Understanding Bruxism (teeth grinding and teeth clenching): Find information on diagnosis, clinical documentation, and medical coding for Bruxism. Learn about symptoms, causes, and treatment options for teeth grinding. Explore resources for healthcare professionals related to Bruxism ICD-10 codes and effective patient care strategies.
Also known as
Other somatoform disorders
Includes bruxism, a condition of teeth grinding or clenching.
Other specified disorders of trigeminal nerve
May include trigeminal neuralgia potentially related to bruxism.
Disturbances of tooth eruption
While not directly bruxism, can be affected by or contribute to teeth grinding.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the bruxism sleep related?
Yes
Code G47.63 (Sleep bruxism)
No
Is the bruxism due to a medication?
When to use each related code
| Description |
|---|
| Grinding or clenching teeth, often during sleep. |
| Jaw joint disorder causing pain, clicking, or limited jaw movement. |
| Headache focused in the temples, often related to jaw tension. |
Coding bruxism without specifying diurnal, nocturnal, or both can lead to claim denials and inaccurate reporting. Use G47.63 for sleep bruxism or F45.8 for awake bruxism.
Lack of documentation supporting the medical necessity of treatment, such as symptoms, temporomandibular joint dysfunction (TMJ) or sleep apnea, increases audit risk.
Failure to code associated conditions like TMJ (M26.6), headaches (various ICD-10 codes), or sleep disorders can impact reimbursement and quality metrics.
Q: What are the most effective evidence-based treatment options for bruxism in adults, differentiating between daytime and nighttime bruxism management?
A: Managing bruxism effectively requires a tailored approach distinguishing between daytime and nighttime presentations. For daytime bruxism (often related to stress or anxiety), cognitive behavioral therapy (CBT), biofeedback, and habit reversal training are evidence-based interventions. Explore how CBT techniques can help patients identify and modify stress triggers contributing to bruxism. Nighttime bruxism management often involves occlusal splints or mouthguards to protect teeth from wear and reduce jaw muscle activity. Consider implementing a combination therapy approach for optimal outcomes. Learn more about the efficacy of different splint designs and materials for specific patient needs. Pharmacological interventions like muscle relaxants may be considered as adjuncts in some cases, but long-term use is generally not recommended. Further research is ongoing to explore the efficacy of botulinum toxin injections for bruxism treatment.
Q: How can I accurately diagnose bruxism in my patients, considering both subjective reports and objective clinical findings, and differentiate it from other temporomandibular disorders (TMDs)?
A: Accurately diagnosing bruxism requires a thorough assessment encompassing both subjective reports and objective clinical findings. Patients may report symptoms like jaw pain, headaches, earaches, tooth sensitivity, and disrupted sleep. Clinicians should carefully examine the masticatory muscles for tenderness and hypertrophy, assess the temporomandibular joint (TMJ) for clicking or popping, and evaluate tooth wear patterns such as attrition, abfraction, and enamel chipping. Consider implementing standardized diagnostic criteria, such as the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), to differentiate bruxism from other TMDs. Polysomnography can be utilized to objectively measure bruxism activity during sleep, though it's not always necessary in routine clinical practice. Explore how electromyography (EMG) can be used to measure muscle activity and assess the severity of bruxism.
Patient presents with symptoms consistent with bruxism, clinically manifesting as teeth grinding or teeth clenching. The patient reports experiencing jaw pain, facial pain, and headaches, particularly upon waking. Assessment reveals signs of temporomandibular joint (TMJ) dysfunction, including tenderness to palpation and limited range of motion. Dental examination shows evidence of tooth wear, attrition, and possible enamel erosion. Differential diagnoses considered include TMJ disorders, sleep disorders, and stress-related orofacial pain. Diagnosis of bruxism is based on patient history, clinical findings, and exclusion of other potential causes. Treatment plan includes patient education regarding stress management techniques, fabrication of a custom-fitted night guard for bruxism therapy, and referral to a dentist for ongoing dental care and management of tooth wear. Follow-up appointment scheduled to assess treatment efficacy and adjust the plan as needed. ICD-10 code F45.8 (Other somatoform disorders) and CPT code 99214 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity) are documented for medical billing and coding purposes.