Bruxism

Mandibular advancement appliances are presented as effective for improving bruxism, although their mechanism is uncertain. Awake bruxism and sleep bruxism differ in likely mechanisms and sex distribution. Bite-focused treatments such as splints, night guards, NTI appliances, and occlusal interventions are not described as reliably reducing bruxism itself. Sleep bruxism is linked to sleep arousal physiology rather than only tooth alignment. The airway hypothesis proposes that bruxism may attempt to open the airway during sleep. Bruxism increases pocket depth between the tooth and gum. Bruxism increases attachment loss where the gum recedes from the tooth. Nighttime teeth grinding causes damage beyond simple mechanical wear. The effects of untreated bruxism compound progressively over years. Bruxism accelerates aging of the entire mouth. Bruxism is grinding, gnashing, or clenching the teeth during sleep or wakefulness. Persistent sleep bruxism should prompt consideration of upper airway evaluation.