INVITED REVIEW ARTICLE Neurologia i Neurochirurgia Polska

Polish Journal of Neurology and Neurosurgery

2022, Volume 56, no. 6, pages: 455–463
DOI: 10.5603/PJNNS.a2022.0073
Copyright © 2022 Polish Neurological Society
ISSN: 0028-3843, e-ISSN: 1897-4260

Common therapeutic approaches in sleep and awake bruxism

— an overview
Krystian Matusz1 , Zofia Maciejewska-Szaniec2 , Tomasz Gredes2, 3 ,
Małgorzata Pobudek-Radzikowska2 , Mariusz Glapiński1 , Natalie Górna2, Agnieszka Przystańska1
1
Department of Anatomy, Poznan University of Medical Sciences, Poznan, Poland
2
Department of Orthodontics and Temporomandibular Disorders, Poznan University of Medical Sciences, Poznan, Poland
3
Department of Orthodontics, Carl Gustav Carus Campus, Technische Universität Dresden, Dresden, Germany

ABSTRACT
Bruxism, a common medical condition characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the man-
dible, can occur during sleep, when it is known as sleep bruxism (SB), or during wakefulness, when it is known as awake bruxism (AB).
Although bruxism often causes headaches, temporomandibular joint pain, masticatory muscle pain, mechanical tooth wear,
prosthodontic complications and cracked teeth, there is still not enough data to define and support a standardised approach
to its treatment.
The aim of this review was to present the pathophysiology, consequences, types and treatment methods of bruxism in order
to increase readers’ knowledge of this topic. Differences between awake and nocturnal bruxism are included, as well as risk
factors and indicators visible during the clinical examination of affected patients. Among the causes we consider are genetics,
stress, oral parafunctions and changes in the Central Nervous System (CNS). Potential and common methods of treatment are
presented, along with suggested guidelines that should be followed when determining an appropriate treatment method. We
draw attention to the notably dynamic development of bruxism in today’s society and the importance of informational and
preventive projects, especially those targeted at high-risk patients as well as those targeted at specialists, in order to better
tackle the bruxism ‘epidemic’.
Key words: bruxism, temporomandibular disorder (TMD), chewing muscle pain, tension headaches
(Neurol Neurochir Pol 2022; 56 (6): 455–463)

Introduction bruxism) [2]. SB is the masticatory muscles activity hap-

pening during sleep, especially in the N1 sleep phase [3],
For years, bruxism has been considered to be a syno- including brief daytime naps, and can be rhythmic (phased)
nym for teeth grinding and it was unclear whether it was or non-rhythmic (tonic). This is neither a motor disorder nor
a pathological behaviour or a disorder. In 2018, a consensus a sleep disorder encountered in the healthy population. SB
was reached, defining bruxism as a repetitive activity in the is associated with headache upon awakening [4], and some
masticatory muscles characterised by clenching or grinding of studies have pointed to its slight effect on insomnia [5]. AB
the teeth and/or stiffening or thrusting of the mandible causing is described as an activity of the masticatory muscles during
forceful contact between the biting surfaces of maxillary and wakefulness characterised by repeated or prolonged contact
mandibular teeth [1]. of the opposing teeth and/or stiffening or thrusting of the
It can occur during sleep (SB, sleep bruxism, noctur- mandible, and is not a motor disorder seen in otherwise
nal bruxism) or while awake (AB, awake bruxism, diurnal healthy populations [1].

Address for correspondence: Krystian Matusz, Department of Anatomy, Poznań University of Medical Sciences, 6 Święcickiego St., 61-781 Poznan, Poland;
e-mail: matukrystian@gmail.com
Received: 12.06.2022 Accepted: 03.11.2022 Early publication date: 29.11.2022
This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to
download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

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Although it has never been proven that bruxism affects 22], repeated damage to prosthetic restorations, disturbances
quality of life [6, 7], there are patients seeking medical help of the amount and composition of secreted saliva, an often
daily from dentists around the world. It is a behaviour af- severe manifestation of craniofacial pain, stiffness of the TMJ
fecting 8–31.4% [2, 8] of the population, and is more usually [23, 24], gingival fluid secretion increase [25], bone exostoses,
encountered in people under the age of 40 and in females [9]. and periodontal leases (increased tooth mobility, gingival
recessions) [21–23, 26, 27].
Aetiology Yet, in most cases, the origin of symptoms is unknown.
Researchers have suggested that there may be some degree The vast majority of researchers agree that the direct trigger
of inherited susceptibility towards SB symptoms progression. of bruxism symptoms comes from the central nervous system
It has been reported that 21–50% of people with SB have (CNS) [28]. It has been proved in metanalysis that bruxism
a close family member who had SB in childhood, suggesting seems to be associated with distinct differences in the neural
the involvement of genetic factors [10, 11]. pathways related to the control of the jaw-closing muscles
With that in mind, Rintakoski et al. [12] tried looking for [29]. Disturbances in the concentration of catecholamines,
any genetic or environmental factors that may play a role in especially dopamine, which affect the mandibular motor
the phenotypic variance of bruxism. They demonstrated that dysfunctions, are thought to be of great importance in the
there is a sex-independent genetic component that occurs mechanism of bruxism [30].
more frequently in phenotypic SB variations than in other The first evidence of such a correlation came from a case
TMD. Based on that, they reported the heredity of bruxism, report in which a patient suffering from Parkinson’s syndrome
although they emphasised that the emancipation is dependent was treated for grinding his teeth with L-3,4-dihydroxypheny-
on age and environment, and so for example the older a pair lalanine (L-DOPA), a dopamine precursor. In a series of con-
of twins, the greater the differences that are observed between trolled studies in young, healthy SB patients, L-DOPA has been
them. Thus, although the genetic factor has been found, the shown to cause a slight but noticeable reduction in episodes of
entire mechanism behind it remains unknown. Similarly, SB compared to a placebo group, while bromocriptine, a dopa-
Maciejewska-Szaniec et al. have reported that polymorphic mine antagonist, has been shown not to affect expected rhyth-
variants in genes related to stress coping are associated with mic activity in the masticatory muscles [31, 32]. Given the pre-
AB, although they cautioned that their research should serve sumed role of norepinephrine in bruxism, experimental trials
only as a spur to conduct further analyses on a bigger sample have been conducted with propranolol and clonidine [33, 34].
group, in order to draw truly objective conclusions [13]. Propranolol, a non-selective beta-blocker, has not caused
On the other hand, one of the most commonly used a significant reduction in SB, but clonidine, an alpha-agonist
explanations of causes of bruxism is stress [5, 14, 15]. We acting on the CNS, has significantly reduced SB score when
can clearly observe an increasing tendency of patients in the compared to a placebo. This effect was partially related to
COVID-19 pandemic period to look at articles on the topic the concomitant reduction in cardiovascular sympathetic
“teeth grinding at night” on the internet [16, 17]. Increased dominance preceding the rhythmic activity of the masticatory
stress during the pandemic resulted in an elevated number of muscles. Simultaneously, fluctuations in the level of dopamine
bruxism episodes in society. That, combined with more dif- and disorders of its receptors in the brain are often associated
ficult access to doctors in the same period resulted in people with chronic stress [14, 15, 35]. The pathophysiological mech-
looking for explanations for their symptoms on the internet, anism in which stress affects the occurrence of bruxism has
leading to growing public awareness [18, 19]. Recently, re- been explained by evidence that individuals with increased
searchers have focused more on younger people such as college levels of neuroticism and anxiety disorders tend to release
students, noting a significant increase in the occurrence of their emotional tension by engaging in activities related to
bruxism in this studied group [20]. bruxism [36]. Increased concentration of stress hormones can
This serves to highlight the presence of a correlation also be noted in many chronic diseases. Psychosocial factors
between age and incidents of bruxism as epidemiologically such as state anxiety and trait anxiety as well as alexithymia
variable, which indicates the need for local research to isolate are also among the reported causes of the occurrence and
vulnerable groups and implement appropriate preventive maintenance of AB [14].
measures. Bruxism-related TMD can be explained by the craniofacial
anatomy. As there is a fixed relationship between the maxillary
Pathophysiology teeth and the base of the skull, and at the same time the man-
Bodily functions disturbed by bruxism can include, among dibular teeth have a set position in relation to the TMJ, this
other things, increased activity of the masticatory muscles, means that misaligned contact of the upper and lower occlusal
masticatory muscle hypertrophy (especially of the masseter), surfaces may have a direct impact on the position and motor
scalloped or burning tongue, linea alba on the cheeks along function of the mandible head in the TMJ [26]. In acute and
the bite line, tooth tissue damage (enamel cracks, abfractions, subacute TMD, significantly greater weakening and thinning of
excessive tooth wear beyond what is expected with age) [9, 21, the mandibular neck ultrastructure have been observed, along

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 Krystian Matusz et al., Bruxism — an overview

with more disorders than in an asymptomatic control group. It depending on the following diagnostic media. The diagnosis
has been shown that mandibular neck weakness and craniofa- basing on the symptoms reported by the patient as “positive
cial symptoms are more common in women with bruxism than self-report” indicates “possible bruxism”, while “probable
in a control group [8]. Clear indications of bruxism have also bruxism” is based on clinical examinations with/without a pos-
been observed in children with asthma and sleep apnoea [37, itive patient interview, and “certain bruxism” is determined
38]. Moreover, there are scientific reports indicating the possi- by instrumental tests with/without a positive history and/or
bility of diagnosing psychological abuse at an early age, based a positive clinical examination [1, 47].
on the severity of bruxism in children. This subject certainly — In relation to the TMD diagnostic criteria, bruxism is
requires further research, as alternative methods of diagnosing determined using Axis II and the Oral Behaviour Check-
various types of violence are exceptionally important for the list (OBC). Axis II is related to an assessment of the
mental health of the very young [39, 40]. It is also possible psychological and physical dimension of pain, including
that drugs such as dopamine antagonists, dopamine agonists, pain intensity, pain-related disability, and the presence
tricyclic antidepressants, and selective serotonin inhibitors, as of depression and non-specific symptoms, based on the
well as alcohol, cocaine and amphetamines, can contribute to patient’s opinion [47]. An awake bruxism diagnosis lacks
the progression of bruxism symptoms. Studies have shown that objective tests, as it is mostly based on medical interview
reducing the dose clearly reduces the symptoms [20, 22, 41]. consisting of a detailed history of tics and parafunction
Dystonias and other muscular problems, as well as de- and visual observation of the patient’s behaviour [48].
velopmental disorders including various types of autism and — An easy way to initially differentiate between sleep and
neurological diseases that may have environmental and trau- awake bruxism symptoms is to observe the severity of them
matic causes, can further be exemplified as bruxism-related during the day: symptoms gradually decrease as the day
conditions [22]. progresses in SB, in contrast to awake bruxism symptoms,
which gradually increase throughout the day [49].
Diagnosis
Due to the variety of symptoms and the overlaps with other Therapy for bruxism
conditions, a bruxism diagnosis requires careful evaluation
that includes questionnaires, records of past bruxism epi- The treatment of bruxism may include various therapy
sodes, and thorough examination. To confirm the diagnosis of options, e.g.:
bruxism, there are two different methods: a non-instrumental — educational therapy for a patient about harmful habits;
method based on the patient’s description of symptoms, ques- — biofeedback;
tionnaires, medical history, and clinical examinations [21, 25, — muscle relaxation exercises;
42–44]; and an instrumental method using electromyography — occlusal splint therapy;
(EMG) and polysomnography, showing muscle activity during — short-term medications;
sleep and the lack of associated epileptic activity [1]. — botulinum toxin injections;
EMG recording of masticatory muscle activity is con- — psychotherapy (stress reduction, lifestyle change, hyp-
sidered to be an objective criterion and together with pol- nosis);
ysomnography should be considered the gold standard in — electric method;
SB diagnosis [1, 2, 9, 45]. Interestingly, in 3.75% of patients — correction of short-circuit disturbances.
with bruxism, EMG has shown epilepsy activity, and in
a polysomnography study, a higher percentage of patients Educational therapy
woke up after falling asleep than in the control group [46]. The purpose of this is to make the patient aware of the
Standardised diagnostic criteria for temporomandibular joint existence of parafunction and its harmfulness, as well as to
dysfunction (DC/TMD) are also helpful in setting a diagnosis interrupt pathological reactions. The patient is recommended
[1, 2, 47]. The minimum diagnostic criteria for SB, according to conduct regular physical activity, maintain muscle and joint
to the International Classification of Sleep Disorders, Revised balance (correct posture), to avoid gum chewing, to not clench
(ICSD-R), include symptoms of clenching and grinding of their teeth, and to maintain correct nasal breathing with the
the teeth while sleeping, and at least one additional symptom correct position of the tongue.
such as excessive tooth wear, tooth grinding heard by other He/she is also advised to use physical self-regulatory tech-
household members, or excessive tension in the facial and niques. The goal of this method is to produce physiological
neck muscles [26]. changes that will reduce pain, fatigue and physical overload
Every dentist should be able to distinguish between the [50]. However, only a small number of well-designed studies
tooth wear caused by bruxism and that caused by malocclu- into the effectiveness of Cognitive Behavioural Therapy (CBT)
sion, especially because evaluation scales helpful in reliable are available at the moment, meaning that further exploration
assessment are widely available [21]. There are three different is needed in order to unequivocally state that CBT has a posi-
levels of probability that a patient suffers from bruxism, tive effect in SB management [51].

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Biofeedback therapy between the physiological load and that generated by stress.
This technique is based on the premise that patients with Occlusal splints can lead to the stabilisation of bruxism by re-
bruxism can consciously ‘unlearn’ their pathological behaviour ducing deformities and deviations in the temporomandibular
[52]. It uses positive feedback as a teaching strategy focused joint, reducing the load on the joint [62]. Different types of
on lowering patients’ stress levers, potentially ensuing in splints vary slightly in their effectiveness, but due to the low
long-term behavioural changes aiming at the reduction or level of commitment needed from the patient, the relatively
elimination of symptoms. low price, and noticeable pain reduction, they are often the
This is, however, a controversial method of remedying chosen option. We must underline nevertheless that most
bruxism, as studies have shown that significant results have splints only mechanically minimise tooth destruction, and
been achieved with AB but not yet with SB [1, 45, 53]. Fur- so do not affect bruxism itself. Additionally, in the case of
thermore, proper sleep hygiene (i.e. relaxation before bedtime, SB, they have to be worn at night, which for some patients is
caffeine reduction, etc.) is recommended for SB control, al- a significant inconvenience [51].
though the therapeutic effect has not been proven [54]. Mobile
phone applications such as BruxApp are available to download Short-term medications
and may be helpful in tracking occurrences of AB as well as Analgesics, sedatives, anxiolytics, antidepressants, and
control attempts. They should make patients aware of the scale muscle relaxants can be used in the pharmacotherapy of brux-
of the problem along with helping to cut down the number of ism [63], whereby the NSAIDs are recommended to use for
episodes of AB [55–57]. The effectiveness of biofeedback ther- pain relief [64]. In order to reduce the increased skeletal muscle
apy in studies is in general highly rated, but the patient often tone, patients are administered tolperisone (e.g. mydocalm
needs to carry a portable device that’s either continuously 50 mg 3 x 1). For anxiolytic and sedative treatment, most often
monitoring muscle tension or frequently reminds the carrier 25 mg of hydroxyzine 1 hour before bedtime is prescribed [26].
to consciously relax their masseters throughout the day [51]. However, recent studies have shown that there is insufficient
evidence-based data to draw definite conclusions concerning
Muscle relaxation and posture exercises medications attenuating SB and/or AB [65].
The proper mandibular resting position is as follows: lips
together, teeth having contact only when swallowing. To bal- Botulinum toxin
ance the overactivity of the masticatory muscles and stretch Botulinum toxin (BTX) has been widely used both in
them, muscle relaxation exercises are recommended. These ex- the treatment of various diseases and in aesthetic medicine.
ercises are also aimed at teaching the patient the correct resting It is a strong neurotoxin — an exotoxin produced by strictly
position of the tongue, the correct path of nasal breathing, and anaerobic bacteria (bacilli called Clostridium botulinum, and
how to avoid parafunction. For example, myorelaxation exer- a few other representatives of the genus Clostridium). Type
cises have been used with good results in our clinic. A single A botulinum toxin (BTX-A) is the most potent toxin known
cycle of relaxation exercises includes five steps: [66]. It binds permanently to the neuromuscular plate, and
I. Setting the mandible in a relaxed position paralyses neuromuscular conduction by fragmenting the
II. Protrusive movement to reach ‘tete-a-tete’ teeth contact SNAP-25 protein (synaptosomal protein) necessary in the
III. Opening mouth process of acetylcholine release from presynaptic terminals.
IV. Closing mouth until tete-a-tete contact After intramuscular injection, there is initially rapid binding
V. Returning jaw to starting position. to specific, high affinity cell surface receptors for the toxin,
Exercises are recommended three times a day, with 20 rep- followed by the toxin being transported across the cell mem-
etitions each time in a half-sitting position with supported brane by receptor-mediated endocytosis, and eventually the
head, straight and uncrossed legs. Patients should exercise toxin is released into the cytosol. This process is accompa-
daily for a month, freely but without force, roughly at the nied by a progressive inhibition of acetylcholine release. The
speed of their heartbeat [52]. results begin to be noticeable after 2–3 days; the maximum
effect occurs around 2–6 weeks after the injection and lasts
Occlusal splint therapy 2-4 months. BTX-A indirectly reduces the bite force (i.e. the
To prevent negative consequences of SB, stabilising and force generated by the masticatory muscles measured at the
repositioning splints can be used [58–60]. These splints elim- contact point of antagonist teeth during biting) by 20–40% in
inate occlusal obstacles, relax the chewing and neck muscles the masseter muscle [67–70]. Therapeutically, very low doses
by passive stretching, improve the occlusive and neuromus- are used, resulting in the effect of botulinum toxin being
cular stabilisation, and reposition the mandibular heads and limited to the area of administration.
articular discs. Recently, there has been an increase in the number of cases
Gomes at el. [61] showed that the use of splint therapy treated with botulinum toxin type A [71–74]. Alonso-Navarro
in the treatment of SB improves quality of life. They showed et al. [75] found BTX-A to be a safe and effective treatment for
that the use of occlusal splints creates a biomechanical balance patients with severe bruxism. They administered BTX-A into

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 Krystian Matusz et al., Bruxism — an overview

both the masseter and temporal muscles, using a final dose Correction of short-circuit disturbances
of 25–40 IU per muscle. The treatment effect lasted between In some cases, correction of malocclusion is sufficient. Im-
13 and 26 weeks. Fernandez-Nunez et al. [76] reported that provements are achieved by integrated dental work including
an injection of BTX-A can reduce the frequency of bruxism orthodontic, prosthetic and conservative treatment. This might
episodes, lower the level of pain, and weaken the bite strength. be explained by the fact that all occlusal obstacles recognised
Kwon et al. [69,70] have recommended the administra- by the stomatognathic system will result in pulp inflammation
tion of BTX-A at a dose of 25–30 BU in the masseter per and, in the longer term, remodelling of first the alveolus, and
side, at three injection sites, and in the temporalis muscle later the entire temporomandibular joint, which will burden
recommended a dose of ​​15–20 BU per side at 2–3 sites. It is the masticatory muscles. Obtaining evenly distributed occlusal
advised to aspirate each time in order to avoid intravenous forces on the surfaces of the teeth will allow harmonious work
administration. Jost [77] recommended in his book a dose of of the muscles and, as the outcome, their relaxation [57, 88, 89].
50–100 U in the masseter per side at three injection sites, and in However, opinions remain divided. Some scientists consider
the temporalis muscle a dose of 50–100 U per side at 3–4 sites the above claims to be true, while others highlight the fact that
as well. Monroy et al. [78] have stated that treatment of brux- in order to properly remodel patients’ occlusion, a dentist has
ism with botulinum toxin can cause dysphagia, slight pain at to interfere, even minimally, with already worn teeth. Both
the injection site, and temporary excessive salivation, but that parties agree though that the problem does not start with the
these symptoms appeared only in patients who received a dose teeth, but rather with the nerves and muscles [49].
above 100 IU or who had other systemic diseases present. It is Future bruxism research should focus on a better under-
believed that doses of below 100 IU of BTX-A administered to standing of the pathophysiology of the condition and the im-
the masseter and temporalis muscles are safe, and that their use pact of its negative and positive clinical factors. Nevertheless,
is practicable in day-to-day clinical practice. Although BTX-A establishing reliable guidelines for a correct diagnosis will be
is a very good agent in the therapy of bruxism, whether the challenging. A ‘4A’ principle has been suggested: accurate,
events of bruxism would recur or rebound after botulinum applicable, affordable and accessible [1]. Additionally, an ir-
toxin injection needs more follow-up clinical evidence [79]. refutable relationship between bruxism, TMD and neck pain
Furthermore, Yurttutan et al. have reported that relaxation is still poorly understood, and calls for further analysis [1, 90].
splints may not be needed in patients treated with BTX-A [73]. And beyond that, the current definition of SB seems to
ignore the fact that the evidence is insufficient and inconclusive
Psychological care in determining how the condition alters sleep quality and how
Psychological factors vastly influence the aetiology and it is related to other sleep disorders. Therefore, changing the
treatment of bruxism [14, 36, 39, 80–82]. Zhang et al. [26] definition status without further exploration of these aspects
showed that the maximum bite force decreased in an experi- is simply wrong [91].
mental group (administered with BTX-A) and in control and
placebo groups as well. The lack of differences between the Clinical implications/bruxism as potential
control group and the placebo group may indicate a substantial manifestation of neurological disorder
role of psychological intervention in the treatment of bruxism.
Psychological counselling, self-suggestion, hippotherapy or TMD caused by bruxism may manifest as otalgia [92]. Based
psychotherapy, relaxation techniques and stress management on self-reports, bruxism may also be accompanied by sleep
are all endorsed in the treatment of bruxism. problems and their awake consequences such as: difficulties
The most recent reports have emphasised the importance initiating sleep (DIS), disrupted sleep (DS), early morning awak-
of proper sleep hygiene, additionally recommending medi- enings (EMA), non-restorative sleep (NRS), tiredness, and sleep
tating or listening to relaxing music while falling asleep [83]. deprivation (SLD) [93]. An association between self-reported
bruxism and increased nightmares has also been found [94].
Biostimulation All of the above points to the conclusion that bruxism
Electro-galvanic stimulation relaxing the muscles is cur- might be a symptom of some neurological disorders. Among
rently used as a therapy for bruxism. Despite its simplicity, these, we can mention obstructive sleep apnoea (OSA)
this is not a widespread method, and there are still only a few (33.3–53.7%); somnologists have been encouraged to consider
publications regarding its efficiency [84]. Another inexpensive SB as a comorbid condition with OSA [95]. Lavigne et al. [96]
new method is photobiomodulation with light-emitting diode have pointed to the frequent coexistence of SB and Restless
(LED) [85], which has been used, with very promising results, Leg Syndrome (RLS); they report, based on a questionnaire,
in the treatment of fibromyalgia [86]. Despite little research, a prevalence of SB of 17.3% of adults with RLS, and of 14.5%
we can already find optimistic results reporting biostimulation of those reporting unpleasant leg sensations at night. 73.7%
to have a magnifying effect on other forms of treatment, for of patients with sleep-related gastroesophageal reflux disease
example in patients with splints having their trigger points have been diagnosed with probable SB (by self-report and
irradiated [87]. clinical inspection) [97].

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There are also reports showing a correlation between SB, primary sleep bruxism. Sleep. 2022; 45(4): zsab207, doi: 10.1093/
REM behavioural disorder and Parkinson’s Disease, although sleep/zsab207, indexed in Pubmed: 34383078.
a full explanation is lacking [95]. In medical interview anal- 4. Vieira KRM, Folchini CM, Heyde MD, et al. Wake-up headache is as-
sociated with sleep bruxism. Headache. 2020; 60(5): 974–980, doi:
ysis of patients with epilepsy, 23.7% of them reported SB,
10.1111/head.13816, indexed in Pubmed: 32323305.
compared to 5.4% of individuals from the control group
5. Chattrattrai T, Blanken TF, Lobbezoo F, et al. A network analysis of
[95]. In one article [97] a report of the occurrence of possible self-reported sleep bruxism in the Netherlands sleep registry: its
SB in patients with nightmares was stated, and furthermore associations with insomnia and several demographic, psychological,
in another questionnaire study [98] the prevalence of SB in and life-style factors. Sleep Med. 2022; 93: 63–70, doi: 10.1016/j.
sleepwalkers and sleeptalkers was reported to be higher than sleep.2022.03.018, indexed in Pubmed: 35429746.
in the control group. 6. Castelo P, Barbosa T, Gavião M. Quality of life evaluation of chil-
Symptoms such as headache, pain and stiffness in the dren with sleep bruxism. BMC Oral Health. 2010; 10: 16, doi:
muscles and joints of the head and neck, difficulty in opening 10.1186/1472-6831-10-16, indexed in Pubmed: 20546581.
and closing the mouth, and tinnitus, are thought to be asso- 7. Machado NA, Costa YM, Quevedo HM, et al. The association of self-
ciated with SB, while AB is associated with joint sounds and -reported awake bruxism with anxiety, depression, pain threshold at
pressure, pain vigilance, and quality of life in patients undergoing
depressive personality disorder [2, 8, 9, 22].
orthodontic treatment. J Appl Oral Sci. 2020; 28: e20190407, doi:
The above consequences of bruxism can be divided into
10.1590/1678-2019-0407, indexed in Pubmed: 32236355.
three groups: 8. Piekartz Hv, Rösner C, Batz A, et al. Bruxism, temporomandibular
— negative, e.g. chewing muscle pain, pathological tooth dysfunction and cervical impairments in females - Results from an
wear, prosthetic complications [41, 50, 99, 100] observational study. Musculoskelet Sci Pract. 2020; 45: 102073,
— positive, e.g. termination of an episode of sleep apnoea, doi: 10.1016/j.msksp.2019.102073, indexed in Pubmed: 31678819.
reducing risk of chemical clash by increased salivation 9. van Selms MKA, Visscher CM, Naeije M, et al. Bruxism and associa-
in patients with gastro-oesophageal reflux disease [1, 25] ted factors among Dutch adolescents. Community Dent Oral Epide-
— neutral, where bruxism is seen as a harmless habit that miol. 2013; 41(4): 353–363, doi: 10.1111/cdoe.12017, indexed in
does not affect masticatory system [1]. Pubmed: 23121154.
10. Caivano T, Felipe-Spada N, Roldán-Cubero J, et al. Influence of genetics
and biopsychosocial aspects as etiologic factors of bruxism. Cranio.
Takeaway message
2021; 39(3): 183–185, doi: 10.1080/08869634.2021.1904181,
As bruxism is multi-factorial and complex, an inter-
indexed in Pubmed: 33853510.
disciplinary approach in diagnosis and treatment is highly 11. Heyat MdB, Akhtar F, Khan MH, et al. Detection, treatment planning,
recommended. Although easier access to a wider range of and genetic predisposition of bruxism: a systematic mapping process
information has increased the awareness of patients suffer- and network visualization technique. CNS Neurol Disord Drug Targets.
ing from bruxism [17], they often only start to seek medical 2021; 20(8): 755–775, doi: 10.2174/18715273196662011101249
advice when the symptoms are already advanced. Thus, the 54, indexed in Pubmed: 33172381.
importance of awareness campaigns and the encouragement 12. Rintakoski K, Hublin C, Lobbezoo F, et al. Genetic factors account for
of earlier check-ups must be underlined [80, 98]. half of the phenotypic variance in liability to sleep-related bruxism in
An equally important aspect is broadening medical young adults: a nationwide Finnish twin cohort study. Twin Res Hum
Genet. 2012; 15(6): 714–719, doi: 10.1017/thg.2012.54, indexed in
professionals’ knowledge of bruxism, which will help earlier
Pubmed: 22953759.
diagnosis and earlier adoption of appropriate treatment. This
13. Maciejewska-Szaniec Z, Kaczmarek-Ryś M, Hryhorowicz S, et al. Poly-
whole topic is a very complex one, and deserves further mul-
morphic variants in genes related to stress coping are associated
tidimensional research. with the awake bruxism. BMC Oral Health. 2021; 21(1): 496, doi:
10.1186/s12903-021-01844-1, indexed in Pubmed: 34610834.
Conflicts of interest: None 14. Przystańska A, Jasielska A, Ziarko M, et al. Psychosocial pre-
Funding: None dictors of bruxism. Biomed Res Int. 2019; 2019: 2069716, doi:
10.1155/2019/2069716, indexed in Pubmed: 31737656.
References 15. Dahoun T, Nour MM, McCutcheon RA, et al. The relationship between
childhood trauma, dopamine release and dexamphetamine-induced
1. Lobbezoo F, Ahlberg J, Raphael KG, et al. International consensus positive psychotic symptoms: a [C]-(+)-PHNO PET study. Transl Psy-
on the assessment of bruxism: report of a work in progress. J Oral chiatry. 2019; 9(1): 287, doi: 10.1038/s41398-019-0627-y, indexed
Rehabil. 2018; 45(11): 837–844, doi: 10.1111/joor.12663, indexed in Pubmed: 31712556.
in Pubmed: 29926505. 16. Almeida-Leite CM, Stuginski-Barbosa J, Conti PC. How psychoso-
2. Manfredini D, Winocur E, Guarda-Nardini L, et al. Epidemiology of cial and economic impacts of COVID-19 pandemic can interfere on
bruxism in adults: a systematic review of the literature. J Orofac Pain. bruxism and temporomandibular disorders? J Appl Oral Sci. 2020;
2013; 27(2): 99–110, doi: 10.11607/jop.921, indexed in Pubmed: 28: e20200263, doi: 10.1590/1678-7757-2020-0263, indexed in
23630682. Pubmed: 32401942.
3. Toyota R, Fukui KI, Kamimura M, et al. Sleep stage-dependent chan- 17. Kardeş E, Kardeş S. Google searches for bruxism, teeth grinding,
ges in tonic masseter and cortical activities in young subjects with and teeth clenching during the COVID-19 pandemic. J Orofac Orthop.

460 www.journals.viamedica.pl/neurologia_neurochirurgia_polska
 Krystian Matusz et al., Bruxism — an overview

2022; 83(6): 1–6, doi: 10.1007/s00056-021-00315-0, indexed in 33. Huynh N, Kato T, Rompré PH, et al. Sleep bruxism is associated
Pubmed: 34185102. to micro-arousals and an increase in cardiac sympathetic acti-
18. Wetselaar P, Vermaire EJH, Lobbezoo F, et al. The prevalence of awa- vity. J Sleep Res. 2006; 15(3): 339–346, doi: 10.1111/j.1365-
ke bruxism and sleep bruxism in the Dutch adult population. J Oral -2869.2006.00536.x, indexed in Pubmed: 16911037.
Rehabil. 2019; 46(7): 617–623, doi: 10.1111/joor.12787, indexed 34. Huynh N, Lavigne GJ, Lanfranchi PA, et al. The effect of 2 sympatholy-
in Pubmed: 30830687. tic medications - propranolol and clonidine - on sleep bruxism: experi-
19. Winocur-Arias O, Winocur E, Shalev-Antsel T, et al. Painful temporo- mental randomized controlled studies. Sleep. 2006; 29(3): 307–316,
mandibular disorders, bruxism and oral parafunctions before and doi: 10.1093/sleep/29.3.307, indexed in Pubmed: 16553016.
during the COVID-19 pandemic era: a sex comparison among dental 35. D’Ambrosio E, Dahoun T, Pardiñas AF, et al. The effect of a genetic va-
patients. J Clin Med. 2022; 11(3), doi: 10.3390/jcm11030589, inde- riant at the schizophrenia associated AS3MT/BORCS7 locus on stria-
xed in Pubmed: 35160041. tal dopamine function: A PET imaging study. Psychiatry Res Neuroima-
20. Quadri MF, Mahnashi A, Al Almutahhir A, et al. Association of ging. 2019; 291: 34–41, doi: 10.1016/j.pscychresns.2019.07.005,
awake bruxism with khat, coffee, tobacco, and stress among ja- indexed in Pubmed: 31386983.
zan university students. Int J Dent. 2015; 2015: 842096, doi: 36. Serra-Negra JM, Lobbezoo F, Martins CC, et al. Prevalence of sleep
10.1155/2015/842096, indexed in Pubmed: 26491448. bruxism and awake bruxism in different chronotype profiles: Hy-
21. Koyano K, Tsukiyama Y, Ichiki R, et al. Assessment of bruxism in the pothesis of an association. Med Hypotheses. 2017; 101: 55–58, doi:
clinic. J Oral Rehabil. 2008; 35(7): 495–508, doi: 10.1111/j.1365- 10.1016/j.mehy.2017.01.024, indexed in Pubmed: 28351492.
-2842.2008.01880.x, indexed in Pubmed: 18557916. 37. Amato JN, Tuon RA, Castelo PM, et al. Assessment of sleep bruxism,
22. Goldstein RE, Auclair Clark W. The clinical management of awake orthodontic treatment need, orofacial dysfunctions and salivary bio-
bruxism. J Am Dent Assoc. 2017; 148(6): 387–391, doi: 10.1016/j. markers in asthmatic children. Arch Oral Biol. 2015; 60(5): 698–
adaj.2017.03.005, indexed in Pubmed: 28550845. –705, doi: 10.1016/j.archoralbio.2015.02.011, indexed in Pubmed:
23. Svensson P, Jadidi F, Arima T, et al. Relationships between cranio- 25757147.
facial pain and bruxism. J Oral Rehabil. 2008; 35(7): 524–547, 38. Buske-Kirschbaum A, von Auer K, Krieger S, et al. Blunted cortisol
doi: 10.1111/j.1365-2842.2008.01852.x, indexed in Pubmed: responses to psychosocial stress in asthmatic children: a general
18557918. feature of atopic disease? Psychosom Med. 2003; 65(5): 806–810,
24. Carra MC, Huynh N, Lavigne G. Sleep bruxism: a comprehensive over- doi: 10.1097/01.psy.0000095916.25975.4f, indexed in Pubmed:
view for the dental clinician interested in sleep medicine. Dent Clin 14508024.
North Am. 2012; 56(2): 387–413, doi: 10.1016/j.cden.2012.01.003, 39. Serra-Negra JM, Pordeus IA, Corrêa-Faria P, et al. Is there an asso-
indexed in Pubmed: 22480810. ciation between verbal school bullying and possible sleep bruxism in
25. Nijakowski K, Ortarzewska M, Morawska A, et al. Bruxism influence adolescents? J Oral Rehabil. 2017; 44(5): 347–353, doi: 10.1111/
on volume and interleukin-1β concentration of gingival crevicular joor.12496, indexed in Pubmed: 28214362.
fluid: a preliminary study. Appl Sci. 2022; 12(4): 2089, doi: 10.3390/ 40. Fulgencio LB, Corrêa-Faria P, Lage CF, et al. Diagnosis of sleep bru-
app12042089. xism can assist in the detection of cases of verbal school bullying
26. Murali RV, Rangarajan P, Mounissamy A. Bruxism: conceptual discus- and measure the life satisfaction of adolescents. Int J Paediatr Dent.
sion and review. J Pharm Bioallied Sci. 2015; 7(Suppl 1): S265–S270, 2017; 27(4): 293–301, doi: 10.1111/ipd.12264, indexed in Pubmed:
doi: 10.4103/0975-7406.155948, indexed in Pubmed: 26015729. 27598528.
27. Hoz-Aizpurua JLd, Diaz-Alonso E, LaTouche-Arbizu R, et al. Sleep bru- 41. Buescher JJ. Temporomandibular joint disorders. Am Fam Physician.
xism. Conceptual review and update. Medicina Oral Patología Oral y 2007; 76(10): 1477–1482, indexed in Pubmed: 18052012.
Cirugia Bucal. 2011; 16(2): e231–e238, doi: 10.4317/medoral.16. 42. Leal TR, de Lima LC, Neves ÉT, et al. Factors associated with awa-
e231, indexed in Pubmed: 21196839. ke bruxism according to perceptions of parents/guardians and self-
28. Klasser GD, Rei N, Lavigne GJ. Sleep bruxism etiology: the evolution -reports of children. Int J Paediatr Dent. 2022; 32(1): 22–30, doi:
of a changing paradigm. J Can Dent Assoc. 2015; 81: f2, indexed in 10.1111/ipd.12786, indexed in Pubmed: 33730404.
Pubmed: 25633110. 43. Botelho J, Machado V, Proença L, et al. Relationship between self-
29. Boscato N, Exposto F, Nascimento GG, et al. Is bruxism associated -reported bruxism and periodontal status: Findings from a cross-sec-
with changes in neural pathways? A systematic review and meta- tional study. J Periodontol. 2019 [Epub ahead of print], doi: 10.1002/
-analysis of clinical studies using neurophysiological techniques. Brain JPER.19-0364, indexed in Pubmed: 31850520.
Imaging Behav. 2022; 16(5): 2268–2280, doi: 10.1007/s11682- 44. Mizutani S, Ekuni D, Tomofuji T, et al. Factors related to the formation
021-00601-w, indexed in Pubmed: 35088353. of buccal mucosa ridging in university students. Acta Odontol Scand.
30. Mascaro MB, Bittencourt JC, Casatti CA, et al. Alternative pathways 2014; 72(1): 58–63, doi: 10.3109/00016357.2013.797102, indexed
for catecholamine action in oral motor control. Neurosci Lett. 2005; in Pubmed: 23692316.
386(1): 34–39, doi: 10.1016/j.neulet.2005.05.062, indexed in 45. Ilovar S, Zolger D, Castrillon E, et al. Biofeedback for treatment of
Pubmed: 15978723. awake and sleep bruxism in adults: systematic review protocol. Syst
31. Lavigne GJ, Soucy JP, Lobbezoo F, et al. Double-blind, crossover, place- Rev. 2014; 3: 42, doi: 10.1186/2046-4053-3-42, indexed in Pubmed:
bo-controlled trial of bromocriptine in patients with sleep bruxism. Clin 24886985.
Neuropharmacol. 2001; 24(3): 145–149, doi: 10.1097/00002826- 46. Shadimetova NM, Saidkhodzhayeva SN. Neurophysiological charac-
200105000-00005, indexed in Pubmed: 11391125. teristics of sleep bruxism in children. World Bull Soc Sci. 2022; 9:
32. Lobbezoo F, Lavigne GJ, Tanguay R, et al. The effect of catecholamine 47–50.
precursor L-dopa on sleep bruxism: a controlled clinical trial. Mov 47. Schiffman E, Ohrbach R, Truelove E, et al. International RDC/TMD
Disord. 1997; 12(1): 73–78, doi: 10.1002/mds.870120113, indexed Consortium Network, International association for Dental Research,
in Pubmed: 8990057. Orofacial Pain Special Interest Group, International Association for

www.journals.viamedica.pl/neurologia_neurochirurgia_polska 461
Neurologia i Neurochirurgia Polska 2022, vol. 56, no. 6

the Study of Pain. Diagnostic criteria for temporomandibular disorders Health. 2019; 19(1): 205, doi: 10.1186/s12903-019-0897-z, indexed
(DC/TMD) for clinical and research applications: recommendations of in Pubmed: 31484524.
the international RDC/TMD consortium network* and orofacial pain 63. Barth SW, Lehner MD, Dietz GPH, et al. Pharmacologic treatments
special interest group†. J Oral Facial Pain Headache. 2014; 28(1): in preclinical tinnitus models with special focus on Ginkgo biloba
6–27, doi: 10.11607/jop.1151, indexed in Pubmed: 24482784. leaf extract EGb 761®. Mol Cell Neurosci. 2021; 116: 103669, doi:
48. Lavigne GJ, Khoury S, Abe S, et al. Bruxism physiology and pathology: 10.1016/j.mcn.2021.103669, indexed in Pubmed: 34560255.
an overview for clinicians. J Oral Rehabil. 2008; 35(7): 476–494, 64. Kulkarni S, Thambar S, Arora H. Evaluating the effectiveness of non-
doi: 10.1111/j.1365-2842.2008.01881.x, indexed in Pubmed: steroidal anti-inflammatory drug(s) for relief of pain associated with
18557915. temporomandibular joint disorders: A systematic review. Clin Exp
49. Shetty S, Pitti V, Satish Babu CL, et al. Bruxism: a literature review. J In- Dent Res. 2020; 6(1): 134–146, doi: 10.1002/cre2.241, indexed in
dian Prosthodont Soc. 2010; 10(3): 141–148, doi: 10.1007/s13191- Pubmed: 32067407.
011-0041-5, indexed in Pubmed: 21886404. 65. de Baat C, Verhoeff M, Ahlberg J, et al. i in. Medications and addictive
50. Carlson CR, Bertrand PM, Ehrlich AD, et al. Physical self-regulation tra- substances potentially inducing or attenuating sleep bruxism and/or
ining for the management of temporomandibular disorders. J Orofac awake bruxism. J Oral Rehabil. 2021; 48(3): 343–354, doi: 10.1111/
Pain. 2001; 15(1): 47–55, indexed in Pubmed: 11889647. joor.13061, indexed in Pubmed: 32716523.
51. Minakuchi H, Fujisawa M, Abe Y, et al. Managements of sleep bruxism 66. Rasetti-Escargueil C, Popoff MR. Antibodies and vaccines against
in adult: a systematic review. Jpn Dent Sci Rev. 2022; 58: 124–136, botulinum toxins: available measures and novel approaches. Toxins
doi: 10.1016/j.jdsr.2022.02.004, indexed in Pubmed: 35356038. (Basel). 2019; 11(9): 528, doi: 10.3390/toxins11090528, indexed
52. Amorim CSM, Espirito Santo AS, Sommer M, et al. Effect of physical in Pubmed: 31547338.
therapy in bruxism treatment: a systematic review. J Manipulative Phy- 67. Botzenhart UU, Gerlach R, Gredes T, et al. Expression rate of myo-
siol Ther. 2018; 41(5): 389–404, doi: 10.1016/j.jmpt.2017.10.014, genic regulatory factors and muscle growth factor after botulinum
indexed in Pubmed: 30041736. toxin A injection in the right masseter muscle of dystrophin deficient
53. Wang LF, Long Hu, Deng M, et al. Biofeedback treatment for sleep (mdx) mice. Adv Clin Exp Med. 2019; 28(1): 11–18, doi: 10.17219/
bruxism: a systematic review. Sleep Breath. 2014; 18(2): 235–242, acem/76263, indexed in Pubmed: 30085421.
doi: 10.1007/s11325-013-0871-y, indexed in Pubmed: 23756884. 68. Shim YJ, Lee HJ, Park KJ, et al. Botulinum toxin therapy for managing
54. Mesko ME, Hutton B, Skupien JA, et al. Therapies for bruxism: a syste- sleep bruxism: a randomized and placebo-controlled trial. Toxins (Ba-
matic review and network meta-analysis (protocol). Syst Rev. 2017; sel). 2020; 12(3): 168, doi: 10.3390/toxins12030168, indexed in
6(1): 4, doi: 10.1186/s13643-016-0397-z, indexed in Pubmed: Pubmed: 32182879.
28086992. 69. Kwon KH, Shin KSu, Yeon SH, et al. Application of botulinum toxin in
55. Manfredini D, Bracci A, Djukic G. BruxApp: the ecological momenta- maxillofacial field: part I. Bruxism and square jaw. Maxillofac Plast
ry assessment of awake bruxism. Minerva Stomatol. 2016; 65(4): Reconstr Surg. 2019; 41(1): 38, doi: 10.1186/s40902-019-0218-0,
252–5, indexed in Pubmed: 27374364. indexed in Pubmed: 31649901.
56. Osiewicz MA, Lobbezoo F, Bracci A, et al. Ecological momentary as- 70. Kwon KH, Shin KSu, Yeon SH, et al. Application of botulinum toxin in
sessment and intervention principles for the study of awake bruxism maxillofacial field: part III. ancillary treatment for maxillofacial surgery
behaviors, part 2: development of a smartphone application for a mul- and summary. Maxillofac Plast Reconstr Surg. 2019; 41(1): 45, doi:
ticenter investigation and chronological translation for the polish ver- 10.1186/s40902-019-0226-0, indexed in Pubmed: 31709199.
sion. Front Neurol. 2019; 10: 170, doi: 10.3389/fneur.2019.00170, 71. Pirazzini M, Rossetto O, Eleopra R, et al. Botulinum neurotoxins: bio-
indexed in Pubmed: 30890999. logy, pharmacology, and toxicology. Pharmacol Rev. 2017; 69(2): 200–
57. Colonna A, Lombardo L, Siciliani G, et al. Smartphone-based appli- –235, doi: 10.1124/pr.116.012658, indexed in Pubmed: 28356439.
cation for EMA assessment of awake bruxism: compliance evalua- 72. Ågren M, Sahin C, Pettersson M. The effect of botulinum toxin
tion in a sample of healthy young adults. Clin Oral Investig. 2020; injections on bruxism: a systematic review. J Oral Rehabil. 2020; 47(3):
24(4): 1395–1400, doi: 10.1007/s00784-019-03098-2, indexed in 395–402, doi: 10.1111/joor.12914, indexed in Pubmed: 31769044.
Pubmed: 31646395. 73. Yurttutan ME, Tütüncüler Sancak K, Tüzüner AM. Which treat-
58. Jokubauskas L, Baltrušaitytė A, Pileičikienė G. Oral appliances for ment is effective for bruxism: occlusal splints or botulinum toxin?
managing sleep bruxism in adults: a systematic review from 2007 to J Oral Maxillofac Surg. 2019; 77(12): 2431–2438, doi: 10.1016/j.
2017. J Oral Rehabil. 2018; 45(1): 81–95, doi: 10.1111/joor.12558, joms.2019.06.005, indexed in Pubmed: 31302066.
indexed in Pubmed: 28859236. 74. Fernández-Núñez T, Amghar-Maach S, Gay-Escoda C. Efficacy of bo-
59. Hardy RS, Bonsor SJ. The efficacy of occlusal splints in the treatment tulinum toxin in the treatment of bruxism: systematic review. Med
of bruxism: a systematic review. J Dent. 2021; 108: 103621, doi: Oral Patol Oral Cir Bucal. 2019; 24(4): e416–e424, doi: 10.4317/
10.1016/j.jdent.2021.103621, indexed in Pubmed: 33652054. medoral.22923, indexed in Pubmed: 31246937.
60. van der Zaag J, Lobbezoo F, Wicks DJ, et al. Controlled assessment of 75. Alonso-Navarro H, Jiménez-Jiménez FJ, Plaza-Nieto JF, et al. Treatment
the efficacy of occlusal stabilization splints on sleep bruxism. J Orofac of severe bruxism with botulinum toxin type A. Rev Neurol. 2011;
Pain. 2005; 19(2): 151–158, indexed in Pubmed: 15895838. 53(2): 73–76, indexed in Pubmed: 21720976.
61. Gomes CA, El-Hage Y, Amaral AP, et al. Effects of massage therapy and oc- 76. Fernández-Núñez T, Amghar-Maach S, Gay-Escoda C. Efficacy of bo-
clusal splint usage on quality of life and pain in individuals with sleep bru- tulinum toxin in the treatment of bruxism: systematic review. Med
xism: a randomized controlled trial. J Jpn Phys Ther Assoc. 2015; 18(1): Oral Patol Oral Cir Bucal. 2019; 24(4): e416–e424, doi: 10.4317/
1–6, doi: 10.1298/jjpta.Vol18_001, indexed in Pubmed: 26733760. medoral.22923, indexed in Pubmed: 31246937.
62. Gholampour S, Gholampour H, Khanmohammadi H. Finite element 77. Jost W. Atlas of Botulinum Toxin Injection. Quintessence Publishing,
analysis of occlusal splint therapy in patients with bruxism. BMC Oral Batavia 2019.

462 www.journals.viamedica.pl/neurologia_neurochirurgia_polska
 Krystian Matusz et al., Bruxism — an overview

78. Monroy PG, da Fonseca MA. The use of botulinum toxin-a in the treat- 89. Ghafournia M, Hajenourozali Tehrani M. Relationship between bru-
ment of severe bruxism in a patient with autism: a case report. Spec xism and malocclusion among preschool children in isfahan. J Dent
Care Dentist. 2006; 26(1): 37–39, doi: 10.1111/j.1754-4505.2006. Res Dent Clin Dent Prospects. 2012; 6(4): 138–142, doi: 10.5681/
tb01508.x, indexed in Pubmed: 16703933. joddd.2012.028, indexed in Pubmed: 23277860.
79. Cheng Y, Yuan L, Ma Li, et al. Efficacy of botulinum - a for nocturnal 90. Lobbezoo F, van der Zaag J, van Selms MKA, et al. Principles for the
bruxism pain and the occurrence of bruxism events: a meta-analy- management of bruxism. J Oral Rehabil. 2008; 35(7): 509–523,
sis and systematic review. Br J Oral Maxillofac Surg. 2022; 60(2): doi: 10.1111/j.1365-2842.2008.01853.x, indexed in Pubmed:
174–182, doi: 10.1016/j.bjoms.2021.03.005, indexed in Pubmed: 18557917.
34955330. 91. Hublin C, Kaprio J, Partinen M, et al. Parasomnias: co-occur-
80. Flueraşu MI, Bocşan IC, Țig IA, et al. The epidemiology of bruxism in rence and genetics. Psychiatr Genet. 2001; 11(2): 65–70, doi:
relation to psychological factors. Int J Environ Res Public Health. 2022; 10.1097/00041444-200106000-00002, indexed in Pubmed:
19(2): 691, doi: 10.3390/ijerph19020691, indexed in Pubmed: 11525419.
35055514. 92. Bashir A, Jawa D, Somani R, et al. All about bruxism - the teeth grinding.
81. Manfredini D, Lobbezoo F. Role of psychosocial factors in the etiology J Adv Med Dent Sci Res. 2021; 9(5): 9–23, doi: 10.21276/jamdsr.
of bruxism. J Orofac Pain. 2009; 23(2): 153–166, indexed in Pubmed: 93. Ahlberg K, Jahkola A, Savolainen A, et al. Associations of reported
19492540. bruxism with insomnia and insufficient sleep symptoms among media
82. Duarte J, Souza JF, Cavalcante-Leão B, et al. Association of po- personnel with or without irregular shift work. Head Face Med. 2008;
ssible sleep bruxism with daytime oral habits and sleep be- 4: 4, doi: 10.1186/1746-160X-4-4, indexed in Pubmed: 18307774.
havior in schoolchildren. Cranio. 2021; 39(5): 372–378, doi: 94. Shokry SM, El Wakeel EE, Al-Maflehi N, et al. Association between
10.1080/08869634.2019.1661113, indexed in Pubmed: 31483213. self-reported bruxism and sleeping patterns among dental students
83. Imbriglio TV, Moayedi M, Freeman BV, et al. Music modulates awake in saudi arabia: a cross-sectional study. Int J Dent. 2016; 2016:
bruxism in chronic painful temporomandibular disorders. Headache. 4327081, doi: 10.1155/2016/4327081, indexed in Pubmed:
2020; 60(10): 2389–2405, doi: 10.1111/head.13971, indexed in 27034672.
Pubmed: 32997813. 95. Kuang B, Li D, Lobbezoo F, et al. Associations between sleep bruxism
84. Lal SJ, Weber, DDS KK. Bruxism Management. [Updated 2022 Oct and other sleep-related disorders in adults: a systematic review. Sleep
12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls 2022. Med. 2022; 89: 31–47, doi: 10.1016/j.sleep.2021.11.008, indexed
85. Kobayashi FY, Castelo PM, Gonçalves ML, et al. Evaluation of the in Pubmed: 34879286.
effectiveness of infrared light-emitting diode photobiomodulation in 96. Lavigne GJ, Montplaisir JY. Restless legs syndrome and sleep bruxism:
children with sleep bruxism: Study protocol for randomized clinical prevalence and association among Canadians. Sleep. 1994; 17(8):
trial. Medicine (Baltimore). 2019; 98(38): e17193, doi: 10.1097/ 739–743, indexed in Pubmed: 7701186.
MD.0000000000017193, indexed in Pubmed: 31567965. 97. Li Y, Yu F, Niu L, et al. Associations among bruxism, gastroesophageal
86. da Silva MM, Albertini R, Leal-Junior EC, et al. Effects of exercise reflux disease, and tooth wear. J Clin Med. 2018; 7(11): 417, doi:
training and photobiomodulation therapy (EXTRAPHOTO) on pain in 10.3390/jcm7110417, indexed in Pubmed: 30404150.
women with fibromyalgia and temporomandibular disorder: study pro- 98. Serra-Negra JM, Lobbezoo F, Correa-Faria P, et al. Relationship of
tocol for a randomized controlled trial. Trials. 2015; 16: 252, doi: self-reported sleep bruxism and awake bruxism with chronotype pro-
10.1186/s13063-015-0765-3, indexed in Pubmed: 26040789. files in Italian dental students. Cranio. 2019; 37(3): 147–152, doi:
87. Demirkol N, Sari F, Bulbul M, et al. Effectiveness of occlusal splints 10.1080/08869634.2018.1431600, indexed in Pubmed: 29376478.
and low-level laser therapy on myofascial pain. Lasers Med Sci. 2015; 99. Erden S. Sleep-related bruxism response to melatonin treatment.
30(3): 1007–1012, doi: 10.1007/s10103-014-1522-7, indexed in J Child Adolesc Psychopharmacol. 2020; 30(3): 201, doi: 10.1089/
Pubmed: 24504660. cap.2019.0143, indexed in Pubmed: 31800301.
88. Ribeiro-Lages MB, Martins ML, Magno MB, et al. Is there associa- 100. Câmara-Souza MB, Figueredo OMC, Rodrigues Garcia RCM. Tongue for-
tion between dental malocclusion and bruxism? A systematic review ce, oral health-related quality of life, and sleep index after bruxism mana-
and meta-analysis. J Oral Rehabil. 2020; 47(10): 1304–1318, doi: gement with intraoral devices. J Prosthet Dent. 2020; 124(4): 454–460,
10.1111/joor.12971, indexed in Pubmed: 32246486. doi: 10.1016/j.prosdent.2019.07.017, indexed in Pubmed: 31831164.

www.journals.viamedica.pl/neurologia_neurochirurgia_polska 463