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J Oral Rehabil. 2018 Nov;45(11):837-844. doi: 10.1111/joor.12663. Epub 2018 Jun 21.

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

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Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
Department of Oral & Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA.
School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA.
Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan.
Sleep Medicine Center, Osaka University Hospital, Osaka, Japan.
Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.
Department of Dentistry, University Hospitals Leuven, Leuven, Belgium.
Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, Lexington, KY, USA.
Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
Centre d'étude du sommeil, Faculty of Dental Medicine, Université de Montréal and Hôpital du Sacré Coeur, Montréal, PQ, Canada.
Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
Scandinavian Center for Orofacial Neurosciences.
School of Dentistry, University of Siena, Siena, Italy.


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.


assessment; awake bruxism; bruxism; clinical inspection; cut-off points; definition; electromyography; polysomnography; self-report; sleep bruxism

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