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Background: Bruxism is defined as a repetitive jaw‐muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism can occur during sleep (sleep bruxism, SB) or during wakefulness (awake bruxism, AB). To date, the effect of AB on the purported negative consequences of bruxism has remained unclear. Objectives: The assessment of AB, its relation to temporomandibular disorders (TMD) treatment modalities, and their possible outcomes were investigated among TMD patients resistant to treatment in primary care and referred to a tertiary care clinic. Methods: The records of 115 patients were studied. Patients were referred to the Head and Neck Centre, Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, for TMD treatment between 2017 and 2020. The data derived from the eligible patients' records included the following: background data (age and sex), referral data (reason and previous treatment), medical background (somatic and psychiatric), clinical and possible radiological diagnoses at a tertiary care clinic, treatment modalities for masticatory muscle myalgia, bruxism assessment, its possible treatment modalities and their outcomes, and overall management outcome. We analysed the outcomes of single treatment modalities and combined groups of modalities. For the demographic data, the Chi‐squared test and Fischer's Exact test were used to determine the associations between the categorical variables. A Sankey‐diagram was used to describe the flow of treatment. Results: Temporomandibular joint‐pain‐dysfunction syndrome (K07.60) was the most frequent single reason to refer a patient to tertiary care (17.4%). At referral, men had myalgia (M79.1) significantly more often (p =.034) than women. Similarly, men had depression (p =.002) more often and other psychiatric diagnoses (p =.034). At tertiary care, the presence of AB was assessed in 53.9%, and self‐reported AB was recorded in 48.7%. In patients with possible AB, those who were prescribed neuropathic pain medication showed significantly less improvement in symptoms (p =.021) than those who underwent splint therapy (p =.009). Overall, half of the patients showed overall improvement in their TMD symptoms from the treatment combinations. Conclusion: Despite several treatment modalities, only half of the patients showed improvement in their symptoms in the present study. A standardised assessment method encompassing all factors contributing to bruxism behaviours and their consequences is suggested. [ABSTRACT FROM AUTHOR]

Background: Bruxism is a masticatory muscle activity occurring during sleep or wakefulness, involving grinding and clenching of teeth and/or jaw bracing. As yet, the aetiology, epidemiology and consequences of awake bruxism (AB) are largely unknown. Objectives: The aims of the study were to AB behaviours using a novel bruxism screener (BruxScreen) questionnaire part and Ecological Momentary Assessment (EMA; BruxApp©) on AB behaviours, and to investigate AB's prevalence among masticatory muscle myalgia patients and non‐patients. Methods: Altogether, 115 participants (masticatory myalgia patients referred to a specialist clinic (n = 67) and non‐patients (n = 46)) filled in a bruxism screener questionnaire to report bruxism behaviours and jaw symptoms. A selection of both groups did a week‐long EMA (patients n = 12, non‐patients n = 11) to report AB behaviours. The chi‐squared test was used to determine group differences in categorical variables. A logistic regression model was fitted to study the probability of AB. Results: According to BruxScreen, bruxism behaviours and jaw symptoms were more frequent in patients than in non‐patients (p <.001). Based on EMA, 14.6% of the behaviour in patients was tooth clenching; for non‐patients, this was 0.5% (p <.000). Relaxed muscles were reported by patients and non‐patients at 20.6% and 56.4%, respectively (p <.021). Logistic regression, adjusted by age and sex, revealed that patients reported AB 5 times more often than non‐patients (OR 4.8, 95% CI 2.1–11.2). Conclusion: Awake bruxism behaviours are significantly more frequent in masticatory muscle myalgia patients than non‐patients and associate with frequent bruxism‐related symptoms. Self‐reported teeth clenching seems to be the most significant sign of AB behaviour. [ABSTRACT FROM AUTHOR]