Abstract
Psychosocial factors may play an important role in the etiology of sleep and awake bruxism. The purpose of this study was to assess the relationship between emotional stress and bruxism in male and female dental students at various stages of their education. Dental education in Israel is based on a six-year curriculum, divided into three stages: pre-medical studies (yr. 1–2), manual skills (yr. 3–4), and clinical experience (yr. 5–6). Each stage requires different capabilities and skills. Questionnaires regarding psychological state (SCL-90) measuring depression, anxiety, and somatization as well as stress evaluation questioners (Perceived Stress Scale questionnaire 14) were completed by 387 dental students in the 1st to 6th years. Sleep and awake bruxism were evaluated based on the respondent’s awareness. During the manual stage of studies, a significant increase was identified, albeit with weak correlations, between stress scales, depression, anxiety, somatization, and the prevalence of awake bruxism, particularly among males. Only in females was sleep bruxism correlated with emotional parameters, whereas no significant difference in sleep bruxism was observed in males throughout the stages of the study. The manual years of dental education were found to be linked to higher levels of emotional distress and awake bruxism, particularly in men. Sleep bruxism, on the other hand, was not directly linked to emotional factors, implying a distinct etiology.
Highlights
Stress is concurrently a stimulus and a reaction that includes both physiological and psychological components, which might affect normal functioning [1]
We evaluated the associations between stress and subsequent emotional and somatic consequences and sleep and awake bruxism among male and female undergraduate dental students at various stages of dental education in Israel
A significant interaction was found between period of studies and sex (F (2,381) = 3.621, p < 0.03), indicating that males showed a significantly higher increase in stress parameters compared to females in the Manual period (Figure 1a)
Summary
Stress is concurrently a stimulus and a reaction that includes both physiological and psychological components, which might affect normal functioning [1]. A systematic review published in 2011 determined that the major sources of dental students’ stress were examinations, clinical requirements, and dental supervisors [3]. The signs and symptoms of stress may include anxiety and depression as well as somatic symptoms such as upset stomach and sweating [3]. These symptoms varied between students, with some differences between female and male dental students observed [4]. Differences were identified in the way stress caused by academic, clinic-related, social, and financial factors affected students of different sexes and at different stages of their education [5]. College or university undergraduate students were found to be prone to stressful conditions and, were more likely to have a high risk of anxiety- and depression-related clinical disorders [6,7,8,9,10,11]
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