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Background: Academic procrastination (AP), a common behavior among students, is influenced by factors such as fear of failure, task aversiveness, anxiety, and stress. Self-generated stress (SGS) refers to the subjective experience of tension that occurs in response to an existing situation. Individuals often overestimate the difficulty and attainability of a task, resulting in increased stress and extended stress duration. SGS can worsen mental and physical health problems, including bruxism. Therefore, this study investigates the possible underlying connections by examining the relationship between AP, SGS, and self-reported (SR) bruxism in medical and dental students., Methods: The present cross-sectional study was undertaken among a sample of 379 students pursuing medical and dentistry degrees in Turkey. The questionnaire, including the Academic Procrastination Scale-Short Form, SR bruxism Scale, and SGS Scale, was administered to the students. According to the responses given to the SR bruxism Scale, 3 types of SR bruxism groups were created as sleep, awake, and compound. A comparative analysis was conducted on AP, SGS, and SR bruxism among medical and dental students. Furthermore, the associations among AP, SGS, and SR bruxism were assessed using the utilization of correlation tables and regression analysis., Results: The prevalence of awake bruxism was higher among dental students (46.6%) compared to medical students (34.7%), suggesting a faculty-dependent trend. A significant positive correlation was observed between SGS and AP (r = 0.212, p < 0.001). Median AP values differed significantly based on awake bruxism (p = 0.007) and compound bruxism (p = 0.013), but not sleep bruxism (p = 0.352). SGS exhibited statistically significant differences across all SR bruxism types: sleep (p < 0.001), awake (p < 0.001), and compound (p < 0.001). Multiple regression analysis identified SGS as a significant risk factor for SR bruxism, with a one-unit increase in stress score elevating the SR bruxism risk by 1.086 times., Conclusions: This study revealed that self-generated stress significantly increases the risk for the development of SR bruxism. A significant relationship was found between academic procrastination and self-generated stress, and this relationship was particularly associated with an increased risk for the development of compound and awake bruxism. Stress-reducing therapy methods should be recommended for students to both increase academic success by reducing academic procrastination and prevent the negative effects of stress-related SR bruxism., (© 2024. The Author(s).)

Background: Bruxism is a recurrent parafunctional habit characterized by clenching or grinding teeth and/or jaw contractions. It is quite common among dental students and is associated with psychosocial factors such as stress and anxiety. This study aimed to compare bruxism awareness and self-assessment among clinical students with and without bruxism., Methods: This study included systemically healthy individuals aged 18 to 27 years. Intraoral and extraoral examinations were performed on 128 4th- and 5th-grade dental students with (64) and without bruxism (64), 4th and 5th-grade dental students at Bolu Abant İzzet Baysal University who met the inclusion criteria. The diagnosis of bruxism was based on the 2018 International Consensus and data collected through a validated 33-item questionnaire covering general information and bruxism awareness. The questionnaire included multiple-choice questions on bruxism types, risk factors, symptoms, and impact on periodontal tissues. Statistical analyses were performed via IBM SPSS Statistics, and p < 0.05 was considered statistically significant., Results: Clenching and teeth grinding during sleep, tooth wear, muscle fatigue, pain in the temples, jaw pain, joint trismus, neck pain, and jaw joint pain and clenching while awake were significantly different in bruxism patients (p < 0.05). There was no significant difference between the two groups in terms of bruxism type, symptoms, treatment methods, periodontal tissues, occlusal trauma, diagnostic methods, or the relationship between lifestyle and bruxism (p > 0.05). While 71.9% of those diagnosed with bruxism stated that they had bruxism, 68.8% of those who were not diagnosed stated that they did not have bruxism., Conclusion: Although dental students are aware of bruxism, their understanding of its multifactorial nature and treatment options needs improvement. Increasing this knowledge could reduce the prevalence of bruxism among dental students and improve patient care., Clinical Trial Registration: The clinical trial was retrospectively registered on ClinicalTrials.gov under the identifier NCT06583044, with a registration date of 03/09/2024. https://register., Clinicaltrials: gov/prs/beta/studies/S000EUYA00000023/recordSummary ., (© 2024. The Author(s).)

Background: Somatosensory tinnitus (ST) is associated with activation of the auditory pathway by trigeminal or cervical afferents., Objective: This is a cross-sectional observational study that aims to verify the association of ST with TMD, bruxism, migraine and psychosocial aspects., Methods: This study was conducted at the Tinnitus Outpatient Clinic of the Clinical Hospital Complex of the Federal University of Paraná. Specific ST characteristics, were evaluated according to the last consensus for the diagnosis of ST. Two groups with 39 individuals each one were formed, the ST group (STG) and the comparison group (CG). TMD was classified according to the Diagnostic Criteria for Temporomandibular Disorders and migraine by the International Classification of Headaches. The presence of probable sleep and awake bruxism was associated with individual's reports and clinical inspections. The applied questionnaires investigated oral behaviours (OB), sleep quality (SQ), psychosocial aspects (PA), central sensitization (CS), tinnitus impact on quality of life (TIQF), and graded chronic pain scale (GCPS)., Results: The STG showed a significant association with modulation manoeuvres and trigger points; myalgias and arthralgia; disc displacement with and without reduction; subluxation; bruxism; and presence of migraine. For the same group, we found a significant association with OB, PA, CS, TIQF and GCPS. There was no significant difference between groups regarding SQ., Conclusion: There is a significant association between the presence of ST and the occurrence of TMD, probable sleep and awake bruxism, and migraine. There is also a greater impairment of OB, PA, CS and TIQF., (© 2024 John Wiley & Sons Ltd.)

Background: Temporomandibular disorders (TMDs) may be an 'idiom' of psychological distress in Confucian heritage cultures (CHCs)., Objectives: This systematic review/meta-analysis estimated the prevalence of TMDs in CHCs and compared the differences in TMD occurrence between time periods and age groups. Additionally, the associated biopsychosocial risk factors were also examined., Methods: The study protocol was developed a priori following the PRISMA guidelines and Joanna Briggs Institute systematic review methodology (CRD42021245526). Electronic searches of seven databases were conducted from January 2002 to Dec 2021. Reference lists of identified studies were hand-searched for additional articles. Study selection, quality assessment, and data extraction were done. Meta-analysis was performed using the RevMan 5.4 software., Results: Forty-eight articles were included in the systematic review. Overall prevalences were: TMDs-15% (95% CI: 15-16%); TMD pain-8% (95% CI: 7-9%); TMJ sounds-24% (95% CI: 21-27%); and TMJ locking-7% (95% CI: 1-13%). While TMD prevalence appeared to have declined from 2002 to 2011 to 2012-2021, the occurrence of TMD pain, TMJ sounds, and locking increased marginally or remained constant. TMD prevalence in children/adolescents was 18% (95% CI: 14-22%) and 17% (95% CI: 16-18%) among adults. Significant associations between TMDs and bruxism/psychological distress/education levels were specified by 73%/90%/88% of the relevant studies., Conclusions: TMDs are prevalent in CHCs and a slight increase in TMD pain (2%) and TMJ sounds (8%) were discerned over the past two decades. TMDs are related to a myriad of biopsychosocial variables, particularly psychological distress, and these factors must be addressed within the cultural context of patients., (© 2024 John Wiley & Sons Ltd.)

Objective: To investigate the effect of the Coronavirus pandemic on the report of psychological status, bruxism, and TMD symptoms., Methods: An online survey was drafted to report the presence of psychological status, bruxism activities, and reported symptoms of TMDs perceived during the COVID-19 pandemic in a population of 506 individuals., Results: Mental health is not positive during the Coronavirus pandemic: almost half the subjects reported an increase in bruxism behaviors, while up to one-third reported an increase in their symptoms involving the TMJ and jaw muscles. Specifically, 36% and 32.2% of participants reported increased pain in the TMJ and facial muscles, respectively, and almost 50% of the subjects also reported more frequent migraines and/or headaches., Conclusion: Increased psychosocial distress during the COVID-19 pandemic can increase the frequency of TMD symptoms and bruxism behaviors, which, in turn, constitute a triangle of mutually interacting factors with the psychological and emotional status.

Objective: To assess the frequency of reported masticatory muscles activity during wakefulness (i.e., awake bruxism [AB]), levels of anxiety, depression, stress, and the oral health-related quality of life (OHRQoL) in college preparatory students., Methods: Sixty-nine college preparatory students participated in the study. AB was evaluated by the Oral Behaviors Checklist (OBC) and a smartphone-based ecological momentary assessment (EMA; [Bruxapp®]). Anxiety and depression were measured by the Hospital Anxiety and Depression Scale, stress was evaluated by the Perceived Stress Scale, and OHRQoL was obtained by The Oral Health Impact Profile-14. Data were analyzed by Pearson's correlation coefficient (α = 0.05)., Results: The average EMA-reported frequency of AB behaviors was 38.4%. Significant correlations were found between AB and the OBC, anxiety, depression, stress, and OHRQoL (p < 0.001)., Conclusion: College preparatory students demonstrated moderate frequency of AB, which was significantly correlated with psychosocial factors.

Objective: In this experimental study, we aimed to determine whether guided music listening (GML) - a music intervention based on models of mood mediation and attention modulation - modulates masticatory muscle activity and awake bruxism in subjects with chronic painful muscular temporomandibular disorders (TMD myalgia, mTMD), a condition causing a significant burden to patients, their families, and healthcare systems., Background: Awake bruxism - a stress behavior characterized by clenching of the teeth - is a strong contributor to chronic mTMD. GML modulates psychological stress and motor responses and could thus reduce muscle activity in chronic musculoskeletal conditions, including mTMD., Methods: We recorded the electromyographic (EMG) activity in the right masseter of 14 women with chronic (>6 months) mTMD (median [IQR] = 39.5.3 [24.3] years) and 15 pain-free women (median [IQR] = 30.0 [3.5] years) during a GML session, including 3 music (stressful, relaxing, and participants' favorite music) and a no-music (pink noise) control blocks, each lasting 15 minutes. We measured the motor effort of the right masseter relative to the participants' maximum voluntary contraction (MVC), the muscular effort to maintain mandibular posture (EMG posture ), and to produce spontaneous awake bruxism episodes (EMG bruxism ), and the duration and frequency of spontaneous awake bruxism episodes. We tested between-group and within-group (between blocks) differences, as well as the effect of the interaction group by experimental block on these outcome measures., Results: In both groups, EMG posture was significantly affected by the interaction group by experimental block (P < .001). Compared to pink noise [mean (95% CI); mTMD: 2.2 (1.6-2.8) %MVC; Controls: 1.1 (0.5-1.7) %MVC], EMG posture increased during the stressful music block [contrast estimate (95% CI); mTMD: +0.8 (0.7-0.8) %MVC; Controls: +0.3 (0.3-0.4) %MVC; both P < .001], and decreased during the relaxing [mTMD: -0.4 (-0.5 to -0.4) %MVC; Controls: -0.3 (-0.4 to -0.3) %MVC; both P < .001] and favorite [mTMD: -0.5 (-0.6 to -0.5) %MVC; Controls: -0.5 (-0.5 to -0.4) %MVC; both P < .001] music blocks. EMG posture was greater in mTMD individuals than controls during the favorite music [contrast estimate (95% CI): +1.1 (0.2-1.9) %MVC; P = .019] and the pink noise [+1.1 (0.2-2.0) %MVC; P = .014] blocks. EMG bruxism was significantly affected by the interaction group by experimental block (P < .001). In mTMD participants, compared to the pink noise block [mean (95% CI); 23.8 (16.0-31.6) %MVC], EMG bruxism increased during the stressful music block [contrast estimate (95% CI); +10.2 (8.6-11.8) %MVC], and decreased during the relaxing [-6.2 (-8.1 to -4.3) %MVC; P < .001] and favorite [-10.2 (-12.2 to -9.1) %MVC; P < .001] music blocks. These effects were not observed in the control group [mean (95% CI); pink noise: 19.3 (10.9-27.6); stressful: 21.2 (12.9-29.4) %MVC; relaxing: 21.6 (13.3-29.9) %MVC; favorite: 24.2 (15.8-32.7) %MVC; all P > .05]. EMG bruxism was significantly greater in mTMD participants than controls during the stressful music block [contrast estimate (95% CI): +12.9 (1.6-24.2) %MVC; P = .026). GML did not affect the duration or the frequency of awake bruxism in either group (median [IQR], mTMD: 23.5 [96.7] s, range 1-1300 seconds; Controls: 5.5 [22.5], range 0-246 seconds; P = .108). The frequency of awake bruxism episodes was greater in the mTMD group compared to controls only during the pink noise block (median [IQR], mTMD: 5 [15.3] episodes, range 0-62 episodes; Controls: 1 [3] episode, range 0-27 episodes; P = .046). No significant between-group differences were found in either the overall time spent engaging in awake bruxism (median [IQR], mTMD: 23.5 [96.7] s, range 1-1300 seconds; Controls: 5.5 [22.5], range 0-246 seconds; P = .108), or during each block (all P > .05)., Conclusions: In subjects with chronic mTMD, relaxing music and the individual's favorite music decreased the muscular effort during spontaneous awake bruxism episodes by 26% and 44% (relative changes), respectively. In contrast, stressful music increases it by about 43%. Because of its positive effects on awake bruxism, GML with selected music could be a promising and non-invasive component of a multimodal approach for the management of chronic mTMD., (© 2020 American Headache Society.)

In their daily practice dentists frequently have patients showing signs of stress-related oral manifestations in different forms. Stress-related aetiology of oral changes are still not investigated enough, and present a subgroup of psychosomatic diseases which had been recognized in medicine a long time ago. Recognition of such psychological or emotional disturbance needs deep evaluation "per exclusionem", and is beneficial for both the patient and clinician. Psychological management should be taken into consideration when treating patients with these psychosomatic disorders. Therapeutic approach comprises different forms of psychotherapy and medication as well.

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: The study aimed to investigate the psychosocial predictors of bruxism. The association of various psychosocial factors such as alexithymia, emotional processing, state and trait anxiety, and stress with awake bruxism was analysed., Methods: The study involved 52 volunteers diagnosed with awake bruxism. The toolkit that was used included the Toronto Alexithymia Scale (TAS-20), the Emotional Processing Scale (EPS), the Cohen Perceived Stress Scale (PSS-10), and the State- and Trait-Anxiety Inventory (STAI), with independent individual psychological diagnoses being made for every patient. The results were statistically analysed using IBM SPSS Statistics 24., Results: The obtained data clearly show that psychological traits-both permanent dispositions (e.g., state anxiety and alexithymia) and temporary states (e.g., trait anxiety, emotional processing deficits, and psychological stress)-are significant determinants of awake bruxism. The percentage of explained variance indicates the presence of other factors as well., Conclusions: Psychosocial factors such as state anxiety and trait anxiety, alexithymia, and perceived stress are as important as somatic causes in the occurrence and maintenance of awake bruxism. The profile of the obtained data suggests the possibility of preventing or minimizing the symptoms of awake bruxism through properly constructed psychoprophylactic interactions., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2019 Agnieszka Przystańska et al.)

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.

Background: Even though bruxism has been shown to be associated with several psychological factors, few studies have been performed on its relationships with anger and frustration., Objective: This study aimed to determine the association between self-reported awake and sleep bruxism and anger and frustration., Methods: In this longitudinal observational study, 55 healthy adult participants with "possible" bruxism reported their experienced level of bruxism and several psychosocial factors and lifestyle factors for 28 consecutive days using a personal logbook. The logbook consisted of a daily diary and a weekly questionnaire composed of Dutch versions of validated questionnaires. The primary outcome data were analysed using multiple regression models., Results: An increase in SB of 1 unit (on a scale ranging from 1 to 10) was associated with an increase in the anger-scale of 0.03 units, and the frustration-scale of 0.04 units. However, the random intercepts were 0.22 for anger and 0.19 for frustration, meaning that there were major differences between individuals. For awake bruxism (AB), the effects were an increase of 0.04 for anger with a random intercept of 0.21 and an increase of 0.03 for frustration with a random intercept of 0.06. The effects of anger and frustration on both SB and AB were not statistically significant., Conclusion: The association between anger and frustration and self-reported bruxism is small on group level. In individual cases, anger and frustration and self-reported bruxism may be co-existent., (© 2018 John Wiley & Sons Ltd.)

Background: Systemic autonomic changes are well known in migraineurs. Also, masticatory disorders are reported to be associated with migraine. However, if those phenomena are interrelated, and how, is unclear. Moreover, the knowledge on the autonomic responses to masticatory stimuli in migraineurs is limited., Objective: To investigate tooth clenching-related cardiac autonomic regulation in migraineurs., Methods: We compared maximal tooth clenching-induced systemic autonomic responses, indicated by heart rate variability and blood pressure changes, in headache-free migraineurs (n = 17) and control subjects (n = 22)., Results: Levels of high-frequency power, reflecting vagal activity, were lower in migraineurs at baseline but increased after tooth clenching whereas in controls they returned to baseline (P < 0.05, mixed model analysis). In multivariate regression model, the presence of migraine predicted the baseline levels of low- and high-frequency power and sympathovagal balance, and the post-test increase in high-frequency power, with the attack frequency and side of headache as the modifiers of the measured changes in migraineurs. The painful signs of temporomandibular disorders, found in clinical oral examination, enhanced both maximal changes in RR intervals and post-test vagal responses to tooth clenching only in migraineurs., Conclusion: The enhanced post-clenching vagal activation may represent a marker of the augmented trigeminocardiac reflex to stimulation of trigeminal area, sensitised in migraineurs. Our results support an involvement of autonomic mechanisms in migraine pathophysiology and are interesting in terms of interactions between migraine and masticatory disorders, elucidating one potential way how masticatory disorders may aggravate migraine., (© 2018 John Wiley & Sons Ltd.)

The aim of this study is to evaluate the frequency of oral behaviors in patients with temporomandibular disorders (TMD) and a control group without TMD.In this baseline case-control study, 260 controls and 260 subjects with TMD completed the oral behaviors checklist defined as a "self-report scale for identifying and quantifying the frequency of jaw overuse behavior" and underwent clinical examinations using the DC/TMJ international examination form (version May 12, 2013). Relationships of oral parafunctions' frequencies between groups were examined. The statistical analysis was performed with IBM SPSS Statistics 23 software.Age and gender distribution in the study groups did not reveal statistical differences (P > 0.05). Multivariate logistic regression analysis was conducted to establish system of independent oral behaviors for prognosis TMD. The stepwise regression analysis demonstrated that very frequent expression of holding, tightening, or tense muscles is associated with 10.83 times (P < 0.05) higher risk of TMD, grinding teeth together during waking hours with 4.94 times (P < 0.05) higher risk, and sustained talking with 2.64 times (P < 0.05) higher risk of TMD. By contrast, it was determined that 3 oral behaviors were less common in the TMD patients compared with the control group: clenching teeth together during waking hours, facing grimaces, and yawning (P < 0.05). The individuals with TMD reported a significantly higher frequency of 10 behaviors (P < 0.05), 3 of which may be regarded as independent risk factors for TMD. In addition, 3 oral behaviors were more frequently observed in the healthy subjects than in the TMD patients.

Objectives: The aim of this study was to investigate the association between psychological factors (Personality and Dental anxiety) with self-reported bruxism-related symptoms., Methods: 526 subjects, over 18 years old and not seeking dental treatment, were recruited from the families and acquaintances of dental students from the University of Salamanca. Bruxism activity was estimated by means of a six-item questionnaire aimed at recording common bruxism-related symptoms and clenching/grinding awareness. The Spanish version of the modified dental anxiety scale (MDAS) was used to determine the level of anxiety perceived in 5 typical scenarios of dental assistance. The NEO-FFI inventory was applied to assess personality profiles associated with 5 different factors (neuroticism, extroversion, openness, agreeableness, and conscientiousness). Pearson correlations, Student T-tests, and logistic regression modelling were used for the statistical analyses., Results: Thirty-five point nine percent of this adults sample was classified as being bruxers, where sleep bruxers comprised more than half of the sample at 20.2%. Bruxers tended to perceive more anxiety in all of the situations included within the MDAS, where they exhibited a higher level of phobia towards the teeth scaling and local anaesthetic injection. The risk of being considered a bruxer is reduced with age (OR: 0.99), and increases proportionally for some personality traits, such as neuroticism (OR: 1.06) and extraversion(OR: 1.04), to the MDAS total score (OR: 1.08) and in smokers (OR: 1.61), after controlling for all potentially confounding factors., Conclusions: Self-reported bruxism is significantly associated to several personality traits (mainly neuroticism and extraversion) and to the level of dental anxiety (MDAS score)., Clinical Significance: Clinicians should be aware of the typical psychological profiles of patients who experience bruxism and the relationship with dental phobias., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: The aim of this study was to determine the prevalence of bruxism in students at the Federal University of the Jequitinhonha and Mucuri Valleys in Brazil. The secondary objectives were to identify the factors associated with bruxism; prevalence of dental wear; and to distinguish the signs and symptoms of temporomandibular dysfunction when present, and verify its relationship with bruxism., Methods: Two hundred fifty-three students (106 males, 147 females) were clinically examined and answered a questionnaire. Trained researchers performed the dental wear evaluation. The incisal edge and occlusal surface were classified as follows: no wear, wear into enamel, wear into dentin, and extensive wear into dentin. Demographic data and factors related to bruxism were obtained by a questionnaire. The participants who presented dental wear and habit of clenching/grinding teeth were classified as bruxers. The data were analyzed by the SPSS program (p < 0.05)., Results: The results showed that 31.6% of the students had bruxism. Of the 7084 teeth evaluated, 376 (5.3%) had some type of facet wear. The teeth that had the highest prevalence of wear facets were the canines. Stress, muscle pain, temporomandibular joint (TMJ) pain, and TMJ noise were significantly associated with bruxism (p < 0.001)., Conclusion: The prevalence of bruxism was 31.6% in this population. The factors most associated with bruxism were stress, muscle pain, TMJ pain, and TMJ noise.

This case report describes the diagnosis of a traumatic periapical lesion, caused by parafunctional habits (bruxism) and associated with bone rarefaction, that had not been identified by periapical radiography. Slight edema was observed clinically at the apical region of the maxillary left canine; however, the tooth demonstrated only physiologic mobility, and the results of a pulpal sensitivity test were inconclusive. A cone beam computed tomogram (CBCT) showed the presence of a periapical lesion. After preparation of the root canal, intracanal medication (calcium hydroxide and paramonochlorophenol) was placed and changed once a month for 2 months. After 60 days (at the time of the second medication change), the edema at the apical region was no longer visible. The root canal was filled, and CBCTs obtained 30 days and 24 months after completion of treatment showed that the lesion had regressed with bone repair. Although it is an expensive procedure, CBCT is important in the examination and diagnosis of periapical lesions that may not be seen in periapical radiographs.

Background: Many studies have shown the correlation between bruxism and stress that affects the quality of life of university students. The present study highlights this correlation-for the first time-in a group of university students in Italy., Methods: We have investigated the prevalence of awake and asleep bruxism and its correlation with perceived stress in a group of 278 Italian undergraduate students (117 M). A self report questionnaire was constructed using a socio-demographic test, the Perceived Stress Scale (PSS) and the item n. 8 of the Fonseca Questionnaire for presence of bruxism., Results: The perceived stress score using PSS-10 scale was 32.2 (SD 4.6, 95% CL 31.6-32.7) for all the subjects, with significant gender difference: M = 31.2 and F = 32.9 (P = 0.0019). The prevalence for awake bruxism was 37.9% (F = 40.8%; M = 34.2%,), while for sleep bruxism was 31.8% (F = 33.3%; M = 29.1%), both without significant gender difference. A positive correlation, with significant concordance and dependence, between stress score and awake bruxism was present for male students only., Conclusions: University students showed higher bruxism and stress levels compared to the general population, with higher stress for females, but, even if female students show higher stress, a correlation between stress and bruxism exists only for male gender. Further studies should be performed.

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.

The aim of this study was to investigate factors associated with mucosal pain in patients with partial removable dental prostheses (PRDPs). In this hospital-based cross-sectional study, 333 patients wearing 500 PRDPs (mean age 71·4 years, men 33·3%) were consecutively recruited from prosthetic clinic of a dental hospital in Japan. Subjects rated pain intensity and frequency of denture-bearing mucosa. An examiner recorded age, gender and systemic diseases as well as dental, mucosa, denture, sensory, behavioural- and psychological-related characteristics that were possibly associated with the mucosal pain. Multivariate analyses were performed to analyse factors related to mucosal pain. Pain intensity was rated as more than score 0 (presence) in 34·2% (171/500) PRDPs, and pain was experienced after denture delivery in 42·8% (214/500) PRDPs. Logistic regression analyses showed that younger age, mucosal damage, poor mucosal condition, bone prominence, poor residual ridge, higher pain sensitivity, presence of awake bruxism, perception of oral dryness, interim denture wear and high number of missing teeth were significant independent predictors for the presence of the mucosal pain intensity and/or frequency (P < 0·05). Multiple factors are associated with mucosal pain in patients with PRDPs. Oral mucosal characteristics, age, pain sensitivity and behavioural factors seem to be more critical for mucosal pain than distribution of missing teeth and number of abutment teeth., (© 2016 John Wiley & Sons Ltd.)

Little is known about the epidemiological characteristics of sleep and awake bruxism (SB and AB) in adolescents. The aims of the study were: to assess the prevalence rates of self-reported SB and AB in Israeli adolescents; to determine the associations between SB/AB and several demographical, exogenous and psychosocial factors in Israeli adolescents; and to investigate the possible concordance between SB and AB. The study made use of a questionnaire. The study population included 1000 students from different high schools in the centre of Israel. Prevalence of self-reported SB and AB in the Israeli adolescents studied was 9·2% and 19·2%, respectively. No gender difference was found regarding the prevalence of SB and AB. Multiple variable regression analysis revealed that the following predicting variables were related to SB: temporomandibular joint sounds (P = 0·002) and feeling stressed (P = 0·001). The following predicting variables were related to AB: age (P = 0·018), temporomandibular joint sounds (P = 0·002), oro-facial pain (P = 0·006), and feeling stressed (P = 0·002) or sad (P = 0·006). A significant association was found between SB and AB; that is, an individual reporting SB had a higher probability of reporting AB compared with an individual who did not report SB (odds ratio = 5·099). Chewing gum was the most common parafunction reported by adolescents. The results of this study demonstrate that self-reports of AB and SB are common in the Israeli adolescents population studied and are not related to gender. The significant correlation found between SB and AB may be a confounding bias that affects proper diagnosis of bruxism through self-reported questionnaires only., (© 2016 John Wiley & Sons Ltd.)

Aims: To determine if retrospective self-report of oral parafunctional behaviors potentially relevant to pain conditions is valid, by comparing oral parafunctional behaviors via a self-report instrument (Oral Behaviors Checklist [OBC]) with in-field reports of oral parafunction., Methods: Individuals with a range of oral parafunctional behaviors, as identified by the OBC, were recruited, and 22 completed the field study. Using the Ecological Momentary Assessment paradigm, each subject was randomly prompted about eight times per day, for a target of 7 days, via portable handheld computer to report current behaviors among 11 queried items. Before and after the field study, a paper version of the OBC was administered. Separately, 74 individuals participated in a test-retest study of the paper OBC. Analyses included regression, correlation, intraclass correlation coefficient (ICC) and area under the receiving operating curve (AUC)., Results: Pre- and postfield study administration of the OBC exhibited substantial reliability (ICC = 0.65), indicating no reactivity during the intervening in-field data collection. Reliability across in-field days was low, indicating high variability in which behavior occurred on which day. Nonobservable behaviors were reported more frequently than observable behaviors. Self-report via OBC was linear with in-field data collection methods (R2 values ranged from 0.1 to 0.7; most values were within 0.3 to 0.4). The predictive value of the self-report total score was AUC (0.88) relative to the in-field study score. Separate test-retest reliability of the OBC was almost perfect (ICC = 0.88)., Conclusions: The OBC is a reliable and valid way to predict behaviors in the natural environment and will be useful for further pain research.

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.

To gain a better understanding of temporomandibular disorders (TMD) pain in adolescents, it is important to study the factors associated with its presence. Therefore, the aim of this study was to investigate potential predictors for TMD pain in adolescents, thereby including a diversity of factors from the biopsychosocial model to determine the strongest predictors. The sample of this cross-sectional study consisted of 1094 adolescents. The presence of TMD pain was assessed using the RDC/TMD, Axis I. Apart from demographical characteristics, the roles of parafunctional habits, psychosocial aspects, menarche and other bodily pain complaints were evaluated. Single and multiple logistic regression models were used to identify associations between the predictor variables and TMD pain. Painful TMD had a prevalence of 25·5%. Logistic regression analyses showed that TMD pain was associated with sleep bruxism (OR = 1·8 95% CI = 1·34-2·34), awake bruxism (OR = 2·1 95% CI = 1·56-2·83), other parafunctional habits (OR = 2·2 95% CI = 1·17-4·08) and bodily pain complaints (OR = 5·0 95% CI = 3·48-7·28). Parafunctional habits and other bodily pain complaints may play an important role in the presence of TMD pain in adolescents. Of course, it remains unclear whether the observed associations between the investigated factors and the adolescent's TMD pain have a true causal linkage., (© 2014 John Wiley & Sons Ltd.)

Bruxism contributes to the development of temporomandibular disorders as well as causes dental problems. Although it is an important issue in clinical dentistry, no treatment approaches have been proven effective. This study aimed to use electromyogram (EMG) biofeedback (BF) training to improve awake bruxism (AB) and examine its effect on sleep bruxism (SB). Twelve male participants (mean age, 26·8 ± 2·5 years) with subjective symptoms of AB or a diagnosis of SB were randomly divided into BF (n = 7) and control (CO, n = 5) groups to undergo 5-h daytime and night-time EMG measurements for three consecutive weeks. EMG electrodes were placed over the temporalis muscle on the habitual masticatory side. Those in the BF group underwent BF training to remind them of the occurrence of undesirable clenching activity when excessive EMG activity of certain burst duration was generated in week 2. Then, EMGs were recorded at week 3 as the post-BF test. Those in the CO group underwent EMG measurement without any EMG BF training throughout the study period. Although the number of tonic EMG events did not show statistically significant differences among weeks 1-3 in the CO group, events in weeks 2 and 3 decreased significantly compared with those in week 1, both daytime and night-time, in the BF group (P < 0·05, Scheffé's test). This study results suggest that EMG BF to improve AB tonic EMG events can also provide an effective approach to regulate SB tonic EMG events., (© 2014 John Wiley & Sons Ltd.)

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.)

Objective: The aim of this study was to determine the prevalence of self-assessed bruxism, the level of Health Related Quality of Life (HRQoL) and their relationship in a group of male inmates. BASIC RESEARCH DESIGN, SETTING: The present study was cross-sectional, its setting was two penal institutions in Italy., Participants: A sample of 280 male prisoners (mean age 39.7 years). Due to the very small number of female prisoners, it was not possible to study both genders., Interventions and Main Outcome Measures: Subjects were administered a questionnaire with items investigating demographic data, self-assessed bruxism and HRQoL using EuroQoL EQ-5D instrument., Results: Bruxism was present in 29.7% of inmates. Results for EQ-5D (in brackets are data for the general population age and gender matched) were: EQ-index 1.3 (0.8), EQ-VAS 62 (80). Percentage reporting a problem for each dimension: Mobility (MO): 7.5 (9.6), Self Care (SC): 6.1 (4.3), Usual Activities (UA): 17.9 (10.1), Pain/discomfort (PD): 43.9 (40.8), Anxiety/depression (AD): 54.6 (31.9). There was a strong correlation between bruxism and EQ-index, showing concordance and dependence and, as expected, discordance and dependence between bruxism and EQ-VAS., Conclusion: Bruxism prevalence is higher and HRQoL is worse in the prison population than in the general population; the presence of bruxism is correlated with lower HRQoL levels, and correlation is stronger for subjects at first prison experience and for higher education levels, thus suggesting higher effect of stress on these subjects.

Purpose: Apparent organic abnormalities are sometimes not identified among patients suffering from chronic pain in the craniocervical region. In some cases, parafunctional activities (PAs) are recognized. PAs are nonfunctional oromandibular activities that include jaw clenching and bruxism, but are considered as factors that contribute to craniomandibular disorders (CMDs). It is now recognized that PAs and CMDs influence musculoskeletal conditions of the upper quarter. Exercise therapy (ET) to improve jaw movement and psychological intervention (PI) to reduce PAs are useful for PAs and CMDs. We hypothesized that ET and PI would be effective for craniocervical pain without organic abnormalities., Methods: Thirty-nine subjects suffering from craniocervical chronic pain were allocated into 3 groups: The control group received only pharmacological treatment; the ET group received jaw movement exercise (JME); and the ET-PI group received JME and PI. Pain and jaw movement were evaluated using a numerical rating scale (NRS)., Results: After interventions, the NRS scores were significantly lower in the ET-PI group, compared with those in the other groups. Jaw movement improved 100% in the ET group, 92% in the ET-PI group, and 0% in the control group., Conclusion: A combination of jaw exercise and psychological intervention to reduce parafunctional activities is more effective than jaw exercise alone for the improvement of craniocervical pain without apparent organic abnormalities., (© 2013 World Institute of Pain.)

Aims: To explore thoughts, experiences, and beliefs regarding temporomandibular disorders (TMD) among Sami women with and without TMD in order to gain insights into their health care experiences and to generate a hypothesis regarding factors associated with long-standing TMD., Methods: Qualitative thematic interviews were conducted with a strategic sample of 17 Sami women, of whom 10 had a TMD diagnosis according to the Research Diagnostic Criteria for TMD and 7 age-matched women who had no signs or symptoms of TMD. Their ages were between 23 and 58 years. The thematic interviews were audiotaped, transcribed verbatim, and analyzed based on Grounded Theory, a qualitative methodology aiming to generate hypotheses grounded in the gathered data., Results: The core category that evolved was "Grin(d) and bear it," which summarizes the Sami participants' various ways and stages of processing and handling the interacting categories (triggers, strains, distrust, and reconciliation with pain and/or difficulties in life). They described divergent as well as similar understandings of triggering factors. Maintaining factors were described as mental-physical strain and stress, and also a jaw-clenching behavior. Women without TMD contributed with factors that helped them to handle strains, reconcile, and stay healthy. They relied on strong social support., Conclusion: Based on the analysis, the following hypothesis was generated: Women with TMD, associated headaches, and neck-shoulder pain may benefit from efforts aimed at empowering them to use their own abilities to reduce stress behavior, strain, and disuse of the jaw. Rehabilitation strategies in groups might increase their sense of coherence and increase social support, which seems to be more limited than in women with no symptoms of TMD.

Background: Bruxism is a parafunctional habit characterized by grinding and/or clenching of the teeth. It may happen while awake (awake bruxism) or while sleeping (sleep bruxism). In adults, the prevalence is 20% for the awake bruxism and 8% for the sleep bruxism. Peripheral, central, and psychosocial factors influence the disorder, which may predispose to pain in the masticatory muscles and neck, headache, decreased pain thresholds in the masticatory and cervical muscles, limitation mandibular range of motion, sleep disorders, stress, anxiety, depression, and overall impairment of oral health. The aim of this study is to compare two distinct physical therapy interventions with dental treatment in pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and oral health in individuals with bruxism., Methods/design: Participants will be randomized into one of three groups: Group 1 (n=24) intervention will consist of massage and stretching exercises; Group 2 (n=24) will consist of relaxation and imagination therapies; and Group 3 (n=24) will receive dental treatment. The evaluations will be performed at baseline, immediately after treatment, and at 2-month follow-up. Pain intensity will be assessed using the visual analogical scale, while pain thresholds will be determined using dolorimetry. Mandibular range of motion will be assessed using digital pachymeter. Sleep quality will be assessed by the Pittsburgh Sleep Quality Index, anxiety by the State-Trait Anxiety Inventory, stress by the Perceived Stress Scale-10, depression by the Beck Depression Inventory, and oral health will be assessed using the Oral Health Impact Profile--14. Significance level will be determined at the 5% level., Discussion: This project describes the randomization method that will be used to compare two physical therapy interventions with dental treatment in the management of pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and oral health in individuals with bruxism. The study will support the practice of evidence-based physical therapy for individuals with bruxism. Data will be published after study is completed., Trial Registration: ClinicalTrials.gov, NCT01778881.

The impact of oral health on quality of life is one aspect when it comes to understanding the significance of oral health. The aim of this study was to analyse the self-reported oral discomfort and clinical status of individuals reporting oral problems never/very seldom affecting quality of life during the last year and compare them with individuals who reported oral problems hardly ever/occasionally or often/very often during the the same period. The study comprised a stratified random sample of 515 individuals who lived in four parishes in the City of Jonköping, Sweden, and turned 20, 30, 40, 50, 60, 70 and 80 years of age in 2003. The impact of oral health on quality of life was examined using the OHIP-14 questionnaire. The individuals were also examined clinically and radiographically. Of the participants, 21% reported no experience of impaired quality of life and 20% of the individuals reported that they had experienced impaired quality of life often or very often during the last year. The highest frequency of oral problems was found among individuals aged 20 and 80 years. Subjective symptoms, such as grinding/clenching and headache, were found among 20- and 30-year-olds. Edentulous individuals and individuals with many missing teeth, individuals with severe periodontal disease or subjective dry mouth answered that they experienced problems according to the OHIP-14 often or very often. A number of individuals, young and old, had thus experienced subjective or clinically verified oral conditions associated with a negative experience of quality of life. This complementary information will provide a deeper understanding of the importance of oral health in the population.

In clinical practice, patients suffering from an occlusal parafunctional activity have increased. It can be observed that a negative influence of environment aggravates patient's health. The aim of this paper is to present the impact of environment and development of human civilization on the prevalence of bruxism and the correlation between them. The authors grasp the most relevant aspects of psychological and anthropological factors changing over time as well as their interactions and describe a relationship between chronic stress and bruxism. Current literature shows how contemporary lifestyle, working environment, diet, and habits influence the patient's psychoemotional situation and the way these factors affect the occluso-muscle condition.

Purpose: Occlusal splints are often prescribed when treating patients with bruxism. The objectives were to determine (a) whether using occlusal splints improves patients' oral health-related quality of life (ohrqol) and (b) whether the quality of the patient-provider relationship affects these patients' splint-related responses and their ohrqol., Materials and Methods: Survey data were collected from 233 patients who had received bite splints during the 5 years prior to data collection., Results: The data showed that 5% of these patients had never used their splint, 20% had used it in the past, and 75% still used it at the time of data collection. Patients using the splint agreed more strongly that their current oral health status had improved, had more positive splint-related responses and more positive pain-related ohrqol scores than patients who were no longer using the splint. The more patients agreed that they were satisfied with their provider, the more positively they evaluated their bite splints and the more positive was their ohrqol., Conclusions: Bite splint users have more positive splint-related responses and a better pain-related ohrqol than patients who received a bite splint but do not use it any longer. The quality of the patient-provider relationship plays an important role in the patients' splint-related responses as well as in the degree to which patients' ohrqol improves.

The aim of the current study was to compare personality traits, presence of oral myofunctional dysfunctions, and other parafunctional habits in bruxing and nonbruxing children. Fifty-four patients aged 10 to 15 years were seen at the Comprehensive Pediatric Dental Clinic and examined by dentists using the RDC/TMD; speech therapists and psychologists were included in the study. Patients were divided into two groups: bruxing (A) and nonbruxing (B). Mean age was 13.1 years, S.D. 1.6. No significant differences in age or gender were found between groups. Group A comprised 44.44% of the population and showed a high frequency of middle conscientiousness scores and low frequency of low neuroticism scores. Presence of TMD, unilateral chewing, and high tongue tip position at rest were all significantly higher. Frequency of oral habits was higher in bruxers, who showed significantly increased gum chewing, and lip, cheek, and object biting compared to nonbruxing controls. Bruxism is considered a risk factor for temporomandibular dysfunction (TMD).

The aim of our study was multi-faceted study of status the psychological of young people suffering from bruxism. A total of 101 people (44 men and 57 women) divided into 4 groups. The study of mental states and personality traits included the Freiburg Personality Inventory (FPI). The majority of subjects characterized by high reactivity and emotional lability, the surveyed with day and combined bruxism is more pronounced symptoms of irritability, tension, and increased excitability. The best approach when examining young patients with bruxism should be based on accounting data and anamnestic examination not only dentists, but also psychologists and psychotherapists to identify the "background" of mental states and personality traits and correction of sharp variations by special methods.

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.

Aim: (1) To study the behavior disorders in children between 5 to 15 years. (2) To study the role of stress in causing behavior disorders. (3) To interpret the orofacial findings in children with behavior disorders. (4) Correlate the orofacial findings with behavior disorder., Materials and Methods: Ninty children with behavior problems between age of 5 to 15 years along with their parents who visited the Department of Child-Guidance Clinic, BYL Nair Charitable Hospital, Mumbai. Intraoral examinations were conducted. Behavioral disorders and factors predisposing to those disorders were recorded., Results: Behavior disorders with orofacial lesions was more common in age group of 8 to 10 years. The children were continuously under stress, which manifested in the form of various orofacial disorders or oral lesions. Most common orofacial condition was bruxism., Conclusion: Awareness of behavior disorders in dental treatment should guide the pediatric dentist to seek child psychiatric consultation for behavioral disorders to enable early evaluation of the underlying disorder., Clinical Significance: The present study suggested that orofacial and behavior characteristics can serve as markers to diagnose children with behavioral disorders. It also serves as a guide to dental clinicians to refer such children to psychiatrists or pediatricians for early identification, prevention and treatment.

Objectives: Previous studies have found an association between bruxism and emotional and behavioral problems in children, but reported data are inconsistent. The objective of this study was to estimate the prevalence of bruxism, and of its components clenching and grinding, and its associations with mental problems and depression., Methods: Data from two Brazilian birth cohorts were analyzed: one from 869 children in Ribeirão Preto - RP (São Paulo), a more developed city, and the other from 805 children in São Luís - SL (Maranhão). Current bruxism - evaluated by means of a questionnaire applied to the parents/persons responsible for the children - was defined when the habit of tooth clenching during daytime and/or tooth grinding at night still persisted until the time of the assessment. Additionally, the lifetime prevalence of clenching during daytime only and grinding at night only was also evaluated. Mental health problems were investigated using the Strength and Difficulties Questionnaire (SDQ) and depression using the Children's Depression Inventory (CDI). Analyses were carried out for each city: with the SDQ subscales (emotional symptoms, conduct problems, peer problems, attention/hyperactivity disorder), with the total score (sum of the subscales), and with the CDI. These analyses were performed considering different response variables: bruxism, clenching only, and grinding only. The risks were estimated using a Poisson regression model. Statistical inferences were based on 95% confidence intervals (95% CI)., Results: There was a high prevalence of current bruxism: 28.7% in RP and 30.0% in SL. The prevalence of clenching was 20.3% in RP and 18.8% in SL, and grinding was found in 35.7% of the children in RP and 39.1% in SL. Multivariable analysis showed a significant association of bruxism with emotional symptoms and total SDQ score in both cities. When analyzed separately, teeth clenching was associated with emotional symptoms, peer problems, and total SDQ score; grinding was significantly associated with emotional symptoms and total SDQ score in RP and SL. Female sex appeared as a protective factor for bruxism, and for clenching and grinding in RP. Furthermore, maternal employment outside the home and white skin color of children were associated with increased prevalence of teeth clenching in SL., Conclusions: Mental health problems were associated with bruxism, with teeth clenching only and grinding at night only. No association was detected between depression and bruxism, neither clenching nor grinding. But it is necessary to be cautious regarding the inferences from some of our results., (© 2011 John Wiley & Sons A/S.)

Objective: The aim of the study was to determine the prevalence and awareness of particular types of oral parafunctions in young healthy students and any association with temporomandibular disorders (TMD)., Material and Methods: The study was performed in a randomly selected group of 303 healthy students (mean age 18.8 years) from the vocational technical school in Wrocław, Poland, who underwent a routine clinical examination and functional analysis of the mouth. On taking the history all subjects were asked about their awareness of various forms of parafunctional activity in their mouth., Results: Almost all subjects revealed various oral parafunctions such as: bruxism, nail and pen biting, chewing gum, and biting the mucosa of lip or cheek. These habits were present singly or as double, triple or even fourfold coincidences in a single person. The most frequent oral parafunctions were habitual gum chewing and bruxism. Subjects were very seldom aware of the last parafunction. TMDs were more prevalent in the presence of bruxism than in other oral parafunctions., Conclusions: The studied students revealed various types of oral parafunctions, however most of them were not aware of clenching and grinding their teeth.

The aim of the current study was to evaluate the prevalence of psychopathological symptoms in patients who self-reported different forms of bruxism by means of clinical and anamnestic diagnostic criteria. Eighty-five participants were divided into four groups as sleep bruxers (12), awake bruxers (24), sleep-awake bruxers (33), and non-bruxers (16). A self-report symptom inventory questionnaire (Symptom Checklist-90-Revised (SCL-90-R)) was filled out by all groups to determine their psychopathological symptoms. As regards mean psychopathological scores, patients with sleep-awake bruxism endorsed the highest scores. In addition, patients with awake bruxism showed higher scores than patients with sleep bruxism and non-bruxism in most SCL-90-R subscales. Kruskal-Wallis test revealed significant differences between groups in any of the SCL-90-R subscales, except for the psychoticism subscale. Mann-Whitney test followed by Bonferroni's test correction between non-bruxer and sleep-awake bruxer groups revealed significant differences in depression, anxiety, hostility, phobic anxiety, paranoid ideation, global severity index, positive symptom distress index, and positive symptom total in all SCL-90-R subscales. Statistical analysis of our study showed that differences between groups were significant in all SCL-90-R subscales except for the psychoticism subscale. Better distinction of bruxism forms may help to develop new treatment strategies for bruxism disorder.

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.)

To examine possible associations between self-reported bruxism, stress, desirability of control, dental anxiety and gagging. Five questionnaires were distributed among a general adult population (402 respondents): the Perceived Stress Scale (PSS), Desirability of Control Scale (DC), Dental Anxiety Scale (DAS), Gagging Assessment Scale (GAS), and Bruxism Assessment Questionnaire. A high positive correlation between DAS and GAS (R = 0·604, P < 0·001) was found. PSS was negatively correlated with DC (R = -0·292, P < 0·001), and was positively correlated with GAS (R = 0·217, P < 0·001) and DAS (R = 0·214, P < 0·001). Respondents who reported bruxing while awake or asleep showed higher levels of GAS, DAS and PSS than those who did not. There were no differences between the bruxers and the non-bruxers (sleep and aware) with regard to the DC scores. The best predictors of awake bruxism were sleep bruxism (OR = 4·98, CI 95% 2·54-9·74) and GAS (OR = 1·10, CI 95% 1·04-1·17). The best predictors of sleep bruxism were awake bruxism (OR = 5·0, CI 95% 2·56-9·78) and GAS (OR = 1·19; CI 95% 1·11-1·27). Self-reported sleep bruxism significantly increases the odds for awake bruxism and vice versa. Tendency for gagging during dental care slightly increases the odds of both types of self-reported bruxism, but desirability of control is not associated with these phenomena., (© 2010 Blackwell Publishing Ltd.)

A symposium was held in Toronto, 2008, in which research progress regarding the biobehavioural dimension of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was presented. An extended workshop was held in April 2009 in which further recommendations were made from an expert panel, using the 2008 symposium material as a base. This paper is a summary of the 2008 symposium proceedings with elaborations based on further developments. Seven studies were conducted between 2001 and 2008, in which the following were investigated: (i) basic properties of Axis II instruments, (ii) reliability and criterion validity of Axis II instruments, (iii) expansion of predictors, (iv) metric equivalence of the depression and non-specific physical symptoms subscales in the RDC/TMD, (v) laboratory investigation of oral behaviours, (vi) field data collection of oral behaviours, and (vii) functional limitation of the jaw. Methods and results for each of these studies are described. Based on the results of these studies that have been published, as well as the direction of interim results from the few studies that await completion and publication, the biobehavioural domain of the RDC/TMD, as published in 1992, is reliable and valid. These results also provide strong evidence supporting the future growth of the biobehavioural domain as the RDC/TMD matures into subsequent protocols for both clinical and research applications., (© 2010 Blackwell Publishing Ltd.)

Aims: To examine temporomandibular disorder (TMD) patients' illness beliefs and self-efficacy in relation to bruxism, and to examine whether these beliefs are related to the severity of patients' self-perceived bruxing behavior., Methods: A total of 504 TMD patients (75% women; mean age ± SD: 40.7 ± 14.6 years), referred to the TMD Clinic of the Academic Centre for Dentistry Amsterdam, completed a battery of questionnaires, of which one inquired about the frequency of oral parafunctional behaviors, including bruxism (clenching and grinding). Patients' illness beliefs were assessed with a question about the perceived causal relationship between bruxism and TMD pain; patients' self-efficacy was assessed with questions about the general possibility of reducing oral parafunctional behaviors and patients' own appraisal of their capability to accomplish this., Results: Sleep bruxism or awake bruxism was attributed by 66.7% and 53.8% of the patients, respectively, as a cause of TMD pain; 89.9% believed that oral parafunctions could be reduced, and 92.5% believed themselves capable of doing so. The higher a patient's bruxism frequency, the more bruxism was believed to be the cause of TMD pain (Spearman's rho 0.77 and 0.71, P < .001) and the more pessimistic the self-efficacy beliefs were about the reducibility of oral parafunctions (Kruskal-Wallis ?2 = 19.91, df = 2, P < .001; and Kruskal-Wallis ?2 = 7.15, df = 2, P = .028)., Conclusion: Most TMD patients believe in the harmfulness of bruxism and the possibility of reducing this behavior. Bruxism frequency is associated with illness beliefs and self-efficacy.

How bruxism develops from adolescence to early adulthood remains unclear. A previous database was revisited to evaluate the natural course of self-reported tooth grinding and clenching among young Finns aged 14-23 using four assessments. Overall, the self-reported frequencies of both grinding and clenching increased during the examination period: from 13.7% to 21.7% and from 9.2% to 14.8%, respectively. There were significant increases (without a statistically significant difference between genders) in both grinding (P = 0.002) and clenching (P = 0.015) between 15 and 23 years. A significant rise in grinding between 18 and 23 years was also found (P = 0.011). It is concluded that self-reported bruxism increases from adolescence to young adulthood. Moreover, there are large differences between individuals, and fluctuations may occur in the natural course of bruxism.

Objective: To compare parental psychopathology and psychiatric disorders in ADHD children with and those without enuresis., Method: The participants of the clinical sample interviewed according to DSM-IV diagnostic criteria were 35 children with ADHD and enuresis, 153 ADHD children without enuresis, 115 fathers, and 172 mothers., Results: Only ODD comorbidity was the predictor of enuresis. Conduct disorder, tic disorder, major depressive disorder, separation anxiety disorder, bruxism, generalized anxiety disorder, obsessive compulsive disorder, and nail biting were not statistically more frequent in ADHD children with enuresis than in the ADHD children without enuresis. The only parental psychiatric disorder that was related to the groups was father's major depressive disorder., Conclusion: Enuresis in ADHD has a relationship with ODD. Physicians who treat patients with ADHD and enuresis should routinely inquire about the presence of major depression in the fathers. (J. of Att. Dis. 2010; 13(5) 464-467).