Bruxism Mechanisms and Management Strategies

Bruxism encompasses involuntary clenching and grinding of the teeth, occurring either during sleep or wakefulness, and arises from a complex interplay of neurobiological, psychological and peripheral factors. Central mechanisms include alterations in dopaminergic and serotonergic signalling, genetic variants affecting muscle‐control pathways and the influence of stress‐sensitive traits. Peripheral contributors range from occlusal discrepancies and masticatory muscle fatigue to changes in the oral microbiome that may modulate neuroimmune communication. Bruxism often co-exists with temporomandibular disorders, obstructive sleep apnoea and mood disturbances, underscoring its multisystem significance. Management strategies span behavioural counselling, physiotherapy and biofeedback, alongside occlusal appliances designed to reduce tooth wear. Pharmacological interventions targeting neurotransmitter imbalances have shown variable efficacy. Emerging approaches include wearable electromyography devices for real-time monitoring and genetic screening to identify individuals at high risk. A deeper understanding of these mechanisms is guiding personalised prevention and therapy, with the ultimate aim of mitigating the global burden of bruxism-related morbidity.

Research from Nature Portfolio

Genetic analyses have begun to clarify how common variants in neurotransmitter receptor and enzyme genes predispose to sleep bruxism and its overlap with obstructive sleep apnoea. Work investigating single-nucleotide polymorphisms in genes encoding dopamine and serotonin receptors has identified specific alleles that both increase bruxism episode indices and intensify the association between bruxism and apnoeic events. These findings support a heritable component to bruxism and suggest that targeted modulation of these pathways may offer novel therapeutic avenues.

Bruxism Mechanisms and Management Strategies publication trend

The graph below shows the total number of articles in bruxism mechanisms and management strategies across all publications each year (not limited to Nature Index journals).

Technical terms

Sleep bruxism: Repetitive masticatory muscle activity during sleep, characterised by clenching or grinding of the teeth.

Awake bruxism: Conscious or semi‐conscious jaw‐muscle activity during wakefulness, typically involving clenching of the teeth.

Mendelian randomisation: An analytical approach using genetic variants as instrumental variables to infer causal relationships between risk factors and outcomes.

Electromyography (EMG): A technique for recording the electrical activity of muscles during contraction.

Single-nucleotide polymorphism (SNP): A variation at a single base position in the DNA sequence among individuals.

Metabolomics: The comprehensive study of small-molecule metabolites within biological samples to characterise physiological or pathological states.

Oral–brain axis: The bidirectional network linking oral microbial communities and central nervous system function via neural, immune and metabolic pathways.

References

1. A Two-Sample Mendelian Randomization Study of Neuroticism and Sleep Bruxism. Journal of Dental Research (2024).
2. Wearable Regionally Trained AI-Enabled Bruxism-Detection System. IEEE Access (2025).
3. Salivary signatures of oral-brain communication in sleep bruxers. Frontiers in Cellular and Infection Microbiology (2023).
4. Genetic basis of sleep bruxism and sleep apnea—response to a medical puzzle. Scientific Reports (2020).