Last updated: August 16, 2023

Summarytoggle arrow icon

Bruxism is involuntary and repetitive teeth grinding and/or jaw clenching due to increased masticatory muscle activity either while asleep (sleep bruxism) or awake (awake bruxism). The exact cause of bruxism remains unknown, but it is believed to be multifactorial, with potential factors including genetic predisposition, sleep architecture, psychological stressors and disorders (e.g., sleep disorders, anxiety disorder), neurological changes and disorders (e.g., due to stimulatory drug use, brain trauma, autonomic nervous system dysfunction). Bruxism is considered primary if it cannot be associated with a medical condition or a certain substance and secondary if it can be associated with a psychiatric or neurological condition (e.g., sleep disorders, cerebral palsy) or the use of a particular substance (esp. stimulants, e.g., SSRIs, anxiolytics, dopaminergic drugs, amphetamine, caffeine). Clinical features of bruxism include abraded teeth, tongue indentations, recessed gums, linea alba in the cheek, headaches, locking of the jaw, temporomandibular joint pain, and facial pain. Diagnosis is based upon self-report, third-party observation (e.g., family member), and physical examination. Electromyography of the masticatory muscle and polysomnography (for sleep bruxism) showing increased muscle activity may support the diagnosis.Treatment includes patient education (e.g., stress management, cognitive behavioral training) and, in secondary bruxism, treatment of any underlying condition, cessation of substance use, and/or adjustment of medication regime. An occlusal splint may be used to relax the jaw and protect the teeth while sleeping. If left untreated, bruxism can lead to severe tooth damage, such as dental attrition and abfraction.

Definitiontoggle arrow icon

  • General: involuntary and repetitive teeth grinding and/or jaw clenching due to increased masticatory muscle activity [1]
  • Sleep bruxism: bruxism that occurs while asleep (mainly during NREM sleep stage 2)
  • Awake bruxism: bruxism that occurs during wakefulness
  • Primary bruxism: no association with any medical condition
  • Secondary bruxism: associated with medical conditions (e.g., parasomnias), medication (e.g., antidepressants), and substance use (e.g., alcohol, caffeine)

Epidemiologytoggle arrow icon

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

The exact causes and pathophysiology of bruxism are unknown, but the following associations have been identified.

Clinical featurestoggle arrow icon

Diagnosticstoggle arrow icon

Treatmenttoggle arrow icon

Complicationstoggle arrow icon

We list the most important complications. The selection is not exhaustive.

Referencestoggle arrow icon

  1. Lobbezoo F, Ahlberg J, Glaros AG, et al. Bruxism defined and graded: an international consensus.. J Oral Rehabil. 2013; 40 (1): p.2-4.doi: 10.1111/joor.12011 . | Open in Read by QxMD
  2. Khoury S, Carra MC, Huynh N, Montplaisir J, Lavigne GJ. Sleep Bruxism-Tooth Grinding Prevalence, Characteristics and Familial Aggregation: A Large Cross-Sectional Survey and Polysomnographic Validation. Sleep. 2016; 39 (11): p.2049-2056.doi: 10.5665/sleep.6242 . | Open in Read by QxMD
  3. Restrepo C, Santamaría A, Manrique R. Sleep bruxism in children: relationship with screen-time and sugar consumption. Sleep Medicine: X. 2021; 3: p.100035.doi: 10.1016/j.sleepx.2021.100035 . | Open in Read by QxMD
  4. Manfredini D, Winocur E, Guarda-Nardini L, Paesani D, Lobbezoo F. Epidemiology of Bruxism in Adults: A Systematic Review of the Literature. J Orofac Pain. 2013; 27 (2): p.99-110.doi: 10.11607/jop.921 . | Open in Read by QxMD
  5. Lobbezoo F, Ahlberg J, Raphael KG, et al. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil. 2018; 45 (11): p.837-844.doi: 10.1111/joor.12663 . | Open in Read by QxMD
  6. Yap AdrianUJ, Chua A. Sleep bruxism: Current knowledge and contemporary management. Journal of Conservative Dentistry. 2016; 19 (5): p.383.doi: 10.4103/0972-0707.190007 . | Open in Read by QxMD
  7. Ohlmann B, Waldecker M, Leckel M, et al. Correlations between Sleep Bruxism and Temporomandibular Disorders. J Clin Med. 2020; 9 (2): p.611.doi: 10.3390/jcm9020611 . | Open in Read by QxMD
  8. Manfredini D, Lobbezoo F. Sleep bruxism and temporomandibular disorders: A scoping review of the literature. J Dent. 2021; 111: p.103711.doi: 10.1016/j.jdent.2021.103711 . | Open in Read by QxMD
  9. List T, Jensen RH. Temporomandibular disorders: Old ideas and new concepts. Cephalalgia. 2017; 37 (7): p.692-704.doi: 10.1177/0333102416686302 . | Open in Read by QxMD

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