Volume 30, Issue 174, August 2026

The Impact of Bruxism on Orthodontic Treatment: A Literature Review

Erwin Górski^1♦, Amelia Sobanek¹, Filip Szewczyk¹, Jakub Deptuch¹, Stanisław Janczarski¹, Aleksandra Pietrzyk²

¹Institute of Dentistry of the Central Clinical Hospital of the Medical University of Łódź, Pomorska 251, 92-213 Łódź, Poland
²Centralna Wojskowa Przychodnia Lekarska CePeLek SPZOZ, 78 Koszykowa Street, 00-911 Warszawa, Poland

^♦Corresponding author
Erwin Górski, Department of Orthodontics, Medical University of Lodz, 251 Pomorska Street, 92-216 Lodz, Poland

ABSTRACT

Dentists now utilize clear aligners and adjunctive therapies, such as botulinum toxin, to treat heavy occlusal forces during orthodontic treatment. There is some evidence suggesting that applying light, continuous forces while protecting occlusion with an occlusal guard (or other protective appliances) enables safe tooth movement in patients with severe bruxism. In this research, there is an attempt to differentiate between the clinical situations, which guarantee good prognosis for orthodontic forces in bruxing patients, and those, which are considered poor. Through literature review, this paper tries to determine the real clinical limits for orthodontic forces. Studies found that modern appliances are indicated for bruxing patients, with success rates comparable to those of traditional orthodontic therapies. They are a highly effective alternative in preventing external apical root resorption (EARR) and managing muscle-related joint pain. With neuromuscular modifications, it is now possible to achieve stable tooth alignment in patients with heavy grinding. In many cases, unmanaged temporomandibular joint pain is a contraindication for active movement due to the threat of iatrogenic complications during force application. The long-term interaction between aligned teeth and continuous grinding forces is unpredictable. Some evidence suggests a risk of late relapse. Managing orthodontic patients with bruxism is a reliable treatment in specific scenarios. It is a predictable treatment when using light continuous forces and hybrid retention. Bruxism management in orthodontics is a rapidly changing field that needs attention from practitioners. Recent progress shows potential, but more studies are required to make these protocols the new standard.

Keywords: bruxism; bruxism during sleep; orthodontic treatment; clear aligner therapy; root resorption

Medical Science, 2026, 30, e149ms3944

PDF

Published: 14 August 2026