Management of bruxism

Identify the cause and address any triggers of bruxism, if possible, which may require a multidisciplinary approach.

Sleep bruxism can be managed by avoiding risk factors, relaxation techniques, hypnotherapy, biofeedback, cognitive behavioural therapy (CBT) and improving sleep hygiene.

Management of awake bruxism requires habit recognition and reversal, and stress management. There is no evidence for hypnotherapy, biofeedback or cognitive behavioural therapy for awake bruxism.

There is insufficient evidence to support the use of drugs in the management of awake or sleep bruxism.

Full-coverage intraoral occlusal appliances (splints or dental guards) can be used to protect the teeth from attrition during sleep bruxism. They should be custom-made by a dentist with appropriate expertise or an oral medicine specialist, regularly reviewed and adjusted as required. In addition to preventing tooth damage, intraoral occlusal appliances reduce muscle strain and loading of the temporomandibular joints; however, they do not cure bruxism. Partial coverage splints should not be used because of the potential for significant occlusal changes and the risk of aspiration.