International consensus on the assessment of bruxism: Report of a work in progress

Abstract

SummaryIn 2013, consensus was obtained on a definition of bruxism as repetitive masticatory muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible and specified as either sleep bruxism or awake bruxism. In addition, a grading system was proposed to determine the likelihood that a certain assessment of bruxism actually yields a valid outcome. This study discusses the need for an updated consensus and has the following aims: (i) to further clarify the 2013 definition and to develop separate definitions for sleep and awake bruxism; (ii) to determine whether bruxism is a disorder rather than a behaviour that can be a risk factor for certain clinical conditions; (iii) to re-examine the 2013 grading system; and (iv) to develop a research agenda. It was concluded that: (i) sleep and awake bruxism are masticatory muscle activities that occur during sleep (characterised as rhythmic or non-rhythmic) and wakefulness (characterised by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible), respectively; (ii) in otherwise healthy individuals, bruxism should not be considered as a disorder, but rather as a behaviour that can be a risk (and/or protective) factor for certain clinical consequences; (iii) both non-instrumental approaches (notably self-report) and instrumental approaches (notably electromyography) can be employed to assess bruxism; and (iv) standard cut-off points for establishing the presence or absence of bruxism should not be used in otherwise healthy individuals; rather, bruxism­related masticatory muscle activities should be assessed in the behaviour’s continuum.

The effect of botulinum toxin injections on bruxism: A systematic review

“…6 The inhibition of ACh release and muscle excitability is progressive, and signs appear within a few days to 1 week, reaching a maximum peak after 5-6 weeks, after which the effect gradually wears off. 10 Sleep bruxism is a rhythmic or non-rhythmic muscle activity that occurs during sleep. 7 Side effects associated with therapeutic doses of the injection of BTA in the oro-facial region are normally mild and transient, such as bruising, swelling, pain around the injection site, headache, and masticatory muscle weakness.…”

“…7 Side effects associated with therapeutic doses of the injection of BTA in the oro-facial region are normally mild and transient, such as bruising, swelling, pain around the injection site, headache, and masticatory muscle weakness. 10 The bite force is mainly generated by the three jaw-closing masticatory muscles; masseter, temporalis and medial pterygoid muscles. This everyday wear of teeth was linear and continuous.…”

“…This everyday wear of teeth was linear and continuous. 10 At this stage, no good treatment for reducing bruxism permanently is currently available. 9 In 2017, an international consensus meeting was held to define bruxism.…”

Knowledge of parents/caregivers about the sleep bruxism of their children from all five Brazilian regions: A multicenter study

“…Sleep bruxism (SB) is a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or non‐rhythmic (tonic) and is not a movement disorder or a sleep disorder in otherwise healthy individuals . SB can be graded as: possible SB, based on a positive self‐report; probable SB, based on a positive clinical inspection, with or without a positive self‐report; and definite SB, based on a positive instrumental assessment, with or without a positive self‐report and/or a positive clinical inspection . This behaviour is directly related to the central nervous system and its aetiology is multifactorial and strongly related to emotional factors .…”

“…This behaviour is directly related to the central nervous system and its aetiology is multifactorial and strongly related to emotional factors . Clinical features of SB include the presence of masticatory muscle hypertrophy, indentations on the lip or tongue, and/or a linea alba on the inner cheek, but those can also be consequences of functional oromotor activity, like swallowing . Other indicators of SB may be damage to the dental hard tissues, repetitive failures of restorative work/prosthodontic constructions, and mechanical wear of the teeth (ie, attrition) .…”