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Orofacial Pain and Temporomandibular Disorders


Clenching & Grinding - Bruxism

What is it?

Bruxism is a repetitive jaw-muscle activity that is characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. It can occur during the day (awake bruxism) or while asleep (sleep bruxism). Awake bruxism usually occurs in the form of clenching or bracing/thrusting of the mandible, while sleep bruxism can be composed of both grinding and clenching of the teeth.


At the Perth Oral Medicine and Dental Sleep Centre, our Clinicians can provide expert advice on how to manage your bruxism habit.

Common signs and symptoms

Common signs and symptoms of bruxism may include:

  • Jaw stiffness in the morning

  • Pain within the jaw muscles or jaw joints

  • Headaches at the temple, especially in the morning

  • Tooth wear

  • Tongue indentation

  • Evidence of “cheek ridging”

  • Cracked teeth/fractures

  • Masseter muscle enlargement

  • Bed partner or partner aware of grinding noises during sleep


Awake bruxism (clenching and/or grinding during the day) has been typically related to stress and is generally seen in situations that require concentration, or during stressful periods. Some believe that is a reaction to daily stress, or part of the complex condition of anxiety in certain individuals. It has also been linked with certain neurological conditions, addiction, and autistic spectrum disorder.

Sleep bruxism (clenching and/or grinding during sleep) is thought to be multifactorial in its cause. While in some cases, the underlying cause is unknown, sleep bruxism has been associated with underlying sleep disorders, such as obstructive sleep apnoea and other sleep related movement disorders, such as restless leg syndrome. Certain neurological disorders such as Parkinson’s disease have also been associated with sleep bruxism, as well as manifestations of anxiety, depression, and somatization. Certain medications such as amphetamines can also induce sleep bruxism.


While there are different ways to diagnose bruxism. The Clinicians at Perth Oral Medicine and Dental Sleep Centre will aim to address any underlying factors contributing towards your bruxism.

Awake bruxism is generally diagnosed by patient recognition of habit of awake clenching.

The American Academy of Sleep Medicine Diagnostic Criteria  has proposed a diagnostic criterion for the assessment of sleep bruxism. This includes the presence of regular or frequent tooth grinding sounds during sleep and one or more of the following clinical signs:

  • Abnormal tooth wear consistent with reports of tooth grinding

  • Transient morning jaw muscle pain, and/or temporal headache, and/or jaw locking upon awakening

Some cases may require a sleep study to diagnose sleep bruxism.


Management of awake bruxism is generally focussed on habit reversal training, relaxation, aiming to reduce emotional stress.

It is difficult to cease the muscle activity during sleep. As such, management of sleep bruxism is based on treating the consequences of sleep bruxism. Management may vary from lifestyle changes, such as avoiding smoking, alcohol, caffeine, and illicit drugs, to behavioural medicine including relaxation and good sleep hygiene. Some individuals may benefit from an occlusal splint  or injectable therapies  to reduce grinding sounds and prevent further damage to the teeth, while others may need additional medications to help with any associated jaw pain .


Unfortunately, bruxism is a complex, multifactorial habit that is difficult to cease. With the right management however, most patients are able to function without jaw pain.

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