Mechanical sensitivity and psychological factors in patients with burning mouth syndrome.

OBJECTIVES: The aim of this study was to compare mechanical sensitivity on the tongue using quantitative sensory testing (QST) and psychological factors using the General Health Questionnaire (GHQ) between burning mouth syndrome (BMS) patients and healthy participants. MATERIALS AND METHODS: Participants comprised 20 female BMS patients (68.1 ± 7.4 years) and 20 healthy females (65.4 ± 4.6 years). Psychological factors were evaluated with GHQ. Tactile detection thresholds (TDT) and filament-prick pain detection thresholds (FPT) were used to evaluate mechanical sensitivity on the tongue in all participants. TDT and FPT were measured on the tongue within both the painful area and the non-painful area in BMS patients, and on the tongue on both sides in healthy participants. As controls, TDT and FPT were measured with Semmes-Weinstein monofilaments on the skin of the mentum and palm in all participants. RESULTS: GHQ scores were significantly higher in BMS patients than in healthy participants (P = 0.024). No significant differences in TDT or FPT on the tongue, mentum, or palm were seen between BMS patients and healthy participants (P > 0.05). BMS patients showed no significant differences in TDT or FPT between the painful and non-painful areas on the tongue (P > 0.05). There were no significant correlations among TDT/FPT and GHQ score in BMS patients (P > 0.05). CONCLUSIONS: These findings could indicate a more important role for psychological factors than mechanical sensitivity in BMS pathophysiology. CLINICAL RELEVANCE: Pain on the tongue in elderly female patients with BMS may be more related to psychological factors.

Perceptual distortion of the tongue by lingual nerve block and topical application of capsaicin in healthy women.

OBJECTIVES: The aim of this study was to examine reports of perceptual distortion evoked by transient deafferentation and burning pain as models of aspects of burning mouth syndrome (BMS). MATERIALS AND METHODS: Sixteen healthy women took part in three experimental sessions that included exposure to lingual nerve block, capsaicin, and control substance. In each session, reported perceptual distortion and mechanical detection threshold (MDT) were assessed at four areas (the tongue, lower front teeth, lower lip, and right thumb) before and at 5, 15, 30 min and 1 and 3 h after the injection or application. A numerical rating scale (NRS) and a template matching procedure were used to quantify the perceptual distortions. RESULTS: There was a significantly higher MDT on the tongue during the lingual nerve block session at 5 min up until 1 h, with the perceived tongue size significantly increased at 5, 15, and 30 min and at 1 h compared to baseline (P < 0.05). Although the perceived size determined by the NRS scores during the capsaicin session was significantly larger for the lower lip at 5 min compared to baseline (P < 0.001), there were no significant effects on the MDT or the perceived sizes for the tongue, lower front teeth, or right thumb at any of the time points. CONCLUSIONS: Perceptual distortions of the tongue may be influenced by non-nociceptive somatosensory changes rather than nociceptive activity. CLINICAL RELEVANCE: The perceptual distortion of the tongue was investigated with models of aspects of BMS and may have implications for future studies in clinical populations.

Repeated clenching causes plasticity in corticomotor control of jaw muscles.

This study tested the effect of short-term tooth-clenching on corticomotor excitability of the masseter muscle using transcranial magnetic stimulation (TMS). Fifteen subjects with normal stomatognathic function participated. All subjects performed a tooth-clenching task (TCT) on five consecutive days. The TCT consisted of 10, 20, and 40% of maximum voluntary contraction in a randomized order within 1 h. All subjects underwent TMS in four sessions: pretask day 1 (baseline), post-task day 1, pretask day 5, and post-task day 5. Motor-evoked potentials (MEPs) from the masseter and the first dorsal interosseous (FDI) muscles were obtained using TMS in four sessions. Motor thresholds decreased, after the TCT, for the masseter muscle MEPs. Masseter muscle MEPs were dependent on stimulus intensity and on session, whereas FDI muscle MEPs were only dependent on stimulus intensity. Post-hoc Tukey tests demonstrated significantly higher masseter muscle MEPs post-task on day 5 with 80 and 90% stimulus intensity and above when compared with pre- and post-task day 1 values. Our results suggest that the performance of repeated TCTs can trigger neuroplastic changes in the corticomotor control of the jaw-closing muscles and that such neuroplastic changes may contribute to the mechanism underlying the clinical manifestations of tooth clenching.

Influence of periodontal afferent inputs for human cerebral blood oxygenation during jaw movements.

Using functional magnetic resonance imaging (fMRI) and near-infrared spectroscopy (NIRS), we examined the role of periodontal afferent inputs on cerebral activation pattern evoked by masticatory muscle activity in twenty-two subjects. Statistical comparisons were used to identify brain regions with significant activation after subtraction of baseline activity from sham teeth-tapping (no periodontal input) and teeth-tapping (periodontal input) activity in an fMRI (N = 14) and NIRS study (N = 8). Both sham teeth-tapping and teeth-tapping significantly activated bilateral sensorimotor cortex and supplementary motor area in the fMRI study. NIRS revealed that oxygenated hemoglobin concentrations increased in sensorimotor cortex; however, there was no significant difference in degree of oxygenated hemoglobin changes between sham teeth-tapping and teeth-tapping. A control study (N = 8) characterized the jaw muscle activity and amplitude of the two motor tasks and demonstrated significantly higher electromyogram (EMG) activity in the jaw closing muscles during teeth contact in the teeth-tapping session. Since the cerebral activation during sham teeth-tapping and teeth-tapping was similar, we suggest that the influence of periodontal afferent inputs and associated jaw muscle activity is relatively minor compared to the rhythmic jaw movements. Although the clinical significance of the present findings remains unknown, they may have implications for the understanding of awake or sleep-related bruxism characterized by subconscious and rhythmic teeth-grinding or teeth-clenching.

Mandibular Jaw Movement and Masticatory Muscle Activity during Dynamic Trunk Exercise.

The examination of jaw movement during exercise is essential for an improved understanding of jaw function. Currently, there is no unified view of the mechanism by which the mandible is fixed during physical exercise. We hypothesized that during strong skeletal muscle force exertion in dynamic exercises, the mandible is displaced to a position other than the maximal intercuspal position and that mouth-opening and mouth-closing muscles simultaneously contract to fix the displaced mandible. Therefore, we simultaneously recorded mandibular jaw movements and masticatory muscle activities during dynamic trunk muscle force exertion (deadlift exercise) in 24 healthy adult males (age, 27.3 ± 2.58 years). The deadlift was divided into three steps: Ready (reference), Pull, and Down. During Pull, the mandibular incisal point moved significantly posteriorly (-0.24 mm, p = 0.023) and inferiorly (-0.55 mm, p = 0.019) from the maximal intercuspal position. Additionally, temporal, masseter, and digastric muscles were activated simultaneously and significantly during Pull (18.63 ± 17.13%, 21.21 ± 18.73%, 21.82 ± 19.97% of the maximum voluntary contraction, respectively), with maintained activities during Down (p < 0.001). Thus, during dynamic trunk muscle force exertion, the mandibular incisal point moved to a posteroinferior position without tooth-touch (an open-mouth position). Simultaneously, the activities of the mouth-opening digastric muscles and the mouth-closing temporal and masseter muscles led to mandibular fixation, which is a type of mandible fixing called bracing.

Intraoral measurement of tactile and filament-prick pain threshold using shortened Semmes-Weinstein monofilaments.

OBJECTIVES: Semmes-Weinstein monofilaments are too long for use in parts of the oral cavity. The present study used shortened Semmes-Weinstein monofilaments to evaluate reliability and spatial differences in the intraoral tactile detection threshold (TDT) and the filament-prick pain detection threshold (FPT) in healthy volunteers. METHODS: For practical purposes, classic Semmes-Weinstein monofilaments with 20 different diameters were cut to half their length (ie, 19 mm) and the bending forces were measured. Eighteen men and 18 women (age range, 20 to 33 y) were recruited to evaluate the reliability and reproducibility of measurements using half-cut monofilaments. The TDT and the FPT were measured on the labial maxillary gingiva, on the palatal maxillary gingiva, and at the anterior tip of the tongue, using a double random staircase method. RESULTS: According to the forces needed to bend the half-cut filaments, they were renumbered from 2.55 to 6.86. There were significant differences of bending force between the half-cut and original monofilaments (P<0.001), Using half-cut filaments, the following differences could be detected; the labial maxillary gingiva had a significantly higher TDT threshold compared with the other test sites (P<0.001). By contrast, the palatal posterior maxillary gingiva had a significantly higher FPT threshold compared with the other test sites (P<0.001). DISCUSSIONS: The present study illustrated that in healthy participants, half-cut Semmes-Weinstein monofilaments reliably and easily assess TDT and FPT intraorally. A combined examination of sensory and pain thresholds using these filaments contributes to the clinical examination for orofacial pain.

Ethnic differences regarding tactile and pain thresholds in the trigeminal region.

UNLABELLED: The aim of the present study was to evaluate ethnic differences of the tactile detection threshold (TDT), the filament-prick pain detection threshold (FPT), the pressure pain detection threshold (PPT), and the pressure pain tolerance detection threshold (PTOL) in the orofacial region of symptom-free subjects. Twenty-two men and 22 women in Belgium and in Japan (age range from 20 to 31 years) participated. The TDT and the FPT were measured on the cheek skin (CS) overlying the masseter muscles (MM), on the maxillary gingiva (MG), and at the tip of the tongue (TT), using Semmes-Weinstein monofilaments. The PPT and PTOL were measured at the central part of the MM, using a pressure algometer. A general linear model was used in each case to capture ethnic and gender effects. Japanese women had the lowest TDT at CS, in contrast to Belgian men, who had the highest value; a significant ethnic and gender effect was found (P=.026 and P<.001, respectively). Similar results were found for FPT at CS with significant ethnic and gender effects (P<.001 for both). There was no significant ethnic effect regarding intra-oral TDT and FPT or regarding PPT and PTOL. PERSPECTIVE: Our findings clearly indicate that future studies of tactile and pain measurements need to standardize and control for gender and ethnicity. Further, a comprehensive evaluation of results from various stimulation modalities may better clarify the pain mechanisms and gender/ethnic characteristics, as well as comparisons between normal subjects and patients.

Influences of differences in tray design and impression material on impression pressure at edentulous mandible.

The aim of this study was to examine the effects of tray design and impression material on impression pressure in a clinical simulation model of an edentulous mandible. Two types of polyvinylsiloxane elastomer, one type of polyether elastomer, and one type of alginate were used. The three tray types had no relief, 0.36 mm of relief, or 1.4 mm of relief, with or without escape holes. Impression pressure was measured at the median alveolar crest, the bilateral alveolar crests corresponding to molars, and the bilateral buccal shelves. Impression pressure significantly differed in relation to tray design and sensor position. In trays without escape holes, impression pressure was highest at the median alveolar crest and lowest at the buccal shelves, for all impression materials. However, impression material had no significant effects on impression pressure. Our results suggest that bite-pressure load on alveolar crests can be alleviated by making an impression with a tray that has relief and escape holes, while applying pressure to buccal shelves and almost no pressure to alveolar crests.

Analysis of correlation between height of residual ridge and bone density of residual ridge crest at edentulous mandible using computed tomography.

PURPOSE: The aim of this study was to investigate the correlation between bone density of the edentulous mandibular ridge crest and residual bone height in edentulous subjects using multidetector computed tomography (MDCT) images. METHODS: A total of 194 bilateral MDCT images from 97 individuals with an edentulous mandible were selected for analysis. The residual ridge ratio (RRR), the CT values at the residual ridge crest, and the CT values at the lowest point of the mandible measured from MDCT images at molar region. RRR was classified into the three groups (Group 1: >2.0, Group 2: 1.5-2.0, Group 3: <1.5). Bone density at the residual ridge crest was evaluated by calculating the ratio of the CT value at the lowest point of the mandible and the CT value of the residual ridge crest ("ratio of CT values"). The relationship between the height of the residual ridge and the bone density of the residual ridge crest was evaluated by ratio of CT values. RESULTS: Median ratio of CT values was 0.62 in Group 1, 0.70 in Group 2, and 0.84 in Group 3, indicating significant differences between all 3 groups (p<0.05). The correlation coefficient for RRR and residual ridge crest bone density was -0.54 in males and -0.55 in females, implying a moderate correlation for both males and females. CONCLUSIONS: The present results suggest a negative correlation between residual bone height and the bone density of the edentulous mandibular ridge crest.

Somatosensory Profile Changes Evoked by Topical Application of Capsaicin to the Tongue in Healthy Individuals.

AIMS: To assess the effect of topical application of capsaicin to the tongue as a surrogate model of burning mouth syndrome (BMS) on somatosensory sensitivity by using a standardized battery of quantitative sensory testing (QST) in healthy volunteers. METHODS: This study comprised two experimental sessions (experimental [capsaicin] and control [Vaseline]) with QST in 16 healthy women. The examiner applied capsaicin or Vaseline to the tongue tip for 5 minutes. Each participant kept their tongue tip in contact with the capsaicin/Vaseline at the bottom of a disposable cup for 5 minutes, during which time the participant rated the perceived intensity of the tongue pain every 30 seconds on an electronic 0 to 10 visual analog scale (VAS). QST was performed on the tongue tip before and immediately after application in each session. The QST data were analyzed by two-way analysis of variance (ANOVA). RESULTS: Mean ± standard error of the mean (SEM) of VAS pain scores during the capsaicin and control sessions were 8.2 ± 0.5 and 1.9 ± 0.2, respectively. The peak of the perceived pain in the capsaicin session was significantly higher than in the control session (P < .001). In the capsaicin session, the postapplication heat pain threshold (HPT) was significantly higher than the preapplication HPT, and the postapplication cold detection threshold (CDT) and mechanical pain threshold (MPT) were significantly lower than before application (P < .001). The average z scores showed a significant somatosensory loss regarding CDT. In the control session, there were no differences between preapplication and postapplication values. CONCLUSION: Topical application of capsaicin to the tongue tip changed somatosensory sensitivity in healthy participants.

Comparing the occlusal contact area of individual teeth during low-level clenching.

The aim of this study was to investigate the occlusal contact area (OCA) in individual teeth during low-level tooth clenching in 24 healthy participants. Before measurements were made, the 100% maximum voluntary contraction (MVC) was determined. At baseline, all subjects were instructed to close their mouth and touch the opposing teeth with minimal force. Occlusal contact was recorded during three jaw motor tasks (baseline, 20% MVC, and 40% MVC) using a blue silicone material. OCA thickness was determined from images and defined on five levels: level 1 (0-149 µm), level 2 (0-89 µm), level 3 (0-49 µm), level 4 (0-29 µm), and level 5 (0-4 µm). Premolar and molar OCAs increased significantly from baseline to 20% MVC and 40% MVC. The OCA of each anterior tooth did not change significantly with increasing clenching intensity at all levels. Our findings suggest that premolar and molar OCAs may be altered by low-intensity clenching, affecting the teeth and periodontal tissues.

Lip muscle training improves obstructive sleep apnea and objective sleep: a case report.

The present study assessed the potential of lip muscle training for improving sleep. A patient with heavy snoring, daytime sleepiness and dry mouth underwent lip muscle training. Lip closure force LCFmax increased by 67.3% and LCFmin by 152% post-training. AHI decreased from 12.2 to 3.9 events/h by reducing hypopneic episodes. TST, sleep stage N3 and REM sleep increased, and WASO, sleep stage N1, and AI decreased. The patient switched from mouth to nose breathing during sleep and stopped snoring. Improved LCF, by moving the tongue into the anterior-superior oral cavity, may increase upper airway space and reduce the hypopnea index.

[Masticatory muscle activity during exertion of the back].

PURPOSE: The lower jaw is considered to be fixed during body exercise. However, its mechanism remains to be elucidated. The present study investigated masticatory muscle activity during of the back. METHODS: The subjects were 9 healthy dentulous patients. The maximum back strength of the patients was measured with a back-dynamometer. Muscle activities of the temporal, masseter and digastric muscles during exertion of the back and mastication of peanuts were measured. Muscle activities of the temporal and masseter muscle during maximum voluntary clenching and that of the digastric muscles during exertion of resistance against forced mouth opening were also measured, and maximum voluntary muscle activities were obtained. The relative percentage of each masticatory muscle against maximum voluntary activity was calculated from the data obtained, and muscle activities during exertion of the back, mastication of peanuts and maximum muscle activity were compared. RESULTS: Muscle activities of the temporal, masseter and digastric muscles during exertion of back muscles against maximum voluntary muscle activity were 32.1%, 26.4% and 97.4% respectively. Muscle activities of these muscles during mastication of peanuts against maximum voluntary muscle activity were 40.7%, 36.0% and 17.3% respectively. CONCLUSIONS: Muscle activities during exertion of the back were 30% in the temporal and masseter muscle, and approximately 100% in the digastric muscles. The result suggests that the digastric muscles play a key role in fixing the mandible in all masticatory muscles including jaw-opening and closing muscles. People exert back strength not only in sports but also in daily life. This study demonstrates the stronger involvement of the digastric muscles in fixation of the mandible during exercise than during strong clenching. The results are of interest in terms of mandibular position, occlusal contact and the load on the temporomandibular joint (TMJ) since there is no wide mouth opening.

Pressure dynamics in the trays caused by differences of the various impression materials and thickness of the relief in the maxillary edentulous model.

PURPOSE: The purpose of this study is to compare the pressure dynamics in the trays caused by differences in the various impression materials and in the thickness of the relief provided for the trays. METHODS: In this study, two types of polyvinylsiloxane elastomers, one type of polyether elastomer and one type of alginate impression material were used. Pressure sensors were embedded at eight locations in a model of an edentulous maxilla, and used a simulation model covered with a pseudomucosa. For each impression material, the measurement was performed five times for each of the three types of trays, and the mean values were determined. Statistical analysis was carried out using one-way analysis of variance and the Tukey's HDS method, and the various pressure sensor values for each of the impression materials were compared 10s and 20s after the start of the measurement. Additionally, we compared differences among the three types of trays after 20s. RESULTS: The pressure values for sensors placed in the relief region tended to become uniform. Furthermore, we saw a tendency for the pressure to increase at the alveolar crests of the first molars on the left and right and at the posterior border of the palate, all of which support the denture, when relief was provided. CONCLUSIONS: The above results suggest that making the final impression for the denture using the selective pressure technique, with consideration given to the pressure dynamic, may lead to a good outcome in terms of preservation of the alveolar ridge.

Pain patterns and mandibular dysfunction following experimental trapezius muscle pain.

AIMS: To clarify the effects of experimental trapezius muscle pain on the spread of pain and on jaw motor function. METHODS: In 12 male subjects aged 25 to 35 years, experimental pain was induced in the superior border of the trapezius muscle by injecting 0.5 mL of hypertonic (6%) saline. The control infusion consisted of a 0.5-mL isotonic (0.9%) saline solution. Pain intensity was evaluated on a visual analog scale (VAS). An experimental (EX) and a control (CT) injection were administered to the subjects in a randomized sequence. RESULTS: Pain intensity as scored on the VAS increased immediately after the EX injection and decreased gradually after reaching a peak of 68.0 +/- 16.1 mm at 60 seconds after injection. The VAS scores in the EX condition were significantly higher than after the CT condition from 30 to 330 seconds after injection (P < .05, analysis of variance [ANOVA]). Mean (+/- SD) maximal unassisted mouth opening before injection in the EX condition was 54 +/- 5.7 mm and decreased immediately after the injection, reaching a low of 47.8 +/- 5.1 mm. A gradual recovery to normal was then observed. This reduction of mouth opening in the EX condition was significant compared with the CT condition from immediately after the injection to 60 seconds after the injection (P < .05, ANOVA). According to the subjects, pain spread most often to the infra-auricular zone (n = 6), and the posterolateral part of the neck (n = 10). CONCLUSION: The present results suggest that experimental trapezius muscle pain can spread over a wide area and is also accompanied by a temporary reduction of mouth opening.

Effect of bench cooling on the dimensional accuracy of heat-cured acrylic denture base material.

OBJECTIVES: In order to obtain an insight on the internal stress caused by both polymerization and thermal shrinkage during the fabrication process of heat-cured denture resin, the effect of bench cooling on the dimensional accuracy of a heat-cured denture base resin was examined. METHODS: A dimensional change of a dumbbell-shaped specimen during the fabrication process was measured directly by using the strain gauge method. After polymerization, the specimens were treated in one of the following two processing methods: (1) rapid cooling: the specimen was removed from a stone mold within a container of boiling water at 100 degrees C and then left to cool in a thermo-stabilized room of 20+/-1 degrees C; (2) bench cooling: the flask was left to cool in a thermo-stabilized room of 20+/-1 degrees C for 140min, after which, the specimen was removed from the stone mold. The strain from deflasking was derived from the difference in the strain, before and after the removal of the specimen from the stone mold. The strain differential, before and after cooling, was determined as the total strain. RESULTS: The bench cooling for the heat-cured denture base resin reduced the strain caused by thermal shrinkage during the fabrication process. The observed reduction in the strain was 26% for the C(L) (direction of center's length), 11% for the E(L) (direction of left-edge's length), and 12% for the E(W) (direction of left-edge's width), when compared with the results obtained from the rapid-cooling method. CONCLUSIONS: The flask should be slowly cooled to room temperature, since the internal stress developed by thermal shrinkage will be relaxed during the cooling process.

Treatment of self-inflicted oral trauma in a comatose patient: a case report.

Trauma to oral soft tissues in comatose patients may be more widespread than reported, as no extensive study of this problem has been conducted. Various appliances for the prevention of self-inflicted injuries to oral tissues particularly in children and the physically and mentally challenged have been documented, but there is little information on their use in adult comatose patients. Because comatose patients lack cerebral control of the masticatory cycle, they can easily injure themselves. Although it is not uncommon for patients with a decreased level of consciousness and in need of intensive care to be restrained to prevent injury due to involuntary movement of the limbs, head and neck restraint is often difficult and may be dangerous to the patient. This case report presents a simple solution to the problem of self-inflicted trauma to oral tissues.

Effect of a repeated jaw motor task on masseter muscle performance.

OBJECTIVE: The aim of this study was to investigate the effects of 5-days repeated jaw-motor tasks on masseter muscle accuracy performance. DESIGN: Sixteen healthy participants performed a tooth-clenching task (TCT) of 58-minutes on five consecutive days. During measurements, electromyography (EMG) of both masseter muscles was recorded. Each day, the 100% maximum voluntary contraction (MVC) level was determined before the TCT. In the first and third TCT series, participants were instructed to target force levels without visual feedback. During the second TCT series, visual feedback on muscle activity level was displayed. One series consisted of three force levels (10%, 20%, and 40% MVC). In the series, participants alternated between a 30-s rest-block and a 30-s task-block for 360 s. In the task-block, participants alternated between a 5-s rest-block and a 5-s task-block. EMG activity during epochs of 5-s was quantified by calculation of the root-mean-square (RMS) values. To evaluate the accuracy of the performance, the coefficient of determination (CD) of the target force level-EMG curve was calculated from all series. RESULTS: No significant day-to-day differences in EMG RMS amplitudes were observed during MVC. CDs differed significantly between the five days (P<0.001). CDs in the first series on day 1 were significantly lower than CDs in the first series on days 4 and 5 (P<0.05). CONCLUSIONS: The findings suggest that a rigorous training paradigm may improve the performance of masseter muscles in terms of accuracy but not MVC. This might have implications for understanding the rehabilitation of patients with functional disorders in the stomatognathic system.

Rheological properties of elastomeric impression materials for selective pressure impression technique.

PURPOSE: The selective impression technique is recommended for removable prosthodontics. However, the viscoelastic rheological properties of impression materials, particularly the time-dependent viscoelastic changes in impression material immediately after tray seating, are unknown. The objective of this study is to clarify the viscoelastic rheological properties of impression materials by focusing on tray seating. METHODS: In this study, eight types of polyvinylsiloxane (PVS), two types of polyether, and two types of alginate impression materials were used. The storage modulus (G'; degree of stiffness) and loss tangent (tanδ; degree of hardening) were determined as functions of time from 0 to 360 s, commencing immediately after the completion of mixing, using a stress control-type rheometer. Thus, G' and tanδ at 0s and 20 s were compared. RESULTS: Stiffness was found to be widely distributed (4.49-0.26 × 10(4)Pa) among PVS-types, even immediately after mixing the impression material. There was also variation among polyethers (1.55-0.5 × 10(4)Pa) and among alginates (0.64-0.21 × 10(4)Pa). The hardening of all impression materials progresses beyond 20 s after the completion of mixing. CONCLUSIONS: The G' values varied with each impression material, even immediately after mixing, and the accurate impression-taking time was determined from the results of tanδ. These results provide unique insight into the selective impression technique.

Repeated tongue lift movement induces neuroplasticity in corticomotor control of tongue and jaw muscles in humans.

This study investigated the effect of repeated tongue lift training (TLT) on the excitability of the corticomotor representation of the human tongue and jaw musculature. Sixteen participants performed three series of TLT for 41 min on each of 5 consecutive days. Each TLT series consisted of two pressure levels (5 kPa and 10 kPa). All participants underwent transcranial magnetic stimulation (TMS) and electromyographic (EMG) recordings of motor evoked potentials (MEPs) in four sessions: (1) before TLT on Day 1 (baseline), (2) after TLT on Day 1, (3) before TLT on Day 5, and (4) after TLT on Day 5. EMG recordings from the left and right tongue dorsum and masseter muscles were made at three pressure levels (5 kPa, 10 kPa, 100% tongue lift), and tongue, masseter, and first dorsal interosseous (FDI) MEPs were measured. There were no significant day-to-day differences in the tongue pressure during maximum voluntary contractions. The amplitudes and thresholds of tongue and masseter MEPs after TLT on Day 5 were respectively higher and lower than before TLT on Day 1 (P<0.005), and there was also a significant increase in tongue and masseter MEP areas; no significant changes occurred in MEP onset latencies. FDI MEP parameters (amplitude, threshold, area, latency) were not significantly different between the four sessions. Our findings suggest that repeated TLT can trigger neuroplasticity reflected in increased excitability of the corticomotor representation of not only the tongue muscles but also the masseter muscles.