Sleep Bruxism — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateOral MedicineSleep BruxismORE Part 1

A 45-year-old patient presents for a dental examination. Clinical examination reveals worn cusps on the posterior teeth bilaterally. The patient's partner reports nocturnal tooth grinding. The patient describes morning jaw stiffness. What diagnosis and management is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Sleep bruxism; management with a stabilisation splint and self-care advice

The correct answer is **A (Sleep bruxism; stabilisation splint and self-care advice)**. The clinical triad of reported nocturnal grinding, morning jaw stiffness, and bilateral occlusal wear identifies sleep bruxism with attrition. Attrition—mechanical wear from tooth-to-tooth contact during grinding—is distinguished from erosion (acid-induced smooth lesions), abrasion (toothpaste/abrasive three-body wear), and abfraction (cervical lesions). While Option A correctly names attrition, it misattributes the cause to malocclusion and proposes orthodontics—inappropriate because bruxism is neurological, not occlusal malalignment. UK and international dental practice standard-of-care for sleep bruxism is protective management with a hard stabilisation splint (preventing dental and joint damage) combined with self-care advice on sleep hygiene and stress reduction. Splints do not prevent grinding but mitigate consequences.

Reference: British Dental Association (2023). How can dentistry manage sleep conditions? https://www.bda.org/news-and-opinion/blog/how-can-dentistry-manage-sleep-conditions/; Royal College of Surgeons of England (2024). Management of painful Temporomandibular disorder in adults. https://www.rcseng.ac.uk/-/media/FDS/Comprehensive-guideline-Management-of-painful-Temporomandibular-disorder-in-adults.pdf