International consensus on the assessment of bruxism: Report of a work in progress

F. Lobbezoo, J. Ahlberg, K. G. Raphael, P. Wetselaar, A. G. Glaros, T. Kato, V. Santiago, E. Winocur, A. De Laat, R. De Leeuw, K. Koyano, G. J. Lavigne, P. Svensson, D. Manfredini

Research output: Contribution to journalComment/debatepeer-review


In 2013, consensus was obtained on a definition of bruxism as repetitive masticatory muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible and specified as either sleep bruxism or awake bruxism. In addition, a grading system was proposed to determine the likelihood that a certain assessment of bruxism actually yields a valid outcome. This study discusses the need for an updated consensus and has the following aims: (i) to further clarify the 2013 definition and to develop separate definitions for sleep and awake bruxism; (ii) to determine whether bruxism is a disorder rather than a behaviour that can be a risk factor for certain clinical conditions; (iii) to re-examine the 2013 grading system; and (iv) to develop a research agenda. It was concluded that: (i) sleep and awake bruxism are masticatory muscle activities that occur during sleep (characterised as rhythmic or non-rhythmic) and wakefulness (characterised by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible), respectively; (ii) in otherwise healthy individuals, bruxism should not be considered as a disorder, but rather as a behaviour that can be a risk (and/or protective) factor for certain clinical consequences; (iii) both non-instrumental approaches (notably self-report) and instrumental approaches (notably electromyography) can be employed to assess bruxism; and (iv) standard cut-off points for establishing the presence or absence of bruxism should not be used in otherwise healthy individuals; rather, bruxism-related masticatory muscle activities should be assessed in the behaviour's continuum.

Original languageEnglish (US)
Pages (from-to)837-844
Number of pages8
JournalJournal of oral rehabilitation
Issue number11
StatePublished - Nov 2018


  • assessment
  • awake bruxism
  • bruxism
  • clinical inspection
  • cut-off points
  • definition
  • electromyography
  • polysomnography
  • self-report
  • sleep bruxism

ASJC Scopus subject areas

  • General Dentistry


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