Bilateral Gum Chewing as Proprioceptive Sensorimotor Re-Education for Patients with Masticatory Muscle Weakness Presenting with Orofacial Pain and Perceived Occlusal Change: A Technical Note with a Retrospective Case Series

Bioengineering (Basel). 2026 Jul 17;13(7):826. doi: 10.3390/bioengineering13070826.

ABSTRACT

Within the Diagnostic Criteria for Temporomandibular Disorders, masticatory myalgia is framed around muscle hyperactivity, yet a recognizable subgroup shows the opposite profile-low muscle tone, fatigue, masticatory pain, and a persistent sense that the bite no longer fits, without structural dental change-and responds poorly to conventional conservative care. We introduce G-SCORE (Gum-chewing-mediated Sensorimotor Calibration of Occlusion through Rhythmic Exercise), a proprioceptive recalibration strategy delivered as a bilateral gum-chewing (BGC) protocol: two equal halves of one sugar-free gum chewed simultaneously and symmetrically on both posterior segments in short, patient-titrated sessions, delivering balanced, rhythmic, low-load input to the trigeminal sensorimotor system. In a retrospective series of 41 patients, we characterized within-subject changes in pain, mandibular mobility, and occlusal parameters. Masticatory pain fell from 5.0 ± 2.9 to 0.7 ± 0.9 (0-10; n = 27; p < 0.001; r = 0.87), with 85% achieving a ≥2-point reduction. Occluding tooth positions and mouth opening also recovered; in an anterior open-bite subgroup, overbite improved (n = 6; p = 0.031). The observed changes were dominated by pain relief and restored bilateral occlusal contact rather than by raw force-a pattern more compatible with sensorimotor recalibration than with muscle hypertrophy. This low-cost, non-invasive technique may help selected patients avoid irreversible occlusal treatment.

PMID:42510491 | DOI:10.3390/bioengineering13070826