Sleep Bruxism



Sleep Bruxism is an oral habit characterized by a rhythmic activity of the temporo-mandibular muscles that causes a forced contact between dental surfaces during sleep.

It is accompanied by tooth clenching or grinding that can be loud enough to be heard by the bed partner.

Sleep bruxism has been linked to cranio-mandibular disorders including headaches, temporo-mandibular joint discomfort and muscle aches, premature loss of teeth due to excessive attrition and mobility, and sleep disruption of the bruxer as well as the bed partner.

Sleep bruxism can have a significant effect on the patient's quality of life.

It may also be associated with a number of disorders.

However, little was known about the epidemiology of sleep bruxism and its risk factors in the general population.

METHODS

A cross-sectional telephone survey using the Sleep-EVAL knowledge based system was performed. A representative sample of three general populations (United Kingdom, Germany, and Italy) consisting of 158 million inhabitants was constituted. Thirteen thousand fifty-seven subjects aged > or = 15 years (United Kingdom, 4,972 subjects; Germany, 4,115 subjects; and Italy, 3,970 subjects) participated.

They were interviewed with a Clinical questionnaire on bruxism (using the International Classification of Sleep Disorders [ICSD] minimal set of criteria).

Associated pathologies (ie, sleep, breathing disorders, and psychiatric and neurologic pathologies) were also investigated.

RESULTS

Grinding of teeth during sleep occurring at least weekly was reported by 8.2% of the subjects, and significant consequences from teeth grinding during sleep (ie, muscular discomfort on awakening, disturbing tooth grinding, or necessity of dental work) were found in half of these subjects.

Moreover, 4.4% of the population fulfilled the criteria of ICSD sleep bruxism diagnosis.

HOW FREQUENT IS SLEEP BRUXISM?


Source: Ohayon MM et al. Risk factors for sleep bruxism in the general population. Chest 2001;119(1):53-61.


At higher risk of reporting sleep bruxism were subjects with:

  • obstructive sleep apnea syndrome (odds ratio [OR], 1.8),
  • loud snoring (OR, 1.4),
  • moderate daytime sleepiness (OR, 1.3),
  • heavy alcohol consumption (OR, 1.8),
  • caffeine consumption (OR, 1.4),
  • tobacco consumption (OR, 1.3),
  • highly stressful life (OR, 1.3),
  • with anxiety (OR, 1.3).

In summary, sleep bruxism is common in the general population and represents the third most frequent parasomnia. It has numerous consequences, which are not limited to dental or muscular problems. Among the associated risk factors, patients with anxiety and sleep-disordered breathing have a higher number of risk factors for sleep bruxism, and this must raise concerns about the future of these individuals. An educational effort to raise the awareness of dentists and physicians about this pathology is necessary.

REFERENCES

  1. Ohayon MM, Li KK, Guilleminault C. Risk factors for sleep bruxism in the general population. Chest. 2001 Jan;119(1):53-61.