Self-reported Bruxism - associations with perceived stress, motivation for control, dental anxiety and gagging*

Prevalence and potential factors associated with probable sleep or awake bruxism and dentin hypersensitivity in undergraduate students

OBJECTIVE: To measure the prevalence of probable sleep or awake bruxism and cervical dentin hypersensitivity of undergraduate students and to determine the symptoms associated with these conditions.METHODOLOGY: This was a cross-sectional study. A diagnosis of probable bruxism was reached when students reported clenching or grinding of the teeth during sleep and/or wakefulness, and when they also presented some of the signs and symptoms of bruxism and masseter muscle pain on palpation. Cervical dentinal hypersensitivity was diagnosed by testing for sensitivity to pain in the cervical region of the teeth. Pain was triggered either by touch (using a #5 probe) or by an air jet spray. The sample consisted of 306 university students aged between 19 and 35 years old. The data were stored and analysed using SPSS software, version 15.0 for Windows.RESULT: The prevalence of probable bruxism was 34.3%, with no predominance regarding sex. Probable awake bruxism was more prevalent (61.9%), mostly occurring when the individual reported being in a state of mental concentration (63.1%). There was no association between probable sleep or awake bruxism and dentin hypersensitivity (p = 0.195). Individuals with probable sleep bruxism had increased odds of having muscular pain in the face upon waking (OR = 14.14, 95% CI 5.06-39.55), and those with probable awake bruxism had a increased odds of having facial muscle fatigue when chewing or talking for a long time (OR = 2.88, 95% CI 1.53-5.43) and muscular pain in the face upon waking (OR = 5.31, 95% CI 1.93-14.62).CONCLUSION: The prevalence of probable bruxism was 34.3% and that of HDC was 57.8%, with 22.2% of these subjects also showing probable bruxism. Individuals with probable bruxism tended to have a higher odds of facial pain when they awakened and when chewing or talking for long periods. There were no associations between probable sleep and awake bruxism and cervical dentin hypersensitivity.

The craniofacial morphology and maximum bite force in sleep bruxism patients with signs and symptoms of temporomandibular disorders

OBJECTIVES

The purpose of the present study was to compare craniofacial morphology and bite force of bruxist patients with signs and symptoms of temporomandibular disorders.

METHOD

Fourteen subjects with sleep bruxism and 14 healthy subjects participated. The signs and symptoms of the temporomandibular disorders were identified according to the Craniomandibular Index (CMI). Maximum bite force was measured using strain-gage transducers. Lateral cephalometric films were taken, and linear and angular measurements were performed.

RESULTS

Bite force between bruxist and non-bruxist females was not significant, whereas males with bruxism revealed higher bite forces. None of the linear and angular measurements differed significantly between bruxist and non-bruxist males. However, higher mandibular corpus length and anterior cranial base length, and lower gonial angle were observed in bruxist females compared to non-bruxist females. Negative correlation between bite force and CMI values was found in both genders.

DISCUSSION

Bruxist females had higher CMI values than bruxist males, which could lead to relatively lower bite forces.

Association between sleep bruxism and gastroesophageal reflux disease

STATEMENT OF PROBLEM

Rhythmic masticatory muscle activity, including sleep bruxism (SB), can be induced in healthy individuals by experimental esophageal acidification, which plays an important role in the pathogenesis of gastroesophageal reflux disease (GERD). However, no robust evidence supports the association between SB and GERD.

PURPOSE

The purpose of this study was to investigate the association between SB and GERD.

MATERIAL AND METHODS

Forty-five individuals were eligible to participate in this observational transversal study at the Gastroenterology Service of the Clinical Hospital of Porto Alegre, Brazil. The participants were classified into 2 groups, those with and without GERD, according to the Montreal Criteria and pH-metry/endoscopy findings. The diagnosis of SB was not assessed in a sleep laboratory but was based on self-report plus clinical inspection, according to the minimal diagnostic criteria of the American Academy of Sleep Medicine. The Lipp Stress Symptom Inventory was used to evaluate self-perceived stress. Univariate and multiple logistic regression analyses were performed with SB as dependent variable and GERD, sex, age, body mass index, and stress as predictors (α=.05; 90% power).

RESULTS

The study population included individuals with SB without GERD (13.3%) and individuals with SB with GERD (31.1%). In participants with GERD, the prevalence of SB was 73.7%. Only the variable GERD was significantly associated with SB (P=.017; odds ratio 6.58; 95% confidence interval 1.40-30.98), although adjusted for stress and age.

CONCLUSIONS

Sleep bruxism is prevalent in GERD patients, and GERD is highly associated with SB.

Self-reported bruxism mirrors anxiety and stress in adults

Objectives: The aims were to analyze whether the levels of self-reported bruxism and anxiety associate among otherwise healthy subjects, and to investigate the independent effects of anxiety and stress experience on the probability of self-reported bruxism. Study Design: As part of a study on irregular shift work, a questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (number of subjects: n=750) and to an equal number of randomly selected employees in the same company with regular eight-hour daytime work. Results: The response rates were 82.3% (56.6 % men) and 34.3 % (46.7 % men), respectively. Among the 874 respondents, those aware of more frequent bruxism reported significantly more severe anxiety (p<0.001). Adjusted by age and gender, frequent bruxers were more than two times more likely to report severe stress (odds ratio 2.5; 95% confidence interval 1.5-4.2) and anxiety (odds ratio 2.2; 95% confidence interval 1.3-3.6) than non-or-mild bruxers. Conclusions: Present findings suggest that self-reported bruxism and psychological states such as anxiety or stress may be related in working age subjects.

Key words:Bruxism, self-report, anxiety, stress, adult.

Effects of sleep bruxism on functional and occlusal parameters: a prospective controlled investigation

This study was conducted to verify the results of a preceding retrospective pilot study by means of a prospective controlled investigation including a larger sample size. Therefore, the aim of this clinical investigation was to analyze the relationship between sleep bruxism and several functional and occlusal parameters. The null hypothesis of this study was that there would be no differences among sleep bruxism subjects and non-sleep bruxism controls regarding several functional and occlusal parameters. Fifty-eight sleep bruxism subjects and 31 controls participated in this study. The diagnosis sleep bruxism was based on clinical criteria of the American Academy of Sleep Medicine. Sixteen functional and occlusal parameters were recorded clinically or from dental study casts. Similar to the recently published retrospective pilot study, with a mean slide of 0.77 mm (s.d., 0.69 mm) in the sleep bruxism group and a mean slide of 0.4 mm (s.d., 0.57 mm) in the control group, the evaluation of the mean comparison between the two groups demonstrated a larger slide from centric occlusion to maximum intercuspation in sleep bruxism subjects (Mann–Whitney U-test; P=0.008). However, following Bonferroni adjustment, none of the 16 occlusal and functional variables differed significantly between the sleep bruxism subjects and the non-sleep bruxism controls. The present study shows that the occlusal and functional parameters evaluated do not differ between sleep bruxism subjects and non-sleep bruxism subjects. However, as the literature reveals a possible association between bruxism and certain subgroups of temporomandibular disorders, it appears advisable to incorporate the individual adaptive capacity of the stomatognathic system into future investigations.

Sleep bruxism: a comprehensive overview for the dental clinician interested in sleep medicine

Sleep bruxism (SB) is a common sleep-related motor disorder characterized by tooth grinding and clenching. SB diagnosis is made on history of tooth grinding and confirmed by polysomnographic recording of electromyographic (EMG) episodes in the masseter and temporalis muscles. The typical EMG activity pattern in patients with SB is known as rhythmic masticatory muscle activity (RMMA). The authors observed that most RMMA episodes occur in association with sleep arousal and are preceded by physiologic activation of the central nervous and sympathetic cardiac systems. This article provides a comprehensive review of the cause, pathophysiology, assessment, and management of SB.

Bruxism, oral parafunctions, anamnestic and clinical findings of temporomandibular disorders in children

The reported prevalence of temporomandibular disorders (TMD) present during childhood and adolescence ranges between 7% and 68%. The range of the reported prevalence of sleep bruxism in children is also wide. The purpose of the current study was threefold: (i) determine the prevalence of oral parafunctions, sleep bruxism and of anamnestic and clinical findings of TMD among Israeli children with primary or mixed dentition; (ii) to establish whether the parafunctional activities are associated with anamnestic and clinical findings of TMD in this population and (iii) to examine the possible impact of stressful life events on the prevalence of bruxism, oral parafunctions, and anamnestic and clinical findings of TMD in children. A total of 244 children (183 girls and 61 boys) aged 5-12 years were included in the study. Each participant underwent a full TMD examination. Parents, in collaboration with their children, completed a questionnaire on TMD symptoms, oral parafunctions and stressful life events in their children's life. Most participants (78·8%) reported at least one oral habit. Of these, only 'jaw play' was associated with TMD anamnestic and clinical findings. Stressful life events were associated only with the performance of multiple oral habits. These findings indicate that the performance of oral parafunctions is commonplace during childhood, with younger children exhibiting fewer oral parafunctions than adolescents. Stressful life events are related with an increase in the performance of multiple oral parafunctions in children but the later are not necessarily associated with anamnestic and clinical findings of TMD in the paediatric population.