Bruxisme

Bruxisme, or teeth grinding and clenching, is a repetitive jaw-muscle activity that involves forceful contact between the teeth and other jaw movements. It can occur during sleep (sleep bruxism) or while awake (awake bruxism). It is not a disease on its own but a movement disorder or parafunctional activity that may accompany other conditions.

Causes and risk factors are multifactorial. Genetic predisposition, neurotransmitter regulation, stress and anxiety, and certain sleep disorders are associated with bruxism. Occlusal factors have been proposed but are not consistently linked to the condition. Substances such as caffeine, alcohol, and tobacco, as well as some medications (notably certain antidepressants), can influence bruxism. Sleep bruxism often coexists with sleep-disordered breathing and other sleep disturbances.

Symptoms and signs vary. Common complaints include jaw, facial, or temporal muscle pain, morning headaches, tooth wear or sensitivity, and audible grinding sounds. Exam findings may show flattened or worn tooth surfaces, chipped teeth, and muscle hypertrophy or tenderness near the jaw joint. In some cases bruxism is episodic and causes little discomfort.

Diagnosis is typically clinical, based on history and dental examination. Polysomnography or self-monitoring may be used in research or complex cases, especially to distinguish sleep bruxism from other sleep disorders or to assess associated conditions.

Treatment aims to reduce symptoms and protect teeth. Options include patient education, stress management, good sleep hygiene, and behavioral therapy. Dental approaches such as occlusal splints or night guards can lessen tooth wear. Addressing underlying sleep disorders, medications with a clinician, and, in rare cases, botulinum toxin injections may be considered. Prognosis varies; many individuals experience mild symptoms or improvement over time.