Possible sleep bruxism, circadian preference, and sleep-related characteristics and behaviors among dental students

Awake bruxism report in a population of dental students with and without ecological momentary assessment monitorization-A randomised trial

OBJECTIVE

The Ecological Momentary Assessment (EMA) concept was the basis for developing a smartphone application for the real-time report of awake bruxism (AB) activities. The aim of this study was to assess the effects of the EMA with a randomised controlled trial designed to compare the frequency of AB reported in two separate single observation points between a group of students monitored over time with an EMA smartphone application and a non-EMA monitored group.

METHODS

Sixty-four (N = 64) dental students (22.3 YO [±2.6]; 52F; 12 M) answered the Oral Behaviour Checklist (OBC-1) and were randomised into an EMA-group (EG) and control group (CG). EG were monitored with a smartphone application for AB report during seven consecutive days and completed three EMA monitoring periods (EMA-1, 2 and 3) at one-month intervals. After the third period (EMA-3), both EG and CG answered again the OBC (OBC-2). Descriptive statistics were performed to characterise the sample. Pearson's chi-squared test, Fixer Exact test and post hoc Z test with Bonferroni correction were performed. The study hypothesis was that EMA could influence the AB reported by the participants because it implies an increase in the awareness, self-recognition, and self-control of bruxism behaviours. The level of significance was set at p < .05.

RESULT

The percentage of participants who changed the report of the activity of clenching their teeth while awake between OBC-1 and OBC-2 was significantly higher among participants in EG, when compared to CG (p = .027). For all other behaviours reported the within- and between-group differences from OBC-1 to OBC-2 were not significant. Clenching and bracing were the most frequently reported, whilst grinding was the less frequent behaviour.

CONCLUSION

A smartphone-based EMA approach demonstrated be useful to monitor AB over time, increasing individual's awareness, particularly to bracing and clenching behaviours.

The association between chronotype profile and temporomandibular disorders among college students

BACKGROUND

Temporomandibular joint disorders (TMDs) are common in young adults, and the link between chronotype profile and TMDs is unclear.

OBJECTIVE

This study examined TMD prevalence and chronotype distribution and explored the relationship between chronotype and TMDs in young adults.

MATERIALS AND METHODS

A total of 663 students from Sichuan University completed questionnaires. Chronotype profiles were assessed using the Morningness-Eveningness Questionnaire, and TMDs were screened using the Fonseca Memory Index. To validate the findings, 68 TMD patients and 136 controls were enrolled.

RESULTS

The prevalence of TMDs was 69.7%, with significant differences among chronotype profiles. The intermediate profile was the most common chronotype. Eveningness profile was associated with higher TMDs prevalence and severity. Muscle pain and side movement difficulty scores were higher in eveningness and intermediate profiles. Female gender (OR 2.345; 95% CI 1.668-3.297) was a TMD risk factor, while morningness profile (OR 0.537; 95% CI 0.297-0.970) was protective. Validation with TMD patients and controls supported these findings, showing higher eveningness profile prevalence in the TMD groups.

CONCLUSIONS

TMDs have a high prevalence in college students, chronotype profiles shown to be associated with TMDs. Morningness is the protection factor in TMDs and PT, eveningness is a risk factor for IT.

Associations between self-reported bruxism, sleep quality, and psychological status among dental students in Turkey

OBJECTIVES

To assess sleep quality among dental students and to identify psychological factors associated with self-reported sleep bruxism (SB).

METHODS

A total of 212 dentistry students from the Usak University Faculty of Dentistry participated in this study. A self-report questionnaire was administered to identify possible SB. The Depression, Anxiety, and Stress Scale (DASS-21) questionnaire was administered to evaluate psychological factors, and the Pittsburgh Sleep Questionnaire Index (PSQI) was used to evaluate sleep quality.

RESULTS

Possible SB was more frequently observed in females than in males. The mean DASS-21 score in those with possible SB was significantly higher than in those without SB (p< 0.001). The mean PSQI (total) score was also significantly higher in those with possible SB than in those without SB (5.0 ± 2.4) (p= 0.007).

CONCLUSION

The findings revealed that psychological factors and sleep quality significantly affected the prevalence of self-reported SB among dental students.

Monitoring of awake bruxism by intelligent app

Background. Bruxism is a topic of much controversy and is continually debated in the field of dentistry due to the multifaceted clinical relationship that results in painful conditions and consequences to patients. The aim of this review was to determine the effectiveness of a smartphones app in monitoring awake bruxism. Methods. PROSPERO (registration number: CRD42021271190). The eligibility criteria were as followed: observational studies, case-control studies, studies that reported odds ratios, and studies on awake bruxism. The following keywords were searched: [smartphones apps] AND [apps] AND [awake bruxism], OR [sleep bruxism], OR [sleep hygiene], OR [parasomnias], AND [habits]. Results. All the included studies found that the use of the smartphone app allows controlled awake bruxism monitoring. The results also show that the slepp bruxism and awake bruxism  are interactive, having negative synergism and substantially increasing the risks of temporomandibular joint pain and temporomandibular disorders. Discussion. In the awake bruxims it was possible to identify 70% symptoms through the different frequencies of behavior provided by the App, within the present technological tools have become daily in young and adult population. The app is effective and easy to use by patients, effectively limiting biases the time of evaluation.

Impact of Confinement by COVID-19 in Awake and Sleep Bruxism Reported by Portuguese Dental Students

Confinement by COVID-19 was a stressful period that could potentially trigger awake bruxism (AB) and/or sleep bruxism (SB) behaviors. This study aims to characterize the AB and SB behaviors reported by Portuguese dental students before the pandemic and during the first period of mandatory confinement by COVID-19. Dental students were included in this longitudinal study. They answered the Portuguese validated version of the Oral Behavior Checklist (OBC) before the COVID-19 pandemic emerged (T1) and one month after mandatory confinement started in Portugal (T2). Descriptive statistics and the linear-by-linear association test were performed to assess changes over time (p ≤ 0.05). Sixty-four dental students (mean age 22.5 ± 2.8 years; 81.5% females) completed the study protocol. Considering AB, there was a general increase of the behavior from T1 to T2. The percentage of participants who reported to “grind their teeth when waking up” just few times decreased (p < 0.001) and the percentage of participants who reported “feeling discomfort/tension in the facial muscles when waking up just few times” increased (p = 0.019). Considering SB, there was a significant decrease of the behavior in all samples. The number of “None” report to grinding teeth during sleep or when waking up increased (p = 0.012). An increase in the self-reporting of feeling discomfort in masticatory muscles when awake or sleeping was observed (p = 0.028). The percentage of participants who did “not remember” any AB or SB activity decreased (p < 0.050). The confinement due to COVID-19 resulted in a forced change in dental students’ lifestyles that resulted in an increase of reported AB and a decrease of reported SB. Clinical Significance: In case of confinement periods, students should be encouraged to try normalizing their daily life by creating healthy routines and, by doing so, reducing the possible predisposition to bruxism and its consequences.

Possible sleep and awake bruxism, chronotype profile and TMD symptoms among Turkish dental students

It was hypothesized that an individual's chronotype profile has an effect on the performance of work or study tasks. Dental students have to cope with both academic and clinical workloads, and the latter requires extra concentration. The first aim was to evaluate the association of sleep bruxism (SB) and awake bruxism (AB) with sleep related items, temporomandibular disorder (TMD) complaints, and chronotype profile; the second aim was to evaluate the association between complaints of TMD and chronotype profile among dental students. The present cross-sectional descriptive study involved 218 dental students whose ages ranged between 18 and 30 years. In order to gather data, students were required to respond to a questionnaire, which aimed to evaluate possible SB and possible AB occurrence and demographics, sleep-related items and complaints of TMD. For the assessment of the chronotype profile, the morningness-eveningness questionnaire (MEQ) was used. The chi-square test, the Mann-Whitney U test, and t-test analyses were performed to evaluate the factors associated with SB, AB and chronotype profile. The frequency of self-reported SB was 25.2% and AB was 28.9%. The prevalence in the eveningness profile who reported possible AB was 45.3%, while it was 24.2% in intermediate individuals and 18.8% in the morningness profile. An association was also found between possible AB and eveningness chronotype profile (p = .009). No association was found between other temporomandibular joint (TMJ) pain and noise and chronotype profiles (p > .05). An association was found between possible AB and eveningness chronotype profile but no association was found between possible SB and chronotype profile. Moreover, complaint of TMD (face, head, neck pain) was observed particularly in students with an eveningness profile.