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Introduction: This study aimed to evaluate whether the presence of awake bruxism was associated with temporomandibular dysfunction symptoms, pain threshold at pressure, pain vigilance, oral health-related quality of life (OHRQoL), and anxiety and depression symptoms in patients undergoing orthodontic treatment., Methodology: This observational study followed patients who had started receiving orthodontic treatment for six months. The following variables were measured three times (at baseline, one month, and six months): pressure pain threshold (PPT) in the right and left masseter, anterior temporalis, and temporomandibular joint (TMJ), and right forearm; pain vigilance and awareness questionnaire; and shortened form of the oral health impact profile (OHIP-14). Anxiety and depression symptoms were measured using the Beck anxiety inventory and the Beck depression inventory, respectively. The patients were divided into two main groups according to the presence (n=56) and absence (n=58) of possible awake bruxism. The multi-way analysis of variance (ANOVA) was applied on the date (p=0.050)., Results: TMJ and/or muscle pain were not observed in both groups. Time, sex, age group, and awake bruxism did not affect the PPT in the masticatory muscles and pain vigilance (p>0.050). However, the primary effect of awake bruxism was observed when anxiety (ANOVA: F=8.61, p=0.004) and depression (ANOVA: F=6.48, p=0.012) levels were higher and the OHRQoL was lower (ANOVA: F=8.61, p=0.004)., Conclusion: The patients with self-reported awake bruxism undergoing an orthodontic treatment did not develop TMJ/masticatory muscle pain. The self-reported awake bruxism is associated with higher anxiety and depression levels and a poorer OHRQoL in patients during the orthodontic treatment.

Objectives: To investigate the association between oral parafunctions, personality traits, anxiety and signs and symptoms of temporomandibular disorders in the adolescents., Methods: Two hundred and seventy adolescents were examined clinically for the signs and symptoms of temporomandibular disorders. Participants completed questionnaires about demographic variables, medical history, symptoms of temporomandibular disorders, parafunctional oral habits, Minnesota Multibasic Personality Inventory, and Spielberger State-Trait Anxiety Inventory., Results: Logistic regression analyses revealed that bruxism was associated with joint tenderness (Odds ratio (OR)=6.38, p < 0.01), joint noises (OR=6.02, p < 0.01) and masticatory muscle tenderness (OR=4.19, p < 0.05) to palpation. State anxiety showed increased risk of joint tenderness (OR=2.47, p < 0.05) and muscle tenderness (OR=3.25, p < 0.05) to palpation., Conclusion: Within the limitations of this study, it was concluded that oral parafunctions, especially bruxism, state anxiety, depression and hysteria were associated with signs and symptoms of temporomandibular disorders in adolescents.

Aims: The aim of this study was to assess the relationship between levels of anxiety symptoms and prevalence of self-report of awake and sleep bruxism in patients with temporomandibular disorders (TMD)., Method: One hundred and eighty-one female patients, aged 19-77 years, were consecutively evaluated. The patients were selected from among those who sought treatment at the TMD and Orofacial Pain Outpatient Clinic of the Petrópolis School of Medicine. All patients completed the questionnaire and underwent clinical examination, both components of the RDC/TMD, in addition to answering questions pertaining to the assessment of levels of anxiety symptoms, taken from the Symptom Check List 90 self-report instrument. The subjects were classified according to the presence of self-reported only awake bruxism, only sleep bruxism, both, or none. A logistic regression procedure was performed to evaluate the possible association through odds ratio between anxiety symptoms and self-reported awake or sleep bruxism. The cofactors for each outcome were age, self-reported bruxism during the circadian period other than the one being evaluated, and the use of selective serotonin reuptake inhibitors., Results: It was possible to demonstrate the presence of a positive and statistically significant relationship between anxiety levels and self-reported awake bruxism. This finding was not observed in those subjects who reported sleep bruxism., Conclusions: A positive relationship was found between self-reported awake bruxism and levels of anxiety symptoms, but not between sleep bruxism and anxiety.

Background: Burning mouth syndrome (BMS) is an idiopathic disease characterized by the feeling of burning in the oral cavity. Ten per cent of patients presenting to oral medicine clinics have BMS. Anxiety and depression are common co-morbidities in BMS, but it is not known if they are associated with specific BMS symptoms., Objective: In an exploratory analysis, this study examined the association of generalized anxiety and depression with individual BMS symptoms., Methods: Forty-one patients were recruited from a dental outpatient clinic (30 with BMS and 11 with other oral conditions), evaluating specific BMS symptoms and their intensity. Anxiety and depression symptoms were assessed using a standardized measure (Clinical Interview Schedule-Revised)., Results: Taste change (p = 0.007), fear of serious illness (p = 0.011), metallic taste (p = 0.018) and sensation of a film on the gums (p = 0.047) were associated with an excess of psychiatric symptoms. More specifically, metallic taste (coefficient = 0.497, 95% CI = 0.149-0.845; p = 0.006) and sensation of film on gums (coefficient = 0.625, 95% CI = 0.148-1.103; p = 0.012) were associated significantly with higher scores for depressive symptoms; taste change (coefficient = 0.269, 95% CI = 0.077-0.461; p = 0.007), bad breath (coefficient = 0.273, 95% CI = 0.065-0.482; p = 0.012) and fear of serious illness (coefficient = 0.242, 95% CI = 0.036-0.448; p = 0.023) were associated with higher anxiety scores., Conclusion: Specific BMS symptoms are associated differentially with generalized anxiety and depression. Dental practitioners should ascertain which BMS symptoms are predominant and be mindful of the association of certain symptoms with anxiety or depression and, where necessary, consider medical consultation.

Anxiety and selective serotonin reuptake inhibitors (SSRIs) are considered aggravating factors for bruxism. We examined the influence of anxiety, depression and SSRI on bruxism in social phobia (SP). Twenty-three drug naïve, 17 SSRI-treated SP patients and 33 healthy controls underwent a psychiatric assessment and completed Leibowitz Social Anxiety Scale and Beck Depression Inventory. Oral parafunctional activity (PF) was evaluated by TM-dental examination and by a questionnaire. Drug- naïve and SSRI-treated SP patients did not differ on demographic and clinical measures. Awake bruxism, 'JAW PLAY' and at least one PF were more prevalent in SP than in controls. Severity of SP predicted the presence of PF. SP, but not depression, was associated with higher risk of oral PF and awake bruxism. Chronic SSRI treatment of SP did not affect sleep and awake bruxism. Dental and anxiety screening may improve the prognosis psychiatric and dental patients. Effective treatment of SP may mitigate bruxism., (© 2014 John Wiley & Sons Ltd.)

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.

Purpose: We investigated the relationship between clenching occurring during the day under natural conditions and psychological attributes., Method: Subjects were 37 dentistry students and staff (14 women, 23 men; mean age 27.4±4.7 years). A portable EMG recording device was used to record muscle activity in the temporal muscles for a continuous 5-h period under subjects' natural conditions, including having lunch. Clenching was identified by electromyography, and subjects were categorized into clenching and non-clenching groups. Psychological testing was performed during the same period using the Modified Taylor Manifest Anxiety Scale (MAS), the Self-rating Depression Scale (SDS), and the Cornell Medical Index (CMI), and the psychological attributes of clenching and non-clenching groups were compared., Results: Of the 37 subjects, 23 were assigned to the clenching group and 14 to the non-clenching group. Thirteen of the 23 subjects of the clenching group and none of the 14 subjects of the non-clenching group were determined to have psychological problems according to the MAS, with a significant difference observed between the clenching and non-clenching groups in terms of anxious tendency (p<0.001; Fisher's exact test). Total muscle activity in the clenching group, excluding eating and talking, was 3.5 times greater compared with the non-clenching group, and a significant difference between the groups was observed (p<0.05; Mann-Whitney U-test)., Conclusions: Daytime clenching was shown to be associated with anxious tendency. Total muscle activity in the clenching group was 3.5 times greater compared with the non-clenching group., (Copyright © 2010 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.)

This study examined the relationship between anxiety, depression and bruxism in 99 patients with temporomandibular disorders (TMD). Patients were divided into two groups: 58 patients with bruxism and 41 without bruxism. Symptoms of TMD were evaluated according to the Craniomandibular Index. The psychological condition of patients was assessed using the Beck Depression Inventory (BDI), the Hospital Anxiety Depression Scales (HADS) and the Hamilton Anxiety Rating Scale (HAMA). The mean anxiety and depression scores (HADS and HAMA) for patients with bruxism were statistically significant higher in patients with bruxism compared with those without bruxism. Thus, there may be an association between bruxism and higher levels of anxiety and/or depression in patients with TMD.

The aim of the present study was to compare the personality pattern, the anxiety level and the temporomandibular disorders (TMD) between bruxist and non-bruxist children with mixed dentition. Fifty-two subjects, with a mean age of 9.45 years (range 8-11) were evaluated and classified as bruxist (n = 26), according to the American Academy of Sleep Medicine (AASM) and the presence of dental wear clinically visible, under the same conditions of artificial light and position. The control children (n = 26) did not present dental wear and did not accomplished all the AASM criteria. The personality pattern and the anxiety of the bruxist children were studied by means of the Children's Personality Questionnaire (CPQ) and the Conners' Parents Rating Scales (CPRS), respectively, and compared with the personality traits and the anxiety level of a non-bruxist population. The TMD were also evaluated using the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) criteria. The data were analysed with the student's t-test, Fisher's exact test and chi-squared tests. A multivariated analysis was performed using a logistic regression with the stepwise likelihood ratio method. Compared with the controls, the bruxist children had significantly higher tension personality and were more anxiety prone. The bruxist children presented more TMD-related signs and symptoms than children in the control group. A strong correlation was found among bruxism, TMD, the high anxiety level and the high tension personality trait.

The present work was an attempt to investigate for the existence of an association between anxiety psychopathology and bruxism. The presence of bruxism was investigated according to validated clinical criteria in 98 subjects, who also filled out a self-report questionnaire (PAS-SR) for the assessment of panic-agoraphobic spectrum. 34.7% (n = 34) of participants were diagnosed as bruxers. The prevalence of anxiety psychopathology was similar between bruxers and non-bruxers, but Mann-Whitney U-test revealed significant differences in total PAS-SR (P = 0.026) score, indicating that subclinical symptoms of the anxiety spectrum might differentiate bruxers from controls. In particular, significant differences emerged in scores of domains evaluating panic (P = 0.039), stress sensitivity (P = 0.006) and reassurance sensitivity symptoms (P = 0.005) of panic-agoraphobic spectrum. Support to the existence of an association between bruxism and certain psychopathological symptoms has been provided.

Background: The etiopathogenesis of bruxism in children is not clear although different authors would associate it with several factors, changes in dentition, malocclusions, certain parasomnias and most notably emotional stress. This study was performed to test the hypothesis that anxiety states measured by "Anxiety Scale for evolutive age" may affect the development of bruxism., Methods: A total of eighty-six children, aged between 7 and 1, were evaluated. In the study-group were enlisted forty-three children with bruxism selected among patients afferent to the paediatric dentistry clinic. The forty-three non bruxer children, the control group, were chosen through the Pair Matching procedures, so that each bruxer child had a matching age case control. The gravity of bruxism was scored by means of 0 to 3 graduated scale of dental wear. The psychological aspects were estimated by means of an Anxiety Scale for evolutive age. Statistical analysis was undertaken using the "Odds Ratio" on statistically significant values. The most significant level was evaluated by the Mc Nemar test., Results: Remarkable differences in anxiety levels were found among the children of the two groups; 72% of bruxers showed significant anxiety scores versus 12% of non bruxers. The results of Odds Ratio reveal that a bruxer child has a 16 times greater probability to be anxious than an non bruxer one., Conclusions: The data provide support for the concept that anxiety state is a prominent factor in the development of bruxing behaviour in children.

Four main causes of bruxism have been studied - high anxiety level, malocclusion, temporomandibular disorders (TMD) and oral habits. Effective dental treatment for this problem is unknown in children with primary teeth, although, high prevalence has been reported. The aim of this study was to investigate the effectiveness of psychological techniques in children with bruxism. A total of 33 children, 3-6 years of age with normal occlusal features, without oral habits, rate in the Conners' parent rating scales (CPRS) and more than 0.75% in Conners' teacher rating scales (CTRS), and one or more temporomandibular joint (TMJ) disorders registered in the Bernal and Tsamtsouris examination, were selected from 188 children. Two psychological techniques, 'directed muscular relaxation' and 'competence reaction', were applied for 6 months. The results were analysed with a Wilcoxon rank sum test. All patients reduced their anxiety level and TMJ disorders, with statistical significance (P < 0.05). The psychological techniques were effective in the reduction of signs of bruxism in children with primary teeth.

Following a negative experience with general anesthesia, a 20-yr-old woman developed anxiety and an inability to relax concomitant with temporomandibular joint dysfunction and pain syndrome. Systematic countering of anxiety by relaxation successfully removed her anxiety and led to a complete resolution of her symptoms. Follow-up at 16 months indicated maintenance of treatment gains and no recurrence of the symptoms during the previous 12 months.