Bruxism is mainly regulated centrally, not peripherally.

Area of Science:

• Neurology
• Sleep Medicine
• Dentistry

Background:

• Bruxism etiology is complex and debated, with historical focus on peripheral factors.
• Current understanding emphasizes a multifactorial origin, including central and peripheral influences.
• Diagnostic challenges complicate interpretation of existing bruxism research.

Purpose of the Study:

• To review and synthesize current knowledge on the multifactorial etiology of bruxism.
• To differentiate between peripheral and central causative factors.
• To highlight the shift in focus towards central pathophysiological mechanisms.

Main Methods:

• Literature review and synthesis of existing research on bruxism etiology.
• Analysis of peripheral (morphological) and central (pathophysiological, psychological) factors.
• Examination of the role of neurotransmitters and sleep-related mechanisms.

Main Results:

• Peripheral factors like occlusal discrepancies have a diminished role in bruxism.
• Central factors, including sleep arousal responses and dopaminergic system disturbances, are increasingly implicated.
• Psychological factors such as stress and personality show equivocal results, requiring further investigation.
• Bruxism appears to be primarily centrally regulated.

Conclusions:

• Bruxism is predominantly regulated by central nervous system mechanisms.
• The etiology of bruxism is multifactorial, with a growing emphasis on central pathophysiological factors.
• Further research is needed to clarify the role of psychological factors in bruxism.