 100: 111-9.
Pop-Jordanova N, Loleska S. On Psychosomatic Problems in Dentistry. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2020 Jun 1;41(1):57-63. doi: 10.2478/prilozi-2020-0023. PMID: 32573480.
Nisar H, Srivastava R. Fundamental concept of psychosomatic disorders: a review. International Journal of Contemporary Medicine Surgery and Radiology. 2018; 3(1): 12–18.
Shetty S, Pitti V, [...], and B. C. Deepthi. Bruxism: A Literature Review. J Indian Prosthodont Soc. 2010 Sep; 10(3): 141–148.
Laat A, Macaluso GM. Sleep bruxism as a motor disorder. Mov Disord. 2002; 17: S67–S69. doi:10.1002/mds.10064.
Ohayon MM, Li KK, Guilleminault C. Risk factors for sleep bruxism in the general population. Chest. 2001; 119: 53–61. doi: 10.1378/chest.119.1.53
Lobbezoo F, Van der Zaag J, Van Selms MK, Hamburger HL, Naeije M. Principles for themanagement of bruxism. J Oral Rehabil. 2008 Jul;35(7):509-23.
Beddis H, Pemberton, M, Davies S. Sleep bruxism: an overview for clinicians. Br Dent J. 2018 Sep28;225(6):497-501.
Fernández-Núñez T, Amghar-Maach S, Gay-Escoda C. Efficacy of botulinum toxin in the treatmentof bruxism: Systematic review. Med Oral Patol Oral Cir Bucal. 2019 Jul 01;24(4):416-424.
Yanıkoğu N. Bruksizm, edi; Taştan K. Bilinmeyen Yönleriyle Hipnoz ve Hipnoterapi. 1. Baskı,Erzurum. Zafer Yayınevi. 2019;955-978.
Clarke JH, Reynolds PJ. Suggestive hypnotherapy for nocturnal bruxism: A pilot study. Am J Clin Hypn 1991; 33:248-253.
Clark JH. (1997) The role of hypnosis in treating bruxism. In: Hypnosis in Dentistry. Hypnosis International Monographs No.3. Germany: M.E.G. Stiftung, pp.79-85.
Simon EP, Lewis DM. Medical hypnosis for temporomandibular disorders: treatment efficacy and medical utilization outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Jul;90(1):54-63. doi: 10.1067/moe.2000.106692. PMID: 10884636.
E. Thomas Dowd (2013) Nocturnal Bruxism and Hypnotherapy: A Case
Study , International Journal of Clinical and Experimental Hypnosis, 61:2, 205-218, DOI:10.1080/00207144.2013.753832
Minakuchi H, Fujisawa M, Abe Y, et al. Managements of sleep bruxism in adult: A systematic review. Japanese Dental Science Review. 2022;58:124-136.
Yanıkoğlu N, Yılmaz AB, Taştan K. Bruksizmi Olan Hastaların Hipnoterapi ile Rehabilitasyonu: 3 Vaka Sunumu. Anadolu Tıbbı Dergisi. 2022; 2: 1-5.
Tandon A, Singh BP, Shanker R, Agrawal KK, Mahour P, Tripathi S. Efficacy of occlusal splint versus sleep hygiene and progressive muscle relaxation on perceived stress and sleep bruxism: A randomized clinical trial. Journal of Prosthodontics. 2024. doi: 10.1111/jopr.13917.
Kent, Gerry. “HARTLAND'S MEDICAL AND DENTAL HYPNOSIS, 4TH EDITION.” Contemporary Hypnosis, vol. 21, no. 1, Jan. 2004, pp. 46–47.
Hammond, D. Corydon, ed. Handbook of Hypnotic Suggestions and Metaphors. New York: W. W. Norton & Company, 1990.
Terhune, D. B., Cleeremans, A., Raz, A., & Lynn, S. J. (2017). Hypnosis and top-down regulation of consciousness. Neuroscience & Biobehavioral Reviews, 81, 59-74.
