Diagnostic Tools and Management Strategies used by Specialized Dentists and Physical Therapists for Patients with Bruxism: a Delphi Procedure

Background: The most valid tool in bruxism diagnostics is considered electromyography/ polysomnography with audio/video recording. Given that this is too expensive and time-consuming for daily practice; many other tools are used to diagnose bruxism. Owing to the lack of knowledge about the etiology and (patho) physiology of bruxism, no definitive intervention exists and current management strategies mainly focus on reducing negative consequences of bruxism. This study aimed to identify diagnostic tools and management strategies that dentists and physical therapists who specialize in the orofacial region consider being the most clinically useful for patients with bruxism and which are actually used. Method: The results of a literature study were used as a starting point for a Delphi procedure. The first round (36 participants) focused on collecting preferences in diagnostics and management of bruxism. In the second round (29 participants), the number of diagnostic tools and management strategies that were rated as clinically useful were narrowed down to those that were actually used by the participants in daily practice. Results: For the diagnostics of both awake and sleep bruxism, mostly aspects of the anamnesis and the clinical examination were considered clinically useful and actually used in daily practice. Moreover, for sleep bruxism, more tools were combined to set the diagnosis than for awake bruxism. Both groups of participants valued habit reversal and lifestyle advice in the management of awake bruxism, and habit reversal, sleep hygiene advice and lifestyle advice for sleep bruxism. In addition, both groups suggested profession-specific strategies. Conclusion: The diagnostic tools and management strategies used in daily practice among specialized dentists and physical therapists in the Netherland form a colorful palette and, as expected, are determined by profession.