How do you diagnose sleep bruxism?

Sleep bruxism is a repetitive stereotypical sleep-related movement disorder. It is characterized by teeth grinding and clenching. Most patients think of bruxism at night after someone told them they grind their teeth or a dentist asked if they grind their teeth at night.

The gold standard for diagnosing sleep bruxism is a polysomnographic evaluation. However, this is costly and not readily available so not a very efficient testing measure. Therefore, a clinical diagnosis is made.

Diagnosis of sleep bruxism is largely based on reports of:

1. Tooth-grinding sounds during sleep

2. Dental findings such as tooth wear

3. Morning symptoms of jaw muscle pain or stiffness, and

4. Masseter muscle hypertrophy and pain

Clinically, I consult with a patient’s dentist to determine if he/she has found any findings of tooth wear during a dental cleaning. Otherwise, tooth grinding sounds and morning symptoms are subjective question during history taking.

Masseter muscle hypertrophy and pain is found through an objective, physical examination of palpation either extra-orally (as shown in picture), or intra-orally.

The treatment for bruxism varies due to the etiology being multifactorial. Many dental experts will recommend a mouth guard to protect the enamel on the teeth.

Manual and rehabilitative clinicians, including physical therapists, work alongside your dental team. We perform myofascial work to the upper cervical spine (neck), the muscles of mastication (i.e. masseter and temporalis), and address postural impairments through pain relieving exercises.

Some clinicians also recommend hypnosis or other psychological therapies to address any anxiety or depression.

If you are grinding your teeth at night and continuing to wake up with headaches, jaw or neck pain, contact us for a consultation so we can help figure out what is the best approach for you.