Bruxism has a multifactorial etiology. The consequenses of bruxism, abrasion of teeth and a possible craniomandibular disorder, present themselves periferal. So, treatment can have divers points of action. Counseling seems to be useful in all cases. Treatment with a hard acrylic occlusal appliance (oral splint) is especially useful in those situations where the patient has a lot of abrasion or suffers from a craniomandibular disorder with pain. Pharmacological treatment will have a more central effect. Some drugs are effective on bruxism. However, the real pharmacological mechanisms have not yet been discovered. In the absence of data from double-blind, polysomnographic, controlled studies, pharmacotherapy treatment is only indicated in severe cases on a short-term base. Until new data come available, the dentist has to use conventional therapies only.