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44th Scientific Meeting
Update on Health, TMD and Sleep from a Global Perspective
May 7-10, 2020 • Orlando
LUNCH & LEARN 3. Bruxism Workshop: Assesssment and Management Guidelines
Daniele Manfredini, DDS, MSc, PhD
Saturday, May 9, 2020 — 12:15 pm – 1:30 pm
SYNOPSIS: Approaches for assessing bruxism can be distinguished as non-instrumental or instrumental. Non-instrumental approaches for assessing bruxism include self-report (questionnaires, oral history) and clinical inspection, both for sleep and awake bruxism. Instrumental approaches for assessment are currently available for both forms of bruxism. Measurement of jaw muscle activity via polysomnography (PSG) or electromyography (EMG) is the standard of reference for sleep bruxism. Ecological momentary assessment (experience sampling methodology [EMA/ESM]) app-based assessments for real time subjective information about masticatory muscle activities at certain time points during the awake phase can also provide evidence of awake bruxism. For various reasons, it must be remarked that using standard cut-off points for everyone for the ‘gold-standard’ assessment of sleep bruxism or non-sleep bruxism should not be considered optimal for clinical use in otherwise healthy individuals. This issue is best exemplified by the still inconclusive literature on the polysomnographic assessment of sleep bruxism and its clinical consequences. Within these premises, this workshop will also discuss the most recent literature on management of bruxism in adults. Currently, there is not enough evidence to define a standard of reference approach for treatment, especially considering the reigning confusion about the treatments oriented to eradicate bruxism causes and those aiming to manage the consequences. Thus, future studies on the indications for bruxism treatment are recommended. Until that, a so-called “Multiple-P” approach including Pep Talk (i.e., counseling), Plates (i.e., oral appliances), Psychology, Physiotherapy, and Pharmacology, is the best available, good-sense, option to manage bruxism and its consequences in the clinical setting.