Stress and Bruxism: A Critical Review and Report of Cases

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Abstract
A critical review is presented of the relationship of stress to bruxism. The review is divided into the following sections: terminology, diagnosis, incidence, etiology, and therapy. Two case reports of subjects in which hypnosis and meditation were used for therapy are given. In regard to the studies, most of them were either uncontrolled or poorly controlled. Nevertheless, it is apparent that stress is etiologically implicated in the onset and maintenance of bruxism. Of the three types of bruxism, acute bruxism is the least deleterious, being situationally-related and short-lived. Nocturnal bruxism is predominantly of the auditory, grinding type. Although it is related to occlusal interferences, stress exacerbates the condition. Diurnal bruxism is usually considered to be of the silent, clenching type. It is generally reported to be stress-initiated and maintained. Indications are that relaxation therapy is effective in the amelioration of all types of bruxism. Future, well-designed and controlled studies are necessary to definitely ascertain the relationships among stress, stress management and bruxism.

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