Current Treatments of Bruxism

Marc Guaita, Birgit Högl, Marc Guaita, Birgit Högl

Abstract

Despite numerous case reports, the evidence for treatment of bruxism is still low. Different treatment modalities (behavioral techniques, intraoral devices, medications, and contingent electrical stimulation) have been applied. A clinical evaluation is needed to differentiate between awake bruxism and sleep bruxism and rule out any medical disorder or medication that could be behind its appearance (secondary bruxism). A polysomnography is required only in a few cases of sleep bruxism, mostly when sleep comorbidities are present. Counselling with regard to sleep hygiene, sleep habit modification, and relaxation techniques has been suggested as the first step in the therapeutic intervention, and is generally considered not harmful, despite low evidence of any efficacy. Occlusal splints are successful in the prevention of dental damage and grinding sounds associated with sleep bruxism, but their effects on reducing bruxism electromyographic (EMG) events are transient. In patients with psychiatric and sleep comorbidities, the acute use of clonazepam at night has been reported to improve sleep bruxism, but in the absence of double-blind randomized trials, its use in general clinical practice cannot be recommended. Severe secondary bruxism interfering with speaking, chewing, or swallowing has been reported in patients with neurological disorders such as in cranial dystonia; in these patients, injections of botulinum toxin in the masticatory muscles may decrease bruxism for up to 1-5 months and improve pain and mandibular functions. Long-term studies in larger and better specified samples of patients with bruxism, comparing the effects of different therapeutic modalities on bruxism EMG activity, progression of dental wear, and orofacial pain are current gaps of knowledge and preclude the development of severity-based treatment guidelines.

Keywords: Bruxism; Intraoral devices; Medications; Polysomnography; Teeth grinding; Treatment.

References

References and Recommended Reading Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

    1. Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ, et al. Bruxism defined and graded: an international consensus. J Oral Rehabil. 2013;40(1):2–4. doi: 10.1111/joor.12011.
    1. Manfredini D, Lobbezoo F. Role of psychosocial factors in the etiology of bruxism. J Orofac Pain. 2009;23(2):153–166.
    1. Kato T, Rompré P, Montplaisir JY, Sessle BJ, Lavigne GJ. Sleep bruxism: an oromotor activity secondary to micro-arousal. J Dent Res. 2001;80(10):1940–1944. doi: 10.1177/00220345010800101501.
    1. Huynh N, Kato T, Rompré PH, Okura K, Saber M, Lanfranchi PA, et al. Sleep bruxism is associated to micro-arousals and an increase in cardiac sympathetic activity. J Sleep Res. 2006;15(3):339–346. doi: 10.1111/j.1365-2869.2006.00536.x.
    1. Blanchet PJ, Rompré PH, Lavigne GJ, Lamarche C. Oral dyskinesia: a clinical overview. Int J Prosthodont. 2005;18(1):10–19.
    1. Clark GT, Ram S. Four oral motor disorders: bruxism, dystonia, dyskinesia and drug-induced dystonic extrapyramidal reactions. Dent Clin N Am. 2007;51(1):225–243. doi: 10.1016/j.cden.2006.09.002.
    1. Kwak YT, Han IW, Lee PH, Yoon JK, Suk SH. Associated conditions and clinical significance of awake bruxism. Geriatr Gerontol Int. 2009;9(4):382–390. doi: 10.1111/j.1447-0594.2009.00538.x.
    1. Winocur E, Gavish A, Voikovitch M, Emodi-Perlman A, Eli I. Drugs and bruxism: a critical review. J Orofac Pain. 2003;17(2):99–111.
    1. Lavigne GJ, Montplaisir JY. Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. Sleep. 1994;17(8):739–743.
    1. Ohayon MM, Li KK, Guilleminault C. Risk factors for sleep bruxism in the general population. Chest. 2001;119(1):53–61. doi: 10.1378/chest.119.1.53.
    1. Maluly M, Andersen ML, Dal-Fabbro C, Garbuio S, Bittencourt L, de Siqueira JT, et al. Polysomnographic study of the prevalence of sleep bruxism in a population sample. J Dent Res. 2013;92(7 Suppl):97S–103S. doi: 10.1177/0022034513484328.
    1. Jensen R, Rasmussen BK, Pedersen B, Lous I, Olesen J. Prevalence of oromandibular dysfunction in a general population. J Orofac Pain. 1993;7(2):175–182.
    1. Tan EK, Jankovic J, Ondo W. Bruxism in Huntington's disease. Mov Disord. 2000;15(1):171–173. doi: 10.1002/1531-8257(200001)15:1<171::AID-MDS1031>;2-Y.
    1. Rompré PH, Daigle-Landry D, Guitard F, Montplaisir JY, Lavigne GJ. Identification of a sleep bruxism subgroup with a higher risk of pain. J Dent Res. 2007;86(9):837–842. doi: 10.1177/154405910708600906.
    1. American Academy of Sleep Medicine . International classification of sleep disorders. 3. Darien: American Academy of Sleep Medicine; 2014.
    1. Kampe T, Edman G, Bader G, Tagdae T, Karlsson S. Personality traits in a group of subjects with long-standing bruxing behaviour. J Oral Rehabil. 1997;24(8):588–593. doi: 10.1046/j.1365-2842.1997.00541.x.
    1. Bayar GR, Tutuncu R, Acikel C. Psychopathological profile of patients with different forms of bruxism. Clin Oral Investig. 2012;16(1):305–311. doi: 10.1007/s00784-010-0492-9.
    1. Lobbezoo F, van der Zaag J, van Selms MK, Hamburger HL, Naeije M. Principles for the management of bruxism. J Oral Rehabil. 2008;35(7):509–523. doi: 10.1111/j.1365-2842.2008.01853.x.
    1. Dubé C, Rompré PH, Manzini C, Guitard F, de Grandmont P, Lavigne GJ. Quantitative polygraphic controlled study on efficacy and safety of oral splint devices in tooth-grinding subjects. J Dent Res. 2004;83(5):398–403. doi: 10.1177/154405910408300509.
    1. van der Zaag J, Lobbezoo F, Wicks DJ, Visscher CM, Hamburger HL, Naeije M. Controlled assessment of the efficacy of occlusal stabilization splints on sleep bruxism. J Orofac Pain. 2005;19(2):151–158.
    1. Harada T, Ichiki R, Tsukiyama Y, Koyano K. The effect of oral splint devices on sleep bruxism: a 6-week observation with an ambulatory electromyographic recording device. J Oral Rehabil. 2006;33(7):482–488. doi: 10.1111/j.1365-2842.2005.01576.x.
    1. Landry ML, Rompré PH, Manzini C, Guitard F, de Grandmont P, Lavigne GJ. Reduction of sleep bruxism using a mandibular advancement device: an experimental controlled study. Int J Prosthodont. 2006;19(6):549–556.
    1. Landry-Schönbeck A, de Grandmont P, Rompré PH, Lavigne GJ. Effect of an adjustable mandibular advancement appliance on sleep bruxism: a crossover sleep laboratory study. Int J Prosthodont. 2009;22(3):251–259.
    1. Arima T, Tomonaga A, Toyota M, Inoue SI, Ohata N, Svensson P. Does restriction of mandibular movements during sleep influence jaw-muscle activity? J Oral Rehabil. 2012;39(7):545–551. doi: 10.1111/j.1365-2842.2012.02310.x.
    1. Madani AS, Abdollahian E, Khiavi HA, Radvar M, Foroughipour M, Asadpour H, et al. The efficacy of gabapentin versus stabilization splint in management of sleep bruxism. J Prosthodont. 2013;22(2):126–131. doi: 10.1111/j.1532-849X.2012.00914.x.
    1. Mohamed SE, Christensen LV, Penchas J. A randomized double-blind clinical trial of the effect of amitriptyline on nocturnal masseteric motor activity (sleep bruxism) Cranio. 1997;15(4):326–332.
    1. Lobbezoo F, Lavigne GJ, Tanguay R, Montplaisir JY. The effect of catecholamine precursor L-dopa on sleep bruxism: a controlled clinical trial. Mov Disord. 1997;12(1):73–78. doi: 10.1002/mds.870120113.
    1. Lavigne GJ, Soucy JP, Lobbezoo F, Manzini C, Blanchet PJ, Montplaisir JY. Double-blind, crossover, placebo-controlled trial of bromocriptine in patients with sleep bruxism. Clin Neuropharmacol. 2001;24(3):145–149. doi: 10.1097/00002826-200105000-00005.
    1. Huynh N, Lavigne GJ, Lanfranchi PA, Montplaisir JY, de Champlain J. The effect of 2 sympatholytic medications—propranolol and clonidine—on sleep bruxism: experimental randomized controlled studies. Sleep. 2006;29(3):307–316.
    1. Shim YJ, Lee MK, Kato T, Park HU, Heo K, Kim ST. Effects of botulinum toxin on jaw motor events during sleep in sleep bruxism patients: a polysomnographic evaluation. J Clin Sleep Med. 2014;10(3):291–298.
    1. Lee SJ, McCall WD, Jr, Kim YK, Chung SC, Chung JW. Effect of botulinum toxin injection on nocturnal bruxism: a randomized controlled trial. Am J Phys Med Rehabil. 2010;89(1):16–23. doi: 10.1097/PHM.0b013e3181bc0c78.
    1. Jadidi F, Castrillon EE, Nielsen P, Baad-Hansen L, Svensson P. Effect of contingent electrical stimulation on jaw muscle activity during sleep: a pilot study with a randomized controlled trial design. Acta Odontol Scand. 2013;71(5):1050–1062. doi: 10.3109/00016357.2012.741702.
    1. Conti PC, Stuginski-Barbosa J, Bonjardim LR, Soares S, Svensson P. Contingent electrical stimulation inhibits jaw muscle activity during sleep but not pain intensity or masticatory muscle pressure pain threshold in self-reported bruxers: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2014;117(1):45–52. doi: 10.1016/j.oooo.2013.08.015.
    1. Valiente López M, van Selms MK, van der Zaag J, Hamburger HL, Lobbezoo F. Do sleep hygiene measures and progressive muscle relaxation influence sleep bruxism? Report of a randomised controlled trial. J Oral Rehabil. 2015;42(4):259–265. doi: 10.1111/joor.12252.
    1. Rintakoski K, Kaprio J. Legal psychoactive substances as risk factors for sleep-related bruxism: a nationwide Finnish Twin Cohort study. Alcohol Alcohol. 2013;48(4):487–494. doi: 10.1093/alcalc/agt016.
    1. Manfredini D, Landi N, Fantoni F, Segù M, Bosco M. Anxiety symptoms in clinically diagnosed bruxers. J Oral Rehabil. 2005;32(8):584–588. doi: 10.1111/j.1365-2842.2005.01462.x.
    1. Huynh NT, Rompré PH, Montplaisir JY, Manzini C, Okura K, Lavigne GJ. Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size. Int J Prosthodont. 2006;19(5):435–441.
    1. Gagnon Y, Mayer P, Morisson F, Rompré PH, Lavigne GJ. Aggravation of respiratory disturbances by the use of an occlusal splint in apneic patients: a pilot study. Int J Prosthodont. 2004;17(4):447–453.
    1. Ramar K, Dort LC, Katz SG, Lettieri CJ, Harrod CG, Thomas SM, et al. Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: an update for 2015. J Clin Sleep Med. 2015;11(7):773–827.
    1. Mainieri VC, Saueressig AC, Fagondes SC, Teixeira ER, Rehm DD, Grossi ML. Analysis of the effects of a mandibular advancement device on sleep bruxism using polysomnography, the BiteStrip, the sleep assessment questionnaire, and occlusal force. Int J Prosthodont. 2014;27(2):119–126. doi: 10.11607/ijp.3675.
    1. Saletu A, Parapatics S, Saletu B, Anderer P, Prause W, Putz H, et al. On the pharmacotherapy of sleep bruxism: placebo-controlled polysomnographic and psychometric studies with clonazepam. Neuropsychobiology. 2005;51(4):214–225. doi: 10.1159/000085917.
    1. Saletu A, Parapatics S, Anderer P, Matejka M, Saletu B. Controlled clinical, polysomnographic and psychometric studies on differences between sleep bruxers and controls and acute effects of clonazepam as compared with placebo. Eur Arch Psychiatry Clin Neurosci. 2010;260(2):163–174. doi: 10.1007/s00406-009-0034-0.
    1. Raphael KG, Janal MN, Sirois DA, Svensson P. Effect of contingent electrical stimulation on masticatory muscle activity and pain in patients with a myofascial temporomandibular disorder and sleep bruxism. J Orofac Pain. 2013;27(1):21–31. doi: 10.11607/jop.1029.
    1. Watts MW, Tan EK, Jankovic J. Bruxism and cranial-cervical dystonia: is there a relationship? Cranio. 1999;17(3):196–201.
    1. Tan EK, Jankovic J. Tardive and idiopathic oromandibular dystonia: a clinical comparison. J Neurol Neurosurg Psychiatry. 2000;68(2):186–190. doi: 10.1136/jnnp.68.2.186.
    1. Guaita M, van Eendenburg C, Donaire A, Aparicio J, Setoain X, Bargalló N, et al. Ictal bruxism treated with temporal lobectomy. Sleep Med. 2015;16(11):1429–1431. doi: 10.1016/j.sleep.2015.05.024.
    1. Meletti S, Cantalupo G, Volpi L, Rubboli G, Magaudda A, Tassinari CA. Rhythmic teeth grinding induced by temporal lobe seizures. Neurology. 2004;62(12):2306–2309. doi: 10.1212/WNL.62.12.2306.
    1. Wali GM. Asymmetrical awake bruxism associated with multiple system atrophy. Mov Disord. 2004;19(3):352–355. doi: 10.1002/mds.10667.
    1. Lai MM. Awake bruxism in a patient with Alzheimer's dementia. Geriatr Gerontol Int. 2013;13(4):1076–1077. doi: 10.1111/ggi.12086.
    1. Tan EK, Jankovic J. Treating severe bruxism with botulinum toxin. J Am Dent Assoc. 2000;131(2):211–216. doi: 10.14219/jada.archive.2000.0149.
    1. Pedemonte C, Pérez Gutiérrez H, González E, Vargas I, Lazo D. Use of onabotulinumtoxinA in post-traumatic oromandibular dystonia. J Oral Maxillofac Surg. 2015;73(1):152–157. doi: 10.1016/j.joms.2014.07.027.
    1. El Maaytah M, Jerjes W, Upile T, Swinson B, Hopper C, Ayliffe P. Bruxism secondary to brain injury treated with botulinum toxin-A: a case report. Head Face Med. 2006;23(2):41. doi: 10.1186/1746-160X-2-41.
    1. Ivanhoe CB, Lai JM, Francisco GE. Bruxism after brain injury: successful treatment with botulinum toxin-A. Arch Phys Med Rehabil. 1997;78(11):1272–1273. doi: 10.1016/S0003-9993(97)90343-9.
    1. Van Zandijcke M, Marchau MM. Treatment of bruxism with botulinum toxin injections. J Neurol Neurosurg Psychiatry. 1990;53(6):530. doi: 10.1136/jnnp.53.6.530.
    1. Tan EK, Chan LL, Chang HM. Severe bruxism following basal ganglia infarcts:insights into pathophysiology. J Neurol Sci. 2004;217(2):229–232. doi: 10.1016/j.jns.2003.10.003.
    1. Yi HS, Kim HS, Seo MR. Trial of oral metoclopramide on diurnal bruxism ofbrain injury. Ann Rehabil Med. 2013;37(6):871–874. doi: 10.5535/arm.2013.37.6.871.
    1. Wise M. Citalopram-induced bruxism. Br J Psychiatry. 2001;178:182. doi: 10.1192/bjp.178.2.182.
    1. Raja M, Raja S. Two cases of sleep bruxism associated with escitalopram treatment. J Clin Psychopharmacol. 2014;34(3):403–405. doi: 10.1097/JCP.0000000000000122.
    1. Ranjan SS, Chandra P, Prabhu S. Antidepressant-induced bruxism: need for buspirone? Int J Neuropsychopharmacol. 2006;9(4):485–487. doi: 10.1017/S1461145705005985.
    1. Grinshpoon A, Weizman A, Amrami-Weizman A. The beneficial effect of trazodone treatment on escitalopram-associated nocturnal bruxism. J Clin Psychopharmacol. 2014;34(5):662. doi: 10.1097/JCP.0000000000000178.
    1. Oulis P, Dimitrakopoulos S, Konstantakopoulos G, Tsaltas E, Kollias K. Low-dose aripiprazole in the treatment of SSRI-induced bruxism. J Neuropsychiatry Clin Neurosci. 2012;24(3) doi: 10.1176/appi.neuropsych.11070175.
    1. Iskandar JW, Wood B, Ali R, Wood RL. Successful monitoring of fluoxetine-induced nocturnal bruxism: a case report. J Clin Psychiatry. 2012;73(3):366. doi: 10.4088/JCP.11cr07321.
    1. Fitzgerald K, Healy A. Dystonias and dyskinesias of the jaw associated with the use of SSRIs. Hum Psychopharmacol. 1995;10:215–221. doi: 10.1002/hup.470100308.
    1. Sabuncuoglu O, Ekinci O, Berkem M. Fluoxetine-induced sleep bruxism in an adolescent treated with buspirone: a case report. Spec Care Dentist. 2009;29(5):215–217. doi: 10.1111/j.1754-4505.2009.00091.x.
    1. Soyata AZ, Oflaz S. Gabapentin treatment in bruxism associated with fluoxetine. J Clin Psychopharmacol. 2015;35(4):481–483.
    1. Lobbezoo F, van Denderen RJ, Verheij JG, Naeije M. Reports of SSRI-associated bruxism in the family physician's office. J Orofac Pain. 2001;15(4):340–346.
    1. Milanlioglu A. Paroxetine-induced severe sleep bruxism successfully treated with buspirone. Clinics (Sao Paulo) 2012;67(2):191–192. doi: 10.6061/clinics/2012(02)17.
    1. Kishi Y. Paroxetine-induced bruxism effectively treated with tandospirone. J Neuropsychiatry Clin Neurosci. 2007;19(1):90–91. doi: 10.1176/jnp.2007.19.1.90.
    1. Feng HM, Kuo SC, Chen CY, Yeh YW. Nocturnal bruxism in a patient with Behçet disease and posttraumatic stress disorder successfully treated with gabapentin. Clin Neuropharmacol. 2014;37(6):190–191. doi: 10.1097/WNF.0000000000000054.
    1. Stein DJ, Van Greunen G, Niehaus D. Can bruxism respond to serotonin reuptake inhibitors? J Clin Psychiatry. 1998;59(3):133. doi: 10.4088/JCP.v59n0308c.
    1. Bostwick JM, Jaffee MS. Buspirone as an antidote to SSRI-induced bruxism in 4 cases. J Clin Psychiatry. 1999;60(12):857–860. doi: 10.4088/JCP.v60n1209.
    1. Albayrak Y, Ekinci O. Duloxetine-induced nocturnal bruxism resolved by buspirone: case report. Clin Neuropharmacol. 2011;34(4):137–138. doi: 10.1097/WNF.0b013e3182227736.
    1. Chang JP, Wu CC, Su KP. A case of venlafaxine-induced bruxism alleviated byduloxetine substitution. Prog Neuropsychopharmacol Biol Psychiatry. 2011;35(1):307. doi: 10.1016/j.pnpbp.2010.11.025.
    1. Alonso-Navarro H, Martín-Prieto M, Ruiz-Ezquerro JJ, Jiménez-Jiménez FJ. Bruxism possibly induced by venlafaxine. Clin Neuropharmacol. 2009;32(2):111–112. doi: 10.1097/WNF.0b013e31816a3519.
    1. Jaffee MS, Bostwick JM. Buspirone as an antidote to venlafaxine-induced bruxism. Psychosomatics. 2000;41(6):535–536. doi: 10.1176/appi.psy.41.6.535.
    1. Kuloglu M, Ekinci O, Caykoylu A. Venlafaxine-associated nocturnal bruxism in a depressive patient successfully treated with buspirone. J Psychopharmacol. 2010;24(4):627–628. doi: 10.1177/0269881109102612.
    1. Brown ES, Hong SC. Antidepressant-induced bruxism successfully treated with gabapentin. J Am Dent Assoc. 1999;130(10):1467–1469. doi: 10.14219/jada.archive.1999.0057.
    1. Pavlovic ZM. Buspirone to improve compliance in venlafaxine-induced movement disorder. Int J Neuropsychopharmacol. 2004;7(4):523–524. doi: 10.1017/S1461145704004638.
    1. Detweiler MB, Harpold GJ. Bupropion-induced acute dystonia. Ann Pharmacother. 2002;36(2):251–254. doi: 10.1345/aph.1A145.
    1. Mendhekar DN, Andrade C. Antipsychotic induced bruxism treated with clozapine. J Neuropsychiatry Clin Neurosci. 2009;21(1):105–106. doi: 10.1176/jnp.2009.21.1.105.
    1. Caykoylu A, Ekinci O, Ugurlu GK, Albayrak Y. Aripiprazole-associated bruxism, akathisia, and parkinsonism in a bipolar patient. J Clin Psychopharmacol. 2011;31(1):134–135. doi: 10.1097/JCP.0b013e3182048cce.

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