Sleep bruxism

Introduction
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By Geoffrey Gerstner PhD DDS MS

In this clinical summary, Dr. Gerstner of the University of Michigan explains that sleep bruxism is classified as a prevalent, simple repetitive movement disorder associated with brief, transient arousals during sleep. Sleep bruxism may provoke destruction of teeth and dental work, sleep disturbance, facial pain, changes in skeletal growth, and lifelong discomfort. Stress and use of SSRIs or nicotine may be aggravating factors. Alternatively, some evidence suggests that bruxism may help alleviate stress. There is also evidence of underlying genetic links. Comorbidities include obstructive sleep apnea, snoring, hypertension, headaches, encephalopathies, epilepsy, affective disorders, psychological stress, and anxiety. Neuroimaging studies provide evidence of functional changes in oral motor cortical areas in patients with bruxism. Treatment with sleep bruxism spans dental orthotics, behavioral modification, and medication, although there are no recommendable treatments for bruxism in children.

Key Points

  • Sleep bruxism is a simple repetitive movement disorder of unknown etiology.
  • Treatment is palliative and involves intraoral appliances, behavioral therapies, and medications.
  • Bruxism is often reported or observed by sleep partners; self-report has a substantial false-negative rate.
  • The diagnostic gold standard involves sleep studies with audio-video recordings to rule out orofacial activity artifacts.
  • Functional magnetic resonance imaging (fMRI) studies of patients with bruxism indicate central activation patterns in oral motor cortical regions reminiscent of overtraining.