The 2025 IADR General Assembly in Barcelona introduced a landmark framework: the International Classification of Oral Behaviors (ICOB). Experts now view bruxism as a multidimensional masticatory muscle behavior. However, the field previously lacked a formal classification system. This roadmap seeks to organize phenotypes and related oral behaviors effectively. Consequently, clinicians can now use a standardized language for diagnosis and research.

Principles of the International Classification of Oral Behaviors

The ICOB framework is primarily organized by circadian manifestation. Specifically, it distinguishes between sleep-related and wakefulness-related behaviors. Furthermore, the system categorizes muscle activity phenotypes. It includes optional descriptors like chronicity and tooth contact. Importantly, the consensus excludes neurological movement disorders to maintain clinical focus. Thus, the classification provides a clearer path for future research and practice.

The workshop established essential research priorities. Future steps involve drafting a formal proposal and conducting Delphi rounds. Researchers will also perform psychometric evaluations to ensure diagnostic clarity. Ultimately, these efforts will standardize clinical decision-making globally. By adopting these shared principles, the dental community improves patient care significantly.

Frequently Asked Questions

What is the primary objective of the ICOB?

The primary objective of the International Classification of Oral Behaviors (ICOB) is to provide a standardized, multidimensional system for organizing bruxism and related oral behaviors for clinical and research purposes.

Which oral behaviors does the ICOB exclude?

The ICOB specifically excludes neurological movement disorders while focusing on masticatory muscle behaviors and phenotypes occurring during sleep and wakefulness.

Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Nykänen L et al. Conceptualizing an international classification of oral behaviors (ICOB): A road map and future developments. Cranio. 2026 Jun 08. doi: 10.1080/08869634.2026.2671967. PMID: 42253108.

Verhoeff MC et al. Updating the Bruxism Definitions: Report of an International Consensus Meeting. J Oral Rehabil. 2025. doi: 10.1111/joor.13840.

Manfredini D et al. Standardised Tool for the Assessment of Bruxism (STAB). J Oral Rehabil. 2024;51(1):29-58. doi: 10.1111/joor.13561.