Neuroscience LettersThe influence of dental occlusion on the body balance in unstable platform increases after high intensity exercise

Sonia Julià-Sánchez (a), Jesús Álvarez-Herms (a), Hannes Gatterer (b), Martin Burtscher (b), Teresa Pagès (a), Ginés Viscor (a)

(a) Departament de Fisiologia i Immunologia, Universitat de Barcelona (UB). (b) Department of Sport Science, Medical Section, University Innsbruck


• The relationship between dental occlusion and balance control remains unclear.
• 10 physically active subjects were analyzed prior to and following a maximal exercise.
• Body balance was evaluated in stable and unstable levels with occlusion in ICP and CR.
• Body balance was significantly better when dental occlusion was set in CR.
• Dental occlusion strongly influenced balance control in fatigue.

Existing evidence suggests that body balance ability is associated with dental occlusion. The purpose of this study was to determine whether: (i) there are differences in balance between opposed dental occlusion (intercuspal position, ICP; cotton rolls, CR) for two extreme levels of stability and (ii) the influence of dental occlusion on the balance control gets stronger under fatigue conditions. To this aim, various measures for assessing postural control in ten physically active subjects were obtained prior to and following a maximal lower limbs exercise consisting in six sets of fifteen seconds stretch-shortening cycle jumping. Balance control at stable and unstable condition was evaluated on an unstable platform Balance System SD for both dental occlusion conditions at random order. Metabolic and psychological measurements ensured the high intensity of the exercise. At unstable level, balance control was significantly improved in the CR condition, for both rest (p = 0.03) and fatigue (p < 0.001). Whereas at stable level, the influence of dental occlusion only reached significance in fatigue condition (p = 0.04). It could be concluded that the sensory information linked to the dental occlusion for the balance control comes strongly into effect when more difficult conditions for the balance control are present (i.e., unstable conditions, fatigue).

Postural control is a complex system that involves different sen-sory and motor components, such as sensory inputs from the visual,somatosensory and vestibular systems, that must be integrated atthe central nervous system in order to regulate orientation andstabilization of the body segments [1]. Over the last few years, a growing interest has focused onthe potential correlation between the stomatognathic system andthe body balance. Recently, it has been proposed that the stom-atognathic system may contribute (∼2%) to the postural balanceregulation [2]. In particular, the presence of some specific mal-occlusal traits seems to negatively influence the balance control[3]. From a neurophysiological perspective, the motor influencesbetween the masticatory and cervical muscles may explain theinfluence of dental occlusion on the body balance [4]. The observa-tion of a beneficial effect of balancing occlusion on several posturalmuscles [5,6] leads to speculate that dental occlusion may affectthe whole body. The neuronal links of the trigeminal nerve to thevestibular nuclei, which are responsible of the masticatory functionand equilibrium control respectively [7,8], reinforce the argument for this relationship. Most literature in the topic have evaluatedthe influence of proprioceptive information of dental occlusion onthe body balance in stable conditions reporting contrasting con-clusions in favor [9–11] or against [12–14]. However, less researchhas focused in assessing the relationship between dental occlusionand balance in unstable conditions, even though unstable platformsare more sensitive [15]. Moreover, a different contribution of theafferent signals for the process of balance control occurs dependingon the stability of the support base [16], thus evidencing a highercontribution of other sources of sensory information when moredifficult conditions for the balance control are present. To data,there is no available literature investigating the influence of den-tal occlusion in fatigue conditions at stable and unstable supportsurface conditions.Therefore, we hypothesized that dental occlusion may con-tribute differently on the body balance control depending on thestability condition (stable versus unstable) and that influence mightbe more evident in fatigue conditions due to reorganization of thesensory information sources. Then, the aim of the present studywas to determine whether: (i) dental occlusion influences bodybalance for two extreme levels of stability (stable/unstable), and(ii) the influence of dental occlusion on the balance control comesstrongly into effect under fatigue conditions.

Our main findings were that: (i) the body balance was sig-nificantly better when dental occlusion was set in CR, and moreespecially, at unstable level measurements; and (ii) the influenceof dental occlusion on the balance control came strongly intoeffect under fatigue conditions. These results lead to speculate thatthe afferent signals from dental occlusion may contribute mosteffectively in the process of balance control when more externalperturbations are present, in this case surface instability and musclefatigue.

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