Summary: In 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, bruxism‐related masticatory muscle activities should be assessed in the behaviour's continuum.
10 February 2023 in Journal of Oral Rehabilitation
Objective: This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences.Methods: The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications.Results: The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self‐reported information on bruxism status and possible consequences (subject‐based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject‐Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self‐report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra‐ and Extra‐Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self‐reported information (subject‐based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep‐related Conditions Assessment (B2), Concurrent Non‐Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration.Conclusions: The instrument is now ready for on‐field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields.
Background: Bruxism is receiving increasing attention from both clinicians and researchers over the past decades. Recently, it has become clear that some aspects of the currently proposed, expert‐driven bruxism definitions raise questions and cause confusion among clinicians, researchers, educators and patients.Objectives: The aim of this report is threefold: (1) to provide the reader with a glossary of the existing definitions, (2) to discuss frequently asked questions regarding these definitions and (3) to suggest a road map for the next steps to be taken towards a better understanding of bruxism.Material and Methods: A closed (invitation‐only) full‐day workshop at the 2024 General Session & Exhibition of the International Association for Dental, Oral and Craniofacial Research (IADR) convened international bruxism experts to discuss the current definitions. Insights from these discussions were compiled, analysed and summarised.Result: The present report provides a glossary of the constituent terms of the currently proposed definitions, an overview of the frequently asked questions and insights into the next steps to be taken. By current consensus and to avoid any further confusion, the addendum ‘in otherwise healthy individuals’ has been removed from the specific definitions of sleep and awake bruxism. In addition, the grading system's hierarchical organisation, as proposed previously, was revised and clarified, proposing the inclusion of terms based on self‐reporting, clinical examination and device‐based assessment tools.Conclusion: To ascertain that we all use the same terminology, we recommend using the current publication when referring to the definitions of bruxism and its constituent terms.
Objectives: Tooth wear is a common finding in adult patients with dental sleep disorders. The aim of this paper was to review the literature on the possible associations between tooth wear and the following dental sleep disorders: sleep‐related oro‐facial pain, oral moistening disorders, gastroesophageal reflux disease (GERD), obstructive sleep apnoea syndrome (OSAS) and sleep bruxism.Methods: A PubMed search was performed on 1 June 2018 using MeSH terms in the following query: Tooth Wear AND (Facial Pain OR Temporomandibular Joint Disorders OR Xerostomia OR Sialorrhea OR Gastroesophageal Reflux OR Sleep Apnea Syndrome OR Sleep Bruxism).Results: The query yielded 706 reports on tooth wear and the mentioned dental sleep disorders. Several associations between tooth wear and the dental sleep disorders were suggested in the literature. It could be concluded that: (a) tooth wear is associated with dental pain and/or hypersensitivity; (b) oral dryness is associated with tooth wear, oro‐facial pain and sleep bruxism; (c) GERD is associated with tooth wear, oro‐facial pain, oral dryness, OSAS and sleep bruxism; (d) OSAS is associated with oral dryness, GERD and sleep bruxism; and (e) sleep bruxism is associated with tooth wear.Conclusions: Tooth wear is associated with the dental sleep disorders oro‐facial pain, oral dryness, GERD and sleep bruxism. The dental sleep disorders are interlinked with each other, which leads to indirect associations as well, and makes the consequences of each single condition difficult to disentangle. Knowledge of these associations is clinically relevant, but more research is needed to confirm their validity.