Bruxism: Innovative Perspectives in Assessment and Therapy
Abstract
Bruxism is a prevalent parafunctional behavior marked by involuntary clenching, grinding, bracing, or thrusting of the mandible during wakefulness or sleep, whose cumulative mechanical load can surpass the adaptive capacity of dental and musculoskeletal tissues and precipitate tooth wear, orofacial pain, and temporomandibular disorders. Reported prevalence estimates range 3.5–96%, reflecting heterogeneity in diagnostic definitions, assessment methods, and study populations, with adult rates averaging approximately 7% and pediatric estimates spanning 3.5–40.6%. Etiologically, bruxism emerges from the interplay of peripheral factors—such as facial morphology and occlusal discrepancies—central neuromuscular dysregulation, psychosocial stressors, pharmacological influences, and genetic predisposition. An integrated diagnostic schema—categorizing cases as possible, probable, or definite based on self-report, clinical examination, electromyography, and polysomnography— enhances consistency across settings. Management prioritizes reversible measures, such as patient education, behavioral modification, physical therapy, pharmacotherapy, and occlusal splint therapy, to reduce parafunctional load, with occlusal adjustment, botulinum toxin injections, or surgical intervention reserved for refractory presentations.
Keywords: bruxism, sleep bruxism, temporomandibular disorders, occlusal splint therapy, pathophysiology of bruxism