Editing Bruxism (section)

===Pain===
Most people with bruxism will experience no pain.<ref name="Cawson 2002" /> The presence or degree of pain does not necessarily correlate with the severity of grinding or clenching.<ref name="Cawson 2002" /> The pain in the muscles of mastication caused by bruxism can be likened to muscle pain after exercise.<ref name="Cawson 2002" /> The pain may be felt over the angle of the jaw (masseter) or in the temple (temporalis), and may be described as a headache or an aching jaw. Most (but not all) bruxism includes clenching force provided by masseter and temporalis muscle groups; but some bruxers clench and grind front teeth only, which involves minimal action of the masseter and temporalis muscles. The temporomandibular joints themselves may also become painful, which is usually felt just in front of the ear, or inside the ear itself. Clicking of the jaw joint may also develop. The forces exerted on the teeth are more than the periodontal ligament is biologically designed to handle, and so inflammation may result. A tooth may become sore to bite on, and further, tooth wear may reduce the insulating width of enamel and dentin that protects the pulp of the tooth and result in hypersensitivity, e.g. to cold stimuli.

The relationship of bruxism with [[temporomandibular joint dysfunction]] (TMD, or temporomandibular pain dysfunction syndrome) is debated. Many suggest that sleep bruxism can be a causative or contributory factor to pain symptoms in TMD.<ref name="Tyldesley 2003" /><ref name="Shetty 2010" /><ref name="Scully 2008">{{cite book |last = Scully |first = Crispian |title = Oral and maxillofacial medicine: the basis of diagnosis and treatment |year = 2008 |publisher = Churchill Livingstone |location = Edinburgh |isbn = 9780443068188 |edition = 2nd |pages = 291, 292, 343, 353, 359, 382 }}</ref><ref name="Glick 2003" /> Indeed, the symptoms of TMD overlap with those of bruxism.<ref name="De Meyer 1997">{{cite journal |vauthors=De Meyer MD, De Boever JA |title=[The role of bruxism in the appearance of temporomandibular joint disorders] |language=fr |journal=Revue Belge de Médecine Dentaire |volume=52 |issue=4 |pages=124–38 |year=1997 |pmid=9709800}}</ref> Others suggest that there is no strong association between TMD and bruxism.<ref name="Cawson 2002" /> A systematic review investigating the possible relationship concluded that when self-reported bruxism is used to diagnose bruxism, there is a positive association with TMD pain, and when stricter diagnostic criteria for bruxism are used, the association with TMD symptoms is much lower.<ref name="Manfredini 2010">{{cite journal |vauthors=Manfredini D, Lobbezoo F |title=Relationship between bruxism and temporomandibular disorders: a systematic review of literature from 1998 to 2008 |journal=Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics |volume=109 |issue=6 |pages=e26–50 |date=June 2010  |pmid=20451831 |doi=10.1016/j.tripleo.2010.02.013}}</ref> In severe, chronic cases, bruxism can lead to [[myofascial pain]] and [[arthritis]] of the temporomandibular joints.{{medical citation needed|date=May 2013}}