Abstract

To assess the presence of bruxism and anxiety among military firefighters with frequent episodic tension-type headache and painful temporomandibular disorders (TMDs). The sample consisted of 162 individuals aged 18 to 55 years divided into four groups. Headache was diagnosed in accordance with the International Classification of Headache Disorders-III. The Research Diagnostic Criteria for Temporomandibular Disorders questionnaire was used to classify TMDs and awake bruxism; sleep bruxism was diagnosed in accordance with the International Classification of Sleep Disorders-3; and anxiety was classified using the Beck Anxiety Inventory. In statistical models, a significance level of 95% was used. The chi-square test was used to assess anxiety. Associations were found among frequent episodic tension-type headache, painful TMDs, awake bruxism and anxiety (p < 0.0005). Sleep bruxism was not a risk factor (p = 0.119) except when associated with awake bruxism (p = 0.011). Anxiety and awake bruxism were independent risk factors for developing frequent episodic tension-type headache associated with painful TMDs; only awake bruxism was a risk factor for frequent episodic tension-type headache with non-painful TMDs.

Highlights

  • The evaluation of frequent episodic tension-type headache was performed by a single neurologist through a questionnaire containing objective questions that were in line with the diagnostic criteria established through the International Classification of Headache Disorders, third edition[4]

  • The presence of sleep bruxism + awake bruxism and abnormal tooth wear were significantly associated with specific groups

  • Awake bruxism was quite common among headache patients (Table 2) and anxiety levels ranging from moderate to severe were found in patients from the third group (Tables 1 and 3)

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Summary

Introduction

Symptoms of anxiety have been correlated with the presence of headaches[7,8,9], TMDs9,10,11 and awake bruxism[12]. The presence of primary headache was associated with complaints of myofascial pain, dental contacts (more frequent and intense) and muscle tension[21]. The objective of the present study was to assess the selfreported presence of bruxism and anxiety symptoms among military firefighters with and without frequent episodic tension-type headache and TMDs, compared with controls.

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