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

• Published in: Journal of oral rehabilitation Vol. 45; no. 11; pp. 837 - 844
• Main Authors: Lobbezoo, F., Ahlberg, J., Raphael, K. G., Wetselaar, P., Glaros, A. G., Kato, T., Santiago, V., Winocur, E., De Laat, A., De Leeuw, R., Koyano, K., Lavigne, G. J., Svensson, P., Manfredini, D.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-11-2018
• Subjects: assessment; awake bruxism; bruxism; Bruxism - classification; Bruxism - diagnosis; Bruxism - etiology; clinical inspection; Consensus; cut‐off points; definition; Diagnosis, Differential; Electromyography; Humans; Mandible; Mastication; Masticatory Muscles - physiopathology; Medicin och hälsovetenskap; Polysomnography; Rhythms; Self report; Sleep; Sleep - physiology; Sleep and wakefulness; sleep bruxism; Teeth; Wakefulness - physiology; assessment; bruxism; self-report; clinical inspection; electromyography; awake bruxism; definition; polysomnography; sleep bruxism; cut-off points
• ISSN: 0305-182X; 1365-2842; 1365-2842
• DOI: 10.1111/joor.12663

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.