{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:56:12Z","timestamp":1792522572513,"version":"4.5.0"},"reference-count":54,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T00:00:00Z","timestamp":1661817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Awake bruxism (AB) is differentiated from sleep bruxism (SB) by the differences in etiology, comorbidities, and consequences related to the different spectrum of muscle activities exerted in relation to the different circadian manifestations. Furthermore, less literature data are available on AB than on SB. The introduction of ecological momentary assessment (EMA) strategies has allowed for collecting valuable data on the frequency of the different activities reported by an individual in his\/her natural environment. This strategy has been further improved with the recent use of smartphone technologies. Recent studies have described an average frequency of AB behaviors, within the range of 23\u201340% for otherwise healthy young adults. An association between AB and some psychological traits has emerged, and the findings have indicated that patients with musculoskeletal symptoms (e.g., temporomandibular joint and\/or muscle pain, muscle stiffness, and fatigue) report higher AB frequencies. Preliminary data suggest that muscle bracing and teeth contact are the most commonly reported behaviors, while teeth clenching is much less frequently reported than commonly believed previously. Report of teeth grinding during wakefulness is almost absent. This paper has critically reviewed the currently available approaches for the assessment of AB. In addition, some future perspectives and suggestions for further research have been provided.<\/jats:p>","DOI":"10.3390\/jcm11175083","type":"journal-article","created":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:13:56Z","timestamp":1661904836000},"page":"5083","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["Current Knowledge and Future Perspectives on Awake Bruxism Assessment: Expert Consensus Recommendations"],"prefix":"10.3390","volume":"11","author":[{"given":"Alessandro","family":"Bracci","sequence":"first","affiliation":[{"name":"Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9877-7640","authenticated-orcid":false,"given":"Frank","family":"Lobbezoo","sequence":"additional","affiliation":[{"name":"Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6088-3739","authenticated-orcid":false,"given":"Birgitta","family":"H\u00e4ggman-Henrikson","sequence":"additional","affiliation":[{"name":"Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malm\u00f6 University, 20506 Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5869-2068","authenticated-orcid":false,"given":"Anna","family":"Colonna","sequence":"additional","affiliation":[{"name":"Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Nyk\u00e4nen","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki, 00100 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7835-574X","authenticated-orcid":false,"given":"Matteo","family":"Pollis","sequence":"additional","affiliation":[{"name":"Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jari","family":"Ahlberg","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki, 00100 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4352-3085","authenticated-orcid":false,"given":"Daniele","family":"Manfredini","sequence":"additional","affiliation":[{"name":"Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"International Network for Orofacial Pain and Related Disorders Methodology (INfORM)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Manfredini, D., Ahlberg, J., and Lobbezoo, F. (2021). Bruxism definition: Past, present, and future\u2014What should a prosthodontist know?. J. Prosthet. Dent.","DOI":"10.1016\/j.prosdent.2021.01.026"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/joor.12011","article-title":"Bruxism defined and graded: An international consensus","volume":"40","author":"Lobbezoo","year":"2013","journal-title":"J. Oral Rehabil."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1111\/joor.12663","article-title":"International consensus on the assessment of bruxism: Report of a work in progress","volume":"45","author":"Lobbezoo","year":"2018","journal-title":"J. Oral Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/joor.12413","article-title":"Is bruxism a disorder or a behavior? Rethinking the international consensus on defining and grading of bruxism","volume":"43","author":"Raphael","year":"2016","journal-title":"J. Oral Rehabil."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1111\/joor.12426","article-title":"Why not stop looking at bruxism as a black\/white condition? Aetiology could be unrelated to clinical consequences","volume":"43","author":"Manfredini","year":"2016","journal-title":"J. Oral Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1111\/joor.13063","article-title":"Why using \u201charmless behaviour\u201d, \u201crisk factor\u201d and \u201cprotective factor\u201d as terms describing the various possible consequences of bruxism is still the best option","volume":"48","author":"Lobbezoo","year":"2020","journal-title":"J. Oral Rehabil."},{"key":"ref_7","unstructured":"Kryger, M., Roth, T., Goldstein, C., and Dement, W.C. (2022). Principles and Practice of Sleep Medicine, Elsevier. [7th ed.]."},{"key":"ref_8","unstructured":"Kryger, M., Roth, T., Goldstein, C., and Dement, W.C. (2022). Principles and Practice of Sleep Medicine, Elsevier. [7th ed.]."},{"key":"ref_9","first-page":"153","article-title":"Role of psychosocial factors in the etiology of bruxism","volume":"23","author":"Manfredini","year":"2009","journal-title":"J. Orofac. Pain"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Emodi-Perlman, A., Manfredini, D., Shalev, T., Bracci, A., Frideman-Rubin, P., and Eli, I. (2021). Psychosocial and Behavioral Factors in Awake Bruxism-Self-Report versus Ecological Momentary Assessment. J. Clin. Med., 10.","DOI":"10.3390\/jcm10194447"},{"key":"ref_11","first-page":"1","article-title":"Awake bruxism frequency and psychosocial factors in college preparatory students","volume":"14","author":"Carvalho","year":"2020","journal-title":"Cranio"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1177\/154411130301400104","article-title":"Neurobiological mechanisms involved in sleep bruxism","volume":"14","author":"Lavigne","year":"2003","journal-title":"Crit. Rev. Oral Biol. Med."},{"key":"ref_13","first-page":"191","article-title":"Topical review: Sleep bruxism and the role of peripheral sensory influences","volume":"17","author":"Kato","year":"2003","journal-title":"J. Orofac. Pain"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1111\/j.1365-2842.2011.02226.x","article-title":"Influence of psychological symptoms on home-recorded sleep-time masticatory muscle activity in healthy subjects","volume":"38","author":"Manfredini","year":"2011","journal-title":"J. Oral Rehabil."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/joor.13271","article-title":"Temporal relationship between sleep-time masseter muscle activity and apnea-hypopnea events: A pilot study","volume":"49","author":"Colonna","year":"2022","journal-title":"J. Oral Rehabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1111\/joor.12833","article-title":"The bruxism construct: From cut-off points to a continuum spectrum","volume":"46","author":"Manfredini","year":"2019","journal-title":"J. Oral Rehabil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1111\/joor.13170","article-title":"Signal acquisition and analysis of ambulatory electromyographic recordings for the assessment of sleep bruxism: A scoping review","volume":"48","author":"Thymi","year":"2021","journal-title":"J. Oral Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e13320","DOI":"10.1111\/jsr.13320","article-title":"Research routes on improved sleep bruxism metrics: Toward a standardised approach","volume":"30","author":"Lavigne","year":"2021","journal-title":"J. Sleep Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/joor.12938","article-title":"Towards a standardised tool for the assessment of bruxism (STAB)\u2014Overview and general remarks of a multidimensional bruxism evaluation system","volume":"47","author":"Manfredini","year":"2020","journal-title":"J. Oral Rehabil."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1111\/j.1365-2842.2008.01880.x","article-title":"Assessment of bruxism in the clinic","volume":"35","author":"Koyano","year":"2008","journal-title":"J. Oral Rehabil."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1111\/joor.12101","article-title":"Correlation between self-reported and clinically based diagnoses of bruxism in temporomandibular disorders patients","volume":"40","author":"Paesani","year":"2013","journal-title":"J. Oral Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1111\/joor.12320","article-title":"Agreement between clinical and portable EMG\/ECG diagnosis of sleep bruxism","volume":"42","author":"Castroflorio","year":"2015","journal-title":"J. Oral Rehabil."},{"key":"ref_23","first-page":"342","article-title":"Tooth wear in young subjects: A discriminator between sleep bruxers and controls?","volume":"22","author":"Abe","year":"2009","journal-title":"Int. J. Prosthodont."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"199","DOI":"10.11607\/ofph.2081","article-title":"Correlation Between Sleep-Time Masseter Muscle Activity and Tooth Wear: An Electromyographic Study","volume":"33","author":"Manfredini","year":"2019","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1111\/joor.12310","article-title":"Validity of self-reported sleep bruxism among myofascial temporomandibular disorder patients and controls","volume":"42","author":"Raphael","year":"2015","journal-title":"J. Oral Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1111\/joor.13042","article-title":"Correlates and genetics of self-reported sleep and awake bruxism in a nationwide twin cohort","volume":"47","author":"Ahlberg","year":"2020","journal-title":"J. Oral Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Van Selms, M., Kroon, J., Tuomilehto, H., Peltomaa, M., Savolainen, A., Manfredini, D., Lobbezoo, F., and Ahlberg, J. (2020). Self-reported sleep bruxism among Finnish symphony orchestra musicians: Associations with perceived sleep-related problems and psychological stress. Cranio, 1\u20138.","DOI":"10.1080\/08869634.2020.1853310"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/j.1365-2842.2011.02281.x","article-title":"Self-reported bruxism and temporomandibular disorders: Findings from two specialised centres","volume":"39","author":"Manfredini","year":"2012","journal-title":"J. Oral Rehabil."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1080\/08869634.2018.1431600","article-title":"Relationship of self-reported sleep bruxism and awake bruxism with chronotype profiles in Italian dental students","volume":"37","author":"Lobbezoo","year":"2019","journal-title":"Cranio"},{"key":"ref_30","first-page":"31","article-title":"Self-reported oral parafunctions and pain intensity in temporomandibular disorder patients","volume":"20","author":"Lobbezoo","year":"2006","journal-title":"J. Orofac. Pain"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"6","DOI":"10.11607\/jop.1151","article-title":"Diagnostic Criteria for Temporomandibular Disorders (DC\/TMD) for Clinical and Research Applications: Recommendations of the International RDC\/TMD Consortium Network* and Orofacial Pain Special Interest Group","volume":"28","author":"Schiffman","year":"2014","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_32","first-page":"306","article-title":"Oral behaviors checklist: Reliability of performance in targeted waking-state behaviors","volume":"20","author":"Markiewicz","year":"2006","journal-title":"J. Orofac. Pain"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"169","DOI":"10.3389\/fneur.2019.00169","article-title":"Ecological Momentary Assessment and Intervention Principles for the Study of Awake Bruxism Behaviors, Part 1: General Principles and Preliminary Data on Healthy Young Italian Adults","volume":"10","author":"Zani","year":"2019","journal-title":"Front. Neurol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1093\/abm\/16.3.199","article-title":"Ecological Momentary Assessment (EMA) in behavioral medicine","volume":"16","author":"Stone","year":"1999","journal-title":"Ann. Behav. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"481","DOI":"10.3389\/fpsyg.2015.00481","article-title":"Virtues, ecological momentary assessment\/intervention and smartphone technology","volume":"6","author":"Runyan","year":"2015","journal-title":"Front. Psychol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1007\/s00784-019-03098-2","article-title":"Smartphone-based application for EMA assessment of awake bruxism: Compliance evaluation in a sample of healthy young adults","volume":"24","author":"Colonna","year":"2020","journal-title":"Clin. Oral Investig."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1111\/joor.13259","article-title":"Utility of Smartphone-based real-time report (Ecological Momentary Assessment) in the assessment and monitoring of awake bruxism: A multiple-week interval study in a Portuguese population of university students","volume":"48","author":"Dias","year":"2021","journal-title":"J. Oral Rehabil."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Emodi-Perlman, A., Manfredini, D., Shalev, T., Yevdayev, I., Frideman-Rubin, P., Bracci, A., Arnias-Winocur, O., and Eli, I. (2021). Awake Bruxism-Single-Point Self-Report versus Ecological Momentary Assessment. J. Clin. Med., 10.","DOI":"10.20944\/preprints202103.0343.v1"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1016\/j.tripleo.2010.02.013","article-title":"Relationship between bruxism and temporomandibular disorders: A systematic review of literature from 1998 to 2008","volume":"109","author":"Manfredini","year":"2010","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1111\/joor.12821","article-title":"To what extent is bruxism associated with musculoskeletal signs and symptoms? A systematic review","volume":"46","author":"Thymi","year":"2019","journal-title":"J. Oral Rehabil."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"103711","DOI":"10.1016\/j.jdent.2021.103711","article-title":"Sleep bruxism and temporomandibular disorders: A scoping review of the literature","volume":"111","author":"Manfredini","year":"2021","journal-title":"J. Dent."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1111\/j.1365-2842.2008.01881.x","article-title":"Bruxism physiology and pathology: An overview for clinicians","volume":"35","author":"Lavigne","year":"2008","journal-title":"J. Oral Rehabil."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"99","DOI":"10.11607\/jop.921","article-title":"Epidemiology of bruxism in adults: A systematic review of the literature","volume":"27","author":"Manfredini","year":"2013","journal-title":"J. Orofac. Pain"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1177\/0022034515625216","article-title":"Longitudinal multilevel modeling of facial pain, muscle tension, and stress","volume":"95","author":"Glaros","year":"2016","journal-title":"J. Dent. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1111\/joor.12129","article-title":"Evaluation of the non-functional tooth contact in patients with temporomandibular disorders by using newly developed electronic system","volume":"41","author":"Funato","year":"2014","journal-title":"J. Oral Rehabil."},{"key":"ref_46","first-page":"185","article-title":"Nonfunctional tooth contact in healthy controls and patients with myogenous facial pain","volume":"21","author":"Chen","year":"2007","journal-title":"J. Orofac. Pain"},{"key":"ref_47","first-page":"252","article-title":"BruxApp: The ecological momentary assessment of awake bruxism","volume":"65","author":"Manfredini","year":"2016","journal-title":"Minerva Stomatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1111\/joor.12627","article-title":"Frequency of awake bruxism behaviours in the natural environment. A 7-day, multiple-point observation of real-time report in healthy young adults","volume":"45","author":"Bracci","year":"2018","journal-title":"J. Oral Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Nyk\u00e4nen, L., Manfredini, D., Lobbezoo, F., K\u00e4mppi, A., Colonna, A., Zani, A., Almeida, A.M., Emodi-Perlman, A., Savolainen, S., and Bracci, A. (2022). A multi-center study on comprehension of awake bruxism terminology: Prior instructions are advisable for a successful Ecological Momentary Assessment by a smart-phone application. J. Clin. Med., 11.","DOI":"10.3390\/jcm11123444"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1111\/joor.13212","article-title":"Smartphone-based evaluation of awake bruxism behaviours in a sample of healthy young adults: Findings from two University centres","volume":"48","author":"Zani","year":"2021","journal-title":"J. Oral Rehabil."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1002\/da.22649","article-title":"Ecological momentary interventions for depression and anxiety","volume":"34","author":"Schueller","year":"2017","journal-title":"Depress. Anxiety"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1093\/jamia\/ocv043","article-title":"Effectiveness of mobile technologies delivering Ecological Momentary Interventions for stress and anxiety: A systematic review","volume":"23","author":"Griffiths","year":"2016","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1111\/ors.12454","article-title":"Bruxism: A summary of current knowledge on aetiology, assessment, and management","volume":"13","author":"Manfredini","year":"2020","journal-title":"Oral Surg."},{"key":"ref_54","unstructured":"Colonna, A., Noveri, L., Ferrari, M., Bracci, A., and Manfredini, D. Electromyographic assessment of masseter muscle activity: A proposal for a 24hr recording device with preliminary data. J. Clin. Med., in submission."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/17\/5083\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:20:02Z","timestamp":1760142002000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/17\/5083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,30]]},"references-count":54,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["jcm11175083"],"URL":"https:\/\/doi.org\/10.3390\/jcm11175083","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,30]]}}}