Abstract
Numerous studies have analyzed the relationship between psychological factors and bruxism. However, the data are often obscured by the lack of precise diagnostic criteria and the variety of the psychological questionnaires used. The purpose of this study is to determine the association between awake bruxism and psychological factors (anxiety, depression, sociability, stress coping, and personality traits). With this aim, 68 participants (13 males) completed a battery of psychological questionnaires, a self-reported bruxism questionnaire, and a clinical examination. Based on their scores on the bruxism questionnaire and the clinical examination, subjects were divided into two groups. Subjects who met the criteria for “probable awake bruxism” were assigned to the case group (n = 29, five males). The control group (n = 39, nine males) was composed of subjects who showed no signs or symptoms of bruxism in the examination nor in the questionnaire. The probable awake bruxism group presented significantly higher levels of trait and state anxiety, symptoms of somatization, and neuroticism than the control group. Despite this, and when their problem coping strategies were considered, awake bruxers showed higher levels in Positive Reappraisal (p < 0.05), a strategy generally considered as adaptive. In conclusion, although awake bruxers in our study showed larger levels of anxiety, somatization, and neuroticism, they also displayed more adapted coping strategies, while according to previous data TMD patients (which generally also present high levels of anxiety, somatization and neuroticism) might tend to present less adaptive coping styles. Thus, awake bruxism may play a positive role in stress coping, which would be compatible with the hypothesis of mastication as a means of relieving psychological tension. This finding should be further confirmed by future research comparing TMD patients with definitive awake bruxers and controls and using larger and more representative samples.
Highlights
Awake bruxism is a masticatory muscle activity during wakefulness that is characterized by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible
In regard to the somatization scale, significant differences were present between groups (p < 0.05), with higher scores appearing among the awake bruxers participants (M = 8.5, SD = 4.8) with in comparison to the healthy ones (M = 5.9, SD = 3.9)
Despite the fact that the awake bruxer’s group displayed higher depression scores than the control group, (M = 7.5, M = 5.6 and SD = 4.4, SD = 3.9, respectively) the statistical analysis revealed that this difference was statistically non-significant, showing only a weak trend (p = 0.09) (Figure 1)
Summary
Awake bruxism is a masticatory muscle activity during wakefulness that is characterized by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible. Sleep bruxism is a masticatory muscle activity during sleep that is characterized as either rhythmic (phasic) or non-rhythmic (tonic) [1]. Stress Coping in Awake Bruxism found a prevalence of 5.0% for awake bruxism and of 16.5% for sleep bruxism [2]. Its prevalence among the young college population is much higher, reaching 37.9% for awake bruxism and 31.8% for sleep bruxism [3]. It has been argued that the mere presence of awake or sleep bruxism should not be considered pathological on its own in otherwise healthy individuals, but rather as a risk for other negative health consequences. In some individuals, it could even have positive consequences for the bruxer (e.g., mediating the recovery from respiratory arousals or reducing teeth wear due to gastroesophageal reflux by increasing salivation) [1]
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