Awake Bruxism—Single-Point Self-Report versus Ecological Momentary Assessment

Alona Emodi-Perlman,Alessandro Bracci,Orit Arnias-Winocur,Pessia Frideman-Rubin,Daniele Manfredini,Ilanit Yevdayev,Ilana Eli,Tamar Shalev

doi:10.3390/jcm10081699

Alona Emodi-Perlman, Alessandro Bracci + Show 6 more

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https://doi.org/10.3390/jcm10081699

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Abstract

Assessment of awake bruxism (AB) is problematic due to the inability to use continuous recordings during daytime activities. Recently, a new semi-instrumental approach was suggested, namely, ecological momentary assessment (EMA), via the use of a smartphone application. With the application, subjects are requested to report, at least 12 times per day, the status of their masticatory muscle activity (relaxed muscles, muscle bracing without tooth contact, teeth contact, teeth clenching, or teeth grinding). The aim of the present study was to test the association between a single observation point self-report and EMA assessment of AB. The most frequent condition recorded by the EMA was relaxed muscles (ca. 60%) and the least frequent was teeth grinding (less than 1%). The relaxed muscle condition also showed the lowest coefficient of variance over a seven-day period of report. Additionally, only the relaxed muscles and the muscle bracing conditions presented an acceptable ability to assess AB-positive and AB-negative subjects, as defined by single-point self-report questions. The combination between self-report and EMA may have the potential to promote our ability to assess AB. We suggest to re-consider the conditions of teeth contact and teeth grinding while using EMA to evaluate AB.

Highlights

The definition of awake bruxism (AB) was set by an international bruxism expert panel as a “masticatory muscle activity during wakefulness that is characterized by repetitive sustained tooth contact and/or bracing or thrusting of the mandible and is not a movement disorder in otherwise healthy individuals” [1]
36 subjects (34%) were defined as AB-positive according to single-point self-report
Non-instrumental approaches for bruxism assessment are mostly based on self-report, which are useful in gathering information on perceived bruxism activities but cannot quantify the duration and intensity of the muscle activity [1,16]

Summary

Introduction

The definition of awake bruxism (AB) was set by an international bruxism expert panel as a “masticatory muscle activity during wakefulness that is characterized by repetitive sustained tooth contact and/or bracing or thrusting of the mandible and is not a movement disorder in otherwise healthy individuals” [1].For a recent review on the current knowledge of the etiology, assessment, and management of bruxism, see Manferdini et al [2]. The definition of awake bruxism (AB) was set by an international bruxism expert panel as a “masticatory muscle activity during wakefulness that is characterized by repetitive sustained tooth contact and/or bracing or thrusting of the mandible and is not a movement disorder in otherwise healthy individuals” [1]. It can be summarized that the exact etiology of bruxism has not been determined yet. The international expert panel suggested grading the assessment of AB as: (i) Possible AB, based merely on a positive self-report; (ii) probable AB, based on a positive clinical inspection, with or without a positive self-report; (iii) definite AB, based on a positive instrumental assessment, with or without a positive self-report and/or a positive clinical inspection [1]

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