Bruxism in the Edentulous State: A Short Review of Contemporary Diagnostic and Management Paradigms

Introduction: Bruxism was originally viewed as a peripheral dental issue, yet the current understanding of bruxism shows that it is a centrally regulated neuromuscular behavior which means that the bruxism exists after tooth loss. 

Review: The present study synthesizes current research findings about bruxism in patients who have lost all their teeth. The study suggests that bruxism is more common among people without teeth than among people with teeth. Recent studies based on instrumental assessment have shown that the prevalence of sleep bruxism is higher in edentulous individuals than that found in the general population. The absence of teeth in the mouth of patients complicates the diagnosis of the disease because the clinician has to rely on the following signs: accelerated wear of the prosthesis, component fractures, and patient complaints, and additional objective evidence of using portable electromyography (EMG). The clinical consequences are very severe and can affect the longevity of both removable dentures and fixed dental prostheses. The literature on bruxism management is predominantly palliative and involves the use of robust prosthetic designs and complementary treatments such as botulinum toxin, which has been proven in a randomized controlled trial. 

Conclusion: The analysis of the literature shows that there is a huge disparity between the relevance of the problem and the amount of dedicated research, which is a clear indication that there is a need for further research to develop evidence-based guidelines for the management of the vulnerable patient population.