Bruxism: a summary of current knowledge on aetiology, assessment and management

Abstract

Bruxism is a common condition that clinicians come across in both adult and children. Prevalence rates in adults range from 22% to 30% for awake bruxism (AB) and from 8% to 16% for sleep bruxism (SB), while in children they raise up to 40% for SB. Currently, bruxism is considered an 'umbrella term' for different jaw muscle activities, occurring during sleep and/or wakefulness. They have a different aetiology, but there is agreement on their central, not peripheral, origin. In otherwise healthy individuals, bruxism can be considered a muscle behaviour, which can be harmless or represent a risk and/or protective factor for clinical consequences, rather than being a disorder per se. Nonetheless, given the merging knowledge on the interaction with several associated factors and concurrent conditions, bruxism should be investigated for being a possible sign of an underlying primary condition. Consequently, treatment should be directed to the management of the possible clinical consequences and/or to the underlying primary conditions. It is generally based on the conservative strategies. The present manuscript summarises the available knowledge on bruxism aetiology, assessment and management for both SB and AB in adults and children, with focus on the future directions to implement the clinical relevance of bruxism researches. Clinical relevance: A narrative overview summarising such a quickly evolving topic as bruxism may be useful to help clinicians understanding the complex relationship among bruxism, the possible underlying primary conditions, and the possible clinical consequences.

Temporomandibular Disorders and Bruxism Outbreak as a Possible Factor of Orofacial Pain Worsening during the COVID-19 Pandemic—Concomitant Research in Two Countries

“…Apparently, anxiety, depression, and personal worries evoked by the Coronavirus pandemic increased the prevalence of TMD and bruxism. This is in line with the literature results, that anxiety, stress, depression, coping strategies, and catastrophizing may precipitate or prolong the TMD pain [ 2 , 3 , 4 , 5 , 6 , 7 , 8 ], and that psychosocial factors are associated with both forms of bruxism [ 13 , 14 , 16 , 17 , 18 , 19 , 20 ]. When the pandemic situation kept changing rapidly from day to day, uncertainty and worries about the present and future were common and unavoidable [ 38 , 39 ].…”

“…In the general population, the prevalence of bruxism is estimated at 8–31% and tends to decrease with age [ 31 ]. SB prevalence is about 16% among young adults and 3–8% among adults, while the AB prevalence in the general population is 22–30% [ 14 ]. Even the reported prevalence of bruxing activities has a large range (2.7–57.3% for AB, 4.1–59.2% for SB) [ 26 ].…”

“…The prevalence of SB is estimated at about 16% among young adults and at 3–8% among adults, while the prevalence of AB in the general population is estimated at about 22–30%. Both forms of bruxism men and women equally [ 14 ].…”

Frequency of Sleep Bruxism Behaviors in Healthy Young Adults over a Four-Night Recording Span in the Home Environment

“…Recently, a panel of experts proposed two distinct definitions for awake and for sleep bruxism; the latter is defined as a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or non-rhythmic (tonic) [1]. This would not be considered a disorder per se in otherwise healthy individuals, but it might be viewed as a protective and/or a risk factor for some clinical consequences [1][2][3].…”

“…Whilst polisomnography (PSG) has always been considered the standard of reference to evaluate the amount of jaw muscle activity associated with specific patterns of sleep arousals, several different non-instrumental and instrumental approaches may be used to assess SB, including clinical or self-reported/questionnaire-based protocols, clinical inspection and electromyographic (EMG) recordings [1,[3][4][5][6][7]. In particular, a count of SB events can be assessed with measurement approaches to quantify the amount of sleep-time EMG activity [1].…”