Sleep and wake bruxism: why they are not the same

Bruxism is described as an activity of the chewing muscles. It can occur while we sleep or while awake, and both forms have different characteristics and evaluation methods.

Sleep bruxism

During sleep, activity can be rhythmic or non-rhythmic. The person is often not aware of it. Signs may include tooth wear, muscle discomfort when waking up, or the report of noises from someone sleeping nearby, but none of these elements alone confirm the diagnosis.

Waking bruxism

During the day it may present as repetitive or sustained tooth contact, jaw tension, or jaw thrusting. It usually appears in moments of concentration, effort or emotional tension. Awareness of daytime habits is an important part of the evaluation.

Is it a disease?

The international consensus proposes to understand bruxism as a behavior that, in healthy people, does not always constitute a disorder. It can act as a risk factor when related to dental wear, fractures, muscle pain or overloading of restorations.

How is it evaluated?

The evaluation may combine patient narrative, clinical examination, and, when indicated, instrumental recordings. For sleep bruxism, sleep studies or electromyography can provide information in selected cases.

Treatment depends on its consequences

There is no single cure for all bruxism. Management seeks to control associated factors and protect structures when there is risk. It may include education, strategies to decrease daytime clenching, sleep review, and a personalized splint when appropriate.

A splint can protect your teeth, but should not be automatically prescribed or designed to permanently change your bite. The plan is defined according to symptoms, wear and tear, history and sleep quality.