When should sleep bruxism be considered in the diagnosis of temporomandibular disorders?

Published:October 05, 2020DOI:


      Both temporomandibular disorders (TMDs) and sleep bruxism (SB) are known to be destructive to the masticatory system. However, the association between the 2 conditions is poorly understood. The aim of our study was to assess the relationship between TMD and SB through the signs and symptoms in 2 patient groups: TMD only and TMD with SB.

      Study Design

      A retrospective chart review was conducted from November 1, 2015, to April 1, 2018, on patients with completed International Network for Orofacial Pain and Related Disorders Methodology history questionnaires and Diagnostic Criteria for Temporomandibular Disorder clinical examinations. Fifty-two patients, including 12 with TMD only and 40 with TMD with SB, met the study criteria. Subjective descriptions and objective measurements of patient symptoms were investigated. The χ2 test and Fisher's exact test were used for statistical analysis.


      The TMD with SB group exhibited increased oral behaviors compared with the TMD-only group (P = .0004). The TMD with SB group also experienced more headaches compared with the TMD-only group (P = .045).


      Our results revealed that patients with jaw pain who self-report increased oral behaviors and/or exhibit temporal headaches should be evaluated for sleep bruxism.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


        • National Institute of Dental and Craniofacial Research
        Prevalence of TMJD and its signs and symptoms.
        National Institutes of Health, 2018 (Available at:) (Accessed September 10, 2018)
        • Wright EF
        • North SL.
        Management and treatment of temporomandibular disorders: a clinical perspective.
        J Manual Manipulat Therapy. 2009; 17: 247-254
        • Lobbezoo F
        • Ahlberg J
        • Glaros AG
        • et al.
        Bruxism defined and graded: an international consensus.
        J Oral Rehabil. 2013; 40: 2-4
        • Reding GR
        • Rubright WC
        • Zimmerman SO
        Incidence of bruxism.
        J Dent Res. 1966; 45: 1198-1204
        • Nishigawa K
        • Bando E
        • Nakano M
        Quantitative study of bite force during sleep associated bruxism.
        J Oral Rehabil. 2001; 28: 485-491
        • Lavigne GJ
        • Khoury S
        • Abe S
        • Yamaguchi T
        • Raphael K
        Bruxism physiology and pathology: an overview for clinicians.
        J Oral Rehabil. 2008; 35: 476-494
        • Yap AUJ
        • Chua AP
        Sleep bruxism: current knowledge and contemporary management.
        J Conserv Dent. 2016; 19: 383
        • Chandwani B
        • Ceneviz C
        • Mehta N
        • Scrivani S
        Incidence of bruxism in TMD population.
        N Y State Dent J. 2011; 77: 54-57
        • Chisnoiu AM
        • Picos AM
        • Popa S
        • et al.
        Factors involved in the etiology of temporomandibular disorders—a literature review.
        Clujul Medical. 2015; 88: 473
        • Schiffman E
        • Ohrbach R
        • Truelove E
        • et al.
        Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group.
        J Oral Facial Pain Headache. 2014; 28: 6
        • Castroflorio T
        • Bargellini A
        • Rossini G
        • Cugliari G
        • Deregibus A
        Sleep bruxism in adolescents: a systematic literature review of related risk factors.
        Eur J Orthod. 2017; 39: 61-68
        • Paesani DA
        • Lobbezoo F
        • Gelos C
        • Guarda-Nardini L
        • Ahlberg J
        • Manfredini D
        Correlation between self-reported and clinically based diagnoses of bruxism in temporomandibular disorders patients.
        J Oral Rehabil. 2013; 40: 803-809
        • Adibi S
        • Levine P
        • Sharp H
        • Piazza J
        What you need to know about bruxism?.
        J Greater Houston Dent Soc. 2017; 88: 15-18
        • Molina OF
        • dos Santos J
        • Mazzetto M
        • Nelson S
        • Nowlin T
        • Mainieri ÉT
        Oral jaw behaviors in TMD and bruxism: a comparison study by severity of bruxism.
        Cranio. 2001; 19: 114-122
        • Miyake R
        • Ohkubo R
        • Takehara J
        • Morita M
        Oral parafunctions and association with symptoms of temporomandibular disorders in Japanese university students.
        J Oral Rehabil. 2004; 31: 518-523
        • Fernandes G
        • Franco AL
        • Aparecida de Godoi Gonçalves D
        • Geraldo Speciali J
        • Bigal ME
        • Camparis CM
        Temporomandibular disorders, sleep bruxism, and primary headaches are mutually associated.
        J Orofac Pain. 2013; 27: 14-20
        • Costa A
        • D'Abreu A
        • Cendes F
        Temporomandibular joint internal derangement: association with headache, joint effusion, bruxism, and joint pain.
        J Contemp Dent Pract. 2008; 9: 9-16
        • Leistad R
        • Sand T
        • Westgaard R
        • Nilsen K
        • Stovner L
        Stress-induced pain and muscle activity in patients with migraine and tension-type headache.
        Cephalagia. 2006; 26: 64-73
        • Kato T
        • Masuda Y
        • Yoshida A
        • Morimoto T
        Masseter EMG activity during sleep and sleep bruxism.
        Archives Italiennes de Biologie. 2011; 149: 478-491