Diagnosis of sleep-related bruxism is based upon the history of the condition, by clinical findings and by electronic diagnostic techniques. There are three levels of accuracy in diagnosis:
POSSIBLE SLEEP-RELATED BRUXISM; Lowest Level of Accuracy
Often, the patient will be aware of tooth clenching or tooth grinding during sleep as they might wake with their teeth clenched or sore. They may wake with headaches or frequently break teeth or dental work. Their teeth may be sensitive to cold or they may notice sensitive notches forming at the gum line of their teeth. They may wake with an acidic taste due to the GERD associated with sleep-related bruxism. When this occurs, the diagnosis is termed “possible sleep-related bruxism”.
PROBABLE SLEEP-RELATED BRUXISM: Moderate Level of Accuracy
If the patient’s dentist discovers signs of sleep-related bruxism clinically and/or radiographically, and the patient is aware, it is termed “probable sleep-related bruxism”. In many cases, the dentist will find the signs of sleep-related bruxism and the patient will be unaware of them or unaware of the connection of symptoms with sleep-related bruxism.
DEFINITE SLEEP-RELATED BRUXISM: Highest Level of Accuracy
If there is an over-night home sleep study with jaw muscle recordings (EMG), that records both the bruxism activity and the associated increase in heart rate, it is termed “definite sleep-related bruxism”. There are a number of home sleep monitors that can record sleep-related bruxism. For an accurate diagnosis, heart rate should also be recorded in real-time, to register activation of the TCR reflex by sleep-related bruxism.
Home sleep studies are considered the gold standard in diagnosing sleep-related bruxism by the American Academy of Sleep Medicine.
We conduct before and after home sleep studies on all of our sleep-related bruxism patients, to ensure the sleep-related bruxism and the Trigeminal Cardiac Reflex have been stabilized.
The American Academy of Sleep Medicine recommend but do not require a home sleep study for this diagnosis and dentists are allowed to treat this condition with a “probable” diagnosis.