Ecological Momentary Assessment of Awake Bruxism Behaviors: A Scoping Review of Findings from Smartphone-Based Studies in Healthy Young Adults

Awake bruxism behaviors frequency in a group of healthy young adults with different psychological scores

OBJECTIVE

To assess the frequency of awake bruxism (AB) behaviors in a group of undergraduate dentistry students and correlate it with the status of anxiety and depression.

MATERIALS AND METHODS

The frequency of five oral behaviors (i.e., relaxed jaw muscle, teeth contact, mandible bracing, teeth clenching, teeth grinding) was evaluated using a smartphone-based ecological momentary assessment (EMA) approach. The anxiety and depression status was investigated with the four-item patient health questionnaire for anxiety and depression (PHQ-4). ANOVA with Tukey post-hoc test was used to assess the difference in frequency of AB behaviors among the four PHQ-4 groups.

RESULTS

Among the four groups, there was a statistically significant difference in the frequency of relaxed jaw muscle, teeth contact, mandible bracing, and teeth clenching, but not for teeth grinding.

CONCLUSION

Based on this cross-sectional study's findings, psyche seems to have a determinant impact on AB behaviors, which is significantly higher in individuals with anxiety and depression traits.

Benefits of the combination of digital and analogic tools as a strategy to control possible awake bruxism: A randomised clinical trial

BACKGROUND

Awake Bruxism (AB) management includes cognitive and behavioural changes. Digital and analogic tools can be used to remind the individual to control/avoid AB behaviours. However, no study addressed both tools together.

OBJECTIVE

To compare the efficacy of the combination of digital (smartphone application) and analogic (adhesive reminders) tools versus digital tool alone for AB management.

METHODS

Seventy-two individuals diagnosed with probable AB were divided into 3 groups: Group 1 (n = 24), used both digital and analogic tools during 30 days; Group 2 (n = 24), used only a digital tool during 30 days and Group 3 (n = 24), used only a digital tool for the first 15 days and then added the analogic tool for 15 days. The AB frequency was measured in real-time with a smartphone app, which sent alerts asking the individuals if they were doing any AB behaviours (bracing, teeth contact, clenching or grinding). Groups were compared using one-way ANOVA and before-after adding an analogic tool (group 3) by paired t-test, considering α = 0.05.

RESULTS

All groups showed a decrease in AB behaviours at the end of the evaluation period. Group 1 (digital and analogic tools) showed the lowest average of AB behaviours among all groups; however, statistically significant differences were found only for the comparison between groups 1 and 2. In group 3, a significantly greater reduction in AB behaviours was found after combining both approaches.

CONCLUSION

The combination of digital and analogic tools showed the greatest reduction of AB frequency and can be recommended for AB control.

Research routes on awake bruxism metrics: Implications of the updated bruxism definition and evaluation strategies

BACKGROUND

With time, due to the poor knowledge on it epidemiology, the need to focus on awake bruxism as a complement of sleep studies emerged.

OBJECTIVE

In line with a similar recent proposal for sleep bruxism (SB), defining clinically oriented research routes to implement knowledge on awake bruxism (AB) metrics is important for an enhanced comprehension of the full bruxism spectrum, that is better assessment and more efficient management.

METHODS

We summarised current strategies for AB assessment and proposed a research route for improving its metrics.

RESULTS

Most of the literature focuses on bruxism in general or SB in particular, whilst knowledge on AB is generally fragmental. Assessment can be based on non-instrumental or instrumental approaches. The former include self-report (questionnaires, oral history) and clinical examination, whilst the latter include electromyography (EMG) of jaw muscles during wakefulness as well as the technology-enhanced ecological momentary assesment (EMA). Phenotyping of different AB activities should be the target of a research task force. In the absence of available data on the frequency and intensity of wake-time bruxism-type masticatory muscle activity, any speculation about the identification of thresholds and criteria to identify bruxers is premature. Research routes in the field must focus on the improvement of data reliability and validity.

CONCLUSIONS

Probing deeper into the study of AB metrics is a fundamental step to assist clinicians in preventing and managing the putative consequences at the individual level. The present manuscript proposes some possible research routes to advance current knowledge. At different levels, instrumentally based and subject-based information must be gathered in a universally accepted standardised approach.

Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis

Background: Temporomandibular disorders (TMDs) are a series of disorders that affect the muscles and joint. Symptoms include joint pain, muscle pain, and limitation of mouth opening. One of several multifactorial diseases, temporomandibular dysfunction has mostly been linked to five etiological factors: occlusion, trauma, severe pain stimuli, parafunctional activities, and psychological elements, including stress, anxiety, and depression. The position of the human body as it is displayed in space is referred to as posture. Several nerve pathways regulate posture, and through ligaments, TMD and posture affect each other. The purpose of this study is to evaluate the possible correlation between posture and TMD through a meta-analysis of the literature; Methods: A literature search was performed on PubMed, Lilacs, and Web of science, and articles published from 2000 to 31 December 2022 were considered, according to the keywords entered. The term “temporomandibular disorders” has been combined with “posture”, using the Boolean connector AND; Results: At the end of the research, 896 studies were identified from the search conducted on the 3 engines. Only three were chosen to draw up the present systematic study summarizing the article’s main findings. The meta-analysis showed through forest plot analysis a correlation between posture and TMD Conclusions: This literature meta-analysis showed a correlation between posture and TMD. Nerve pathways probably regulate both body posture and mandibular posture. Further clinical studies will be needed to confirm this hypothesis and to indicate the main conclusions or interpretations.