Bruxism Research Articles

Is There an Increase in Possible Sleep Bruxism in Children Over Time? A Longitudinal Study.

Bruxism is a behaviour that has several consequences in an individual's life, especially when it starts in childhood. However, bruxism can be a potential protective factor, which is an attribute that reduces the chance of a negative health outcome. To evaluate the incidence of sleep bruxism (SB) and dental wear in children and adolescents. This longitudinal study began in 2014 and 2016 (baseline) with initial 1816 children followed for 5 and 3 years, respectively. The follow-up data collection started in 2019. The diagnosis of SB was parents report (baseline) and self-report (follow-up) due to age groups of each phase, and questions related to symptoms of SB were collected. Five calibrated examiners (kappa >0.7) collected the clinical data. The clinical variables were dental erosion and dental wear. Contextual, individual, behaviour and clinical characteristics were collected. A multilevel logistic regression model was used to investigate the association of contextual, individual, behaviour and clinical characteristics with SB. Poisson regression for repeated measures was performed to evaluate the incidence of SB and dental wear (incidence rate ratio-IRR and confidence interval-95% CI). Two hundred and fifty-three children and adolescents answered questionnaires and were clinically examined. The mean age of the follow-up in 2019 was 11.25 years old (±2.19). There was no increase in the incidence of SB (95% CI: 0.74-1.35). Children/adolescents had a 2.2 higher risk to present dental wear (95% CI: 1.89-2.60). SB at the follow-up was associated with the contextual variable, earache, erosion and awake bruxism. In this population, children with SB remained with this behaviour and showed higher dental wear over the years.

Performance evaluation of portable respiratory polygraphy for assessing sleep bruxism in adults.

Polysomnography (PSG) is the gold standard for sleep bruxism (SB) assessment, it is expensive, not widely accessible, and time-consuming. Given the increasing prevalence of SB, there is a growing need for an alternative, readily available, reliable and cost-effective diagnostic method. This study aimed to evaluate the diagnostic validity of portable respiratory polygraphy (PRPG) compared with PSG for SB diagnosis. One hundred and three subjects underwent simultaneous examinations using PRPG (NOX T3, NOX Medical) and PSG (NOX A1, NOX Medical) in a sleep laboratory. The mean Bruxism Episodes Index (BEI) measured by PRPG was 4.70 ± 3.98, whereas PSG yielded a mean BEI of 3.79 ± 3.08. The sensitivity for detecting sleep bruxism (BEI >2) by PRPG was 48.3%, with a specificity of 81.2%. The positive predictive value was estimated at 51.9%, and the negative predictive value at 78.9%. However, when distinguishing between mild bruxism (BEI >2 < 4) and severe bruxism (BEI >4), PRPG demonstrated a sensitivity of 77.8% and 68.3% and a specificity of 48.6% and 71.4%, respectively. Polysomnography continues to be the SB diagnostic gold standard tool, as the sensitivity and specificity of PRPG are significantly lower when compared with PSG. Nevertheless, PRPG could serve as an alternative tool for SB screening or diagnosis, despite its limitations. Furthermore, our data indicate that comorbidities such as sleep apnea and sleep quality do not influence the diagnostic accuracy of PSG, suggesting its potential as a screening instrument in individuals with other sleep disorders.

Sleep bruxism in children main methods of treatment: a systematic review with meta-analysis.

Sleep bruxism is both masticatory muscle activities characterized by repeated or prolonged tooth contact as well as bracing or thrusting of the jaw. This meta-analysis evaluates the differences between sexes and which therapy is most effective in treating bruxism. A literature search was performed on PubMed, Lilacs, Web of Science and Scopus, and articles published from 2000 to 2022 were considered according to the keywords entered. The term "Bruxism" has been combined with "Children" using the boolean connector AND. At the end of the research, 1462 studies were identified from the search conducted on the three engines. Only four were chosen to draw up the present systematic study. The Forrest plot found that photo biomodulation therapy has a higher efficacy (Odds Ratio (OR) 0.10; 95% Confidence Interval (CI) from 0.03 to 0.43), followed by treatment with hydroxyzine (OR 0.19; 95% CI from 0.03 to 1.04). The average between girls and boys with bruxism is 18.5 for boys and 19.5 for girls. This meta-analysis showed that treatment by photobiomodulation has more significant effects on bruxism, followed by treatment with hydroxyisalazine. However, this meta-analysis has limitations due to the diversity of treatment evaluation methods.

Fluoxetine, but not paroxetine, alters the jaw-closing muscle activity during non-rapid eye movement sleep in mice

Sleep bruxism is an involuntary, exaggerated jaw-closing activity during sleep. Selective serotonin reuptake inhibitor (SSRI) use is a risk factor for bruxism. However, the effect of various SSRIs on masseter (jaw-closing) muscle activity remains unclear. Here, we examined the effects of long-term administration of two SSRIs, fluoxetine (FLX) and paroxetine (PRX), for 14 days on masseter muscle activity during wakefulness, non-rapid eye movement (NREM) sleep, and rapid eye movement (REM) sleep for 24 h in mice. Vigilance states were scored based on electroencephalographic, electrooculography and neck electromyographic (EMG) activities. The EMG activity of the masseter muscle was quantified in 6 h periods. FLX and PRX did not affect the duration of the three vigilance states. Both drugs significantly prolonged the REM sleep episode duration while decreasing the number of episodes. FLX significantly increased REM sleep onset latency. Neither FLX nor PRX affected the mean masseter EMG activity during wakefulness. FLX significantly increased the relative time of masseter muscle activity in NREM sleep during 02:00–08:00 and 08:00–14:00, while PRX did not affect three vigilance states. Overall, FLX had a limited but significant effect on masseter muscle activity in NREM sleep during specific periods.

Primary tooth wear in children from different social environments

Bilingual schools have more hours and high levels of academic demands. Aims: To compare the degree of dental wear and frequency of severe wear facets between children from public rural schools (RG) and children from private bilingual schools in Buenos Aires City (PG). To compare the presence of facets to parents’ reports on bruxism and their opinion on the importance to health of bruxism and snoring. Materials and Method: The sample (n=90) consisted of 5- and 10-year-old children. Their parents/ guardians were asked to complete a structured questionnaire on bruxism and snoring. Children’s degrees of dental wear on primary incisors, canines and molars were identified and recorded. The data were analyzed statistically. Results: The relative risk of wear between PG and RG was 1.82. Bruxism and snoring were reported by 22.9% of the parents/guardians of 5-year-olds and 8.8% of the parents/ guardians of 10-year-olds. In 10-year-olds, significant differences were found between RG and PG for canine wear degree 3 (p=0.01). Conclusions: Children from highly demanding schools presented more dental wear. Higher frequency of severe dental wear was observed in primary canines and molars late in the tooth replacement period regardless of whether sleep bruxism was reported. Parents/guardians from different social conditions considered that bruxism and snoring are important to health to similar degrees.

Assessment of Comorbid Psychopathologies, Psychosocial Factors and Psychiatric Treatment Approach in Children and Adolescents with Sleep Bruxism

Background: Previous studies have revealed a close relationship between a variety of psychopathologies and psychosocial factors, and bruxism. However, psychosocial factors and psychiatric difficulties in children and adolescents with bruxism have not been extensively studied. In the current study, we sought to examine the sociodemographic characteristics, psychosocial factors, and comorbid psychopathologies of children and adolescents with sleep bruxism. Materials and Methods: The study included 67 children and adolescents between the ages of 4-17 who were diagnosed with sleep bruxism and followed up at two different Child and Adolescent Psychiatry outpatient clinics between 2018 and 2024. Data on behavioral and emotional characteristics and comorbid psychiatric disorders of these patients, clinical features of bruxism, and treatment approaches to bruxism were retrospectively investigated. Results: Our results indicated that 41.8 of the sample had at least one comorbid psychiatric disorder, and 10.4% had subthreshold psychiatric symptoms. The most common comorbid psychiatric disorders were anxiety disorders, attention deficit hyperactivity disorder, nocturnal enuresis, and conduct disorders. In 41.8% of cases, bruxism was linked to psychosocial factors. Comorbid psychiatric disorders were significantly more prevalent in the school and adolescent age groups than in preschoolers. Similarly, the connection between bruxism and psychosocial factors became more evident with age. The frequency of a positive family history of bruxism was 44.8%. As treatment options for bruxism, the behavioral approach and pharmacotherapy were preferred in 88.1% of cases, and only the behavioral approach was applied to 11.9%. The most common drugs used in pharmacotherapy were hydroxyzine, tricyclic antidepressants, antipsychotics, atypical antidepressants, and melatonin. In terms of response to treatment, 83.6% of the sample responded (completely or partially), while 16.4% did not respond or were resistant to treatment. Conclusions: This study yielded that psychiatric comorbidity is quite common in the pediatric population with sleep bruxism. The outcomes suggest that bruxism is not only a dental problem but is also associated with a variety of psychopathologies and psychosocial factors. Therefore, health professionals who may encounter bruxism should be aware of the relationship between bruxism and psychopathologies and psychosocial factors. It is recommended that children with bruxism be investigated carefully in a multidisciplinary and holistic approach from a bio-psycho-social perspective and screened for psychosocial and psychiatric difficulties.

A Two-Sample Mendelian Randomization Study of Neuroticism and Sleep Bruxism

Sleep bruxism (SB) affects a considerable part of the population and is associated with neuroticism, stress, and anxiety in various studies. However, the causal mechanisms between neuroticism and SB have not been examined. Understanding the reasons for SB is important as understanding bruxism may allow improved comprehensive management of the disorders and comorbidities related to it. Previous studies on the association of risk factors to SB have provided important symptomatic insight but were mainly questionnaire based or limited in sample size and could not adequately assess causal relationships. The aim of this study was to elaborate the possible causal relationship of neuroticism as a risk factor for SB through a Mendelian randomization (MR) approach by combining questionnaires, registry data, and genetic information in large scale. We performed a two-sample MR study using instrumental genetic variants of neuroticism, including neuroticism subcategories, in the UK Biobank (n = 380,506) and outcome data of probable SB using FinnGen (n [cases/controls] = 12,297/364,980). We discovered a causal effect from neuroticism to SB (odds ratio [OR] = 1.38 [1.10–1.74], P = 0.0057). A phenotype sensitive to stress and adversity had the strongest effect (OR = 1.59 [1.17–2.15], P = 0.0028). Sensitivity analyses across MR methods supported a causal relationship, and we did not observe pleiotropy between neuroticism and SB (MR-Egger intercept, P = 0.87). Our findings are in line with earlier observational studies that connect stress and SB. Furthermore, our results provide evidence that neurotic traits increase the risk of probable SB.

Advanced Sensing System for Sleep Bruxism across Multiple Postures via EMG and Machine Learning.

Diagnosis of bruxism is challenging because not all contractions of the masticatory muscles can be classified as bruxism. Conventional methods for sleep bruxism detection vary in effectiveness. Some provide objective data through EMG, ECG, or EEG; others, such as dental implants, are less accessible for daily practice. These methods have targeted the masseter as the key muscle for bruxism detection. However, it is important to consider that the temporalis muscle is also active during bruxism among masticatory muscles. Moreover, studies have predominantly examined sleep bruxism in the supine position, but other anatomical positions are also associated with sleep. In this research, we have collected EMG data to detect the maximum voluntary contraction of the temporalis and masseter muscles in three primary anatomical positions associated with sleep, i.e., supine and left and right lateral recumbent positions. A total of 10 time domain features were extracted, and six machine learning classifiers were compared, with random forest outperforming others. The models achieved better accuracies in the detection of sleep bruxism with the temporalis muscle. An accuracy of 93.33% was specifically found for the left lateral recumbent position among the specified anatomical positions. These results indicate a promising direction of machine learning in clinical applications, facilitating enhanced diagnosis and management of sleep bruxism.

Associations between abnormal sleep behavior and indoor environmental risk factors among children with a chronic cough in Wuxi, China: a cross-sectional study

BackgroundIndoor environmental factors, such as pet ownership, presence of cockroaches, mattress quality, fuel usage (gas or electricity), use of biomass for cooking and heating, exposure to tobacco smoke or household molds can significantly affect the sleep quality of children with chronic cough. However, data regarding the effects of indoor environmental conditions on sleep in this population are limited. This study aimed to assess the prevalence of abnormal sleep behaviors and to establish associations between indoor environmental factors and sleep behaviors among children with chronic cough in Wuxi, China.MethodsA cross-sectional design was employed in this study, involving children aged 3–18 years. Data on sociodemographic factors, allergies, home environmental exposures, and sleep characteristics of the participants were collected using paper-based questionnaires. The association between indoor environmental factors and sleep behaviors in children with chronic cough was analyzed using logistic regression models.ResultsThe findings demonstrated that the prevalence of chronic cough among children in Wuxi was 15.50%. The chronic cough group exhibited a significantly higher incidence of eczema, wheezing, rhinitis, food allergy, and nasosinusitis than the non-chronic cough group. In addition, children with chronic cough also tended to have a family history of sleep disorders and adenoid hypertrophy (P < 0.01). After adjusting for confounding factors, a significant association was observed between bruxism (teeth grinding) and chronic cough (sometimes: odds ratio [OR] = 1.04; confidence interval [CI] = 1.01–1.08; always: OR = 1.11; CI = 1.04–1.19; P < 0.01). Among children with chronic cough, recent home decoration was associated with sleepwalking (OR = 1.04; CI = 1.00–1.07; P < 0.05), mold exposure was associated with bruxism (OR = 1.15; CI = 1.0–1.31; P < 0.05), and carpet use at home was associated with apnea (OR = 1.09; CI = 1.02–1.17; P < 0.05), twitching during sleep (OR = 1.13; CI = 1.00–1.27; P < 0.01) and morning headache (OR = 1.14; CI = 1.05–1.23; P < 0.01).ConclusionChildren with chronic cough are more prone to some abnormal sleep behaviors than children without chronic cough. Household decoration within a year, household mold exposure, and carpet use were all significantly positively associated with abnormal sleep behaviors in children with chronic cough. Our study provides novel insights into the impact of the indoor environment on children’s sleep and the occurrence of chronic cough, offering guidance for tailored health promotion programs for families.

What do Brazilian paediatric dentists know about bruxism in children? Cross-sectional study.

Little is known about the knowledge of paediatric dentists on bruxism in children. The aim of this cross-sectional study was to assess the knowledge of paediatric dentists on the concept, associated factors of bruxism and management of sleep bruxism (SB) in children'. An electronic questionnaire was sent to paediatric dentists in the state of Goiás, Brazil. Information was collected on (1) characteristics of the participants; (2) the concept of bruxism; (3) diagnosis; (4) associated factors; (5) strategies for the management of SB; and (6) updated knowledge on bruxism in children. The data were analysed descriptively. Fifty-seven paediatric dentists participated (10.7% of the total number of professionals). A high level of agreement was found with statements on the concepts of SB (94.7%) and awake bruxism (96.5%). The main strategy for the diagnosis was the combination of a parental report and a clinical examination (79.0%). Most participants indicated that bruxism is associated with anxiety/stress (96.5%), screen use (93%), airway obstruction (91.2%), and sleep apnoea (91.2%). In suspected cases of bruxism, the dentists would send the child for assessment by other health care providers (87.7%). The management options frequently indicated were the use of an occlusal splint, aromatherapy, and homeopathy. More than 70% of them considered themselves to be updated on the issue and sought information through scientific articles and discussions with colleagues. Paediatric dentists have knowledge on the concept of bruxism and associated factors. However, further information is needed on the management of this condition in children.

INVESTIGATION OF THE RELATIONSHIP BETWEEN BRUXISM SYMPTOMS AND RESTLESS LEG SYNDROME

Investigation of the Relationship Between Bruxism Symptoms And Restless Leg Syndrome Objective: This study aims to examine the relationship between bruxism symptoms and restless legs syndrome (RLS), focusing on the frequency and severity of RLS symptoms in patients with bruxism. Methods: Ethical approval was obtained from the Non-Interventional Clinical Research Ethics Committee of Recep Tayyip Erdoğan University (Protocol No: 2019/66). A total of 134 patients (50 males, 84 females) diagnosed with bruxism out of 212 patients presenting with jaw pain between April 10 and July 6, 2019, were included in the study. The average age of the participants was 47. Patients completed the Bruxism Determination Questionnaire and the RLS Severity Scale. Data were analyzed using SPSS (IBM SPSS for Windows, version 26). Relationships and correlations were determined using descriptive statistics and various statistical tests. Results: No statistically significant difference was found between bruxism symptoms and RLS severity (p&gt;0.05). However, a significant positive correlation was found between the number of bruxism symptoms and the RLS severity score (19.3%, p=0.025). Additionally, smoking was found to affect bruxism symptoms but not RLS severity. Conclusion: Bruxism symptoms increase with the severity of RLS, but no significant inverse relationship was observed. While smoking affects bruxism symptoms, it does not affect RLS severity. Further research with larger sample sizes and more objective evaluation criteria is needed to better understand the relationship between these two conditions. Keywords: Bruxism; sleep bruxism, restless leg syndrome; cigarette smoking

The Interactions between Smoking and Sleep.

Smoking a cigarette before bed or first thing in the morning is a common habit. In this review, the relationship between smoking and sleep is investigated based on the existing literature. Out of 6504 unique items that were identified via a PubMed search related to smoking and sleep, 151 were included in this review. Tobacco smoking disrupts sleep architecture by reducing slow wave and rapid eye movement (REM) sleep and undermining sleep quality. Furthermore, smoking affects sleep-related co-morbidities, such as obstructive sleep apnea-hypopnea syndrome (OSAHS), insomnia, parasomnias, arousals, bruxism, and restless legs, as well as non-sleep-related conditions such as cardiovascular, metabolic, respiratory, neurologic, psychiatric, inflammatory, gynecologic and pediatric issues, while poor sleep quality also seems to worsen the chances of successful smoking cessation. In conclusion, the existing literature suggests that there is a wicked relation between smoking and sleep.

Driving Stress-Induced Effects on the Orofacial Region and Its Functions and Health Behaviors in Riyadh: A Cross-Sectional Survey.

Driving stress is a multifaceted phenomenon, and the experience of driving invokes stress. Driving causes the activation of stress-response mechanisms, leading to short-term and long-term stress responses resulting in physiological and behavioral changes. The aim of this study was to evaluate driving stress-initiated effects on orofacial functions and health behaviors in the Riyadh population. A cross-sectional survey was conducted in Riyadh using a pre-validated set of questionnaires for habitual information, a driving stress assessment using a driving-behavior inventory, and an assessment of parafunctional habits and effects on orofacial functions. The results indicate that nearly 50% of the sample spends more than two hours commuting, and more than 50% of the sample has inadequate sleep and insufficient exercise. Oral parafunctional habits like nail biting (p = 0.039) and lip or object biting (p = 0.029) had a significant correlation with aggressive driving behaviors, whereas the grinding of teeth (p = 0.011), the clenching of jaws (p = 0.048), lip or object biting (p = 0.018), and pain in mastication (p = 0.036) had a positive correlation with driving dislikes. Driving stress can be detrimental to one's health and not only impacts health behaviors but also induces oral parafunctional habits and adversely affects orofacial regions and functions. Acute driving stress responses may be transient. However, prolonged driving stress can be maladaptive and can increase the risk of chronic diseases including chronic temporomandibular joint disorders and parafunctional habit-related changes in the oral cavity.

Efficacy of occlusal splint versus sleep hygiene and progressive muscle relaxation on perceived stress and sleep bruxism: A randomized clinical trial.

The objective was the comparison of an occlusal device (OD), and sleep hygiene and progressive muscle relaxation (SH & PMR) on perceived stress and sleep bruxism activity (burst/episode and episode/hour) in participants with sleep bruxism. Sixty-six participants with self-reported sleep bruxism were selected and randomly allocated into two groups: OD group or SH & PMR group. Assessment of perceived stress and sleep bruxism activity were the primary outcomes. The Perceived Stress Scale-10 (PSS-10 scale) was used to measure perceived stress and bruxism episodes/hour and bursts/episode recorded by electromyography of masseter and temporalis. These outcomes were assessed at baseline, 1 month, 6 months, and 1 year. The paired t-test assessed changes in PSS-10 scores and sleep bruxism activity within the same group over different time points (baseline, 1 month, 6 months, and 1 year). The unpaired t-test compared scores between two groups (OD and SH & PMR) at each time point to evaluate intervention differences. The chi-square test compared gender distribution between both groups. PSS-10 scores were found to decrease with the OD at 1 month and 6 months compared to baseline and SH & PMR at all subsequent follow-ups. This decrease was not statistically significant (p>0.05) between the OD and SH & PMR groups at all follow-ups. OD and SH & PMR significantly reduced bruxism episodes/hour and bursts/episode at all follow-ups (p<0.05). There were no adverse effects related to any intervention. The ODand SH & PMR both effectively reduced PSS-10 scores over 6 months and significantly decreased bruxism episodes and bursts per episode. Both methods are safe and effective for managing sleep bruxism and reducing stress.

Neonatal Riga-Fede disease: A systematic review of 84 cases collected over 120 years

Background: Traumatic ulceration of the tongue due to congenital teeth is known as Riga-Fede disease (RFD). The literature on RFD consists largely of anecdotal case reports, thereby lacking valid clinical recommendations. While managing a newborn with RFD complicated by Ludwig’s angina, this knowledge gap was recognized. Therefore, this systematic review was conducted to gain insight into the optimal management and the possible complications of RFD. Methods: A literature search was conducted using PubMed, Google Scholar, and Science Direct, supplemented with African Journals Online, Indmed, and manual searches. Papers published between 1900 and July 2023 in any language were retrieved. Neonates with natal or neonatal teeth and ulceration of the oral mucosa were included. Papers with incomplete data and review articles were excluded. Results: A total of 84 newborns with RFD from 62 published reports (including the case reported herein) were analyzed. Most of the reports were from the Indian subcontinent, and the frequency of reporting has increased since the year 2000. Tongue ulceration in all cases was due to mandibular incisors. There was no significant difference in the median duration of healing between the tooth extraction group (14 days) and the conservative management group (18 days). There was only a very weak positive correlation between the duration of symptoms and healing time, which was statistically insignificant. Conclusion: Healing of mucosal ulcers in RFD is often protracted and does not appear to be influenced by the duration of symptoms or by the modality of treatment. Extraction of the offending teeth is more common (75% of cases) than conservative management, such as grinding (ameloplasty) or resin capping of teeth. RFD is mostly a benign disorder; however, serious complications such as meningitis, Ludwig’s angina, and soft tissue abscesses can rarely occur with Staphylococcus aureus infections.

Global Prevalence of Sleep Bruxism and Awake Bruxism in Pediatric and Adult Populations: A Systematic Review and Meta-Analysis.

Background/Objectives: The purpose of this systematic review was to assess the global prevalence of sleep bruxism and awake bruxism in pediatric and adult populations. Methods: This systematic review was conducted by analyzing studies published from 2003 to 2023. The following keyword combination was utilized: prevalence, epidemiology, population, and bruxism. The PubMed database was analyzed, supplemented by manual searches using the Google search. Additionally, the snowballing procedure method was applied. A double assessment of the quality of publications was carried out to preserve the highest possible quality of evidence (e.g., Joanna Briggs Institute critical appraisal checklist). Analyses were conducted using the R statistical language. Results: The global bruxism (sleep and awake) prevalence is 22.22%. The global sleep bruxism prevalence is 21% and awake prevalence is 23%. The occurrence of sleep bruxism, based on polysomnography, was estimated at 43%. The highest prevalence of sleep bruxism was observed in North America at 31%, followed by South America at 23%, Europe at 21%, and Asia at 19%. The prevalence of awake bruxism was highest in South America at 30%, followed by Asia at 25% and Europe at 18%. Conclusions: One in four individuals may experience awake bruxism. Bruxism is a significant factor among women. It was observed that age is a significant factor for the occurrence of sleep bruxism in women. Among the limitations of the study is the lack of analysis of the prevalence of bruxism in Africa and Australia due to not collecting an adequate sample for analysis. The study was registered in the Open Science Framework (10.17605/OSF.IO/ZE786).

Comparison between botulinum toxin type A injection on masseter muscle only and additional injection on anterior belly of digastric muscle in sleep bruxism patients: A clinical trial.

This study aims to evaluate the effects on bite force and muscle thickness of the botulinum toxin (BoNT) injection for patients with sleep bruxism (SB) by comparing injections into the masseter muscle only and both the masseter and the anterior belly of the digastric muscle (ABDM) in a clinical trial. Twelve SB patients received BoNT-A injections using US-guided techniques into the masseter muscle only (Group A), while the remaining 12 SB patients received injections into both the masseter and ABDM (Group B). Bite force and muscle thickness were measured before injection, as well as 1 and 2 months after injection. The bite force and masseter muscle thickness decreased in both Group A and Group B before injection, and at 1 and 2 months after injection. However, there was no significant difference (p > .05, repeated measures analysis of variance) between the two groups, and there was also no significant difference in ABDM thickness (p > .05, repeated measures analysis of variance). This study is the first to assess the short-term effects of BoNT injected into ABDM for SB control. Results show no influence on SB reduction, suggesting the need for further research on BoNT's effectiveness in controlling intense ABDM contractions during sleep and assessing suprahyoid muscle potential impact on rhythmic masticatory muscle activity occurrence.

Stress a determinant for bruxism in medical students-a qualitative and quantitative assessment.

Abstract- Background-Bruxism is an oral habit consisting of involuntary rhythmic or spasmodic nonfunctional gnashing, grinding, or clenching of teeth, unlike chewing movements of the mandible, which may lead to occlusal trauma. There are many scientific reports about the coexistence of bruxism, stress. Objective- the purpose of this study is to assess the development of symptoms of bruxism due to stress in medical students and to evaluate the correlation between occurrence of bruxism and perceived stress. Methodology- A mixed method survey questionnaire was prepared regarding questions based on scientific evidence of co-relation between bruxism, stress and stress faced by medical students. This survey based questionnaire was circulated digitally pan India and the respondents were undergraduate, post graduate students and junior and senior residents from different medical institutions. Therefore a random sample of 300 participants was selected, and gender, age, stress factors specific results were derived. Result- 14.7% of students are suffering from moderate bruxism and 85.3% of students suffering from severe bruxism due to stress. The test result showed that stress was main factor affecting the habit of bruxism with chi square value 12.39 and p value is 0.006. Conclusion- The study found that majority of the participating medical students reported to have bruxism majorly due to stress and Corelated variables majorly responsible for stress are large course of study, competition in this field, overthinking about the study related problems and uncertainty of result what is expected and do not feel happy with their own work performance.

Lifespan of Splints in a Sample of German Soldiers Hospitalised with Post-traumatic Stress Disorder (PTSD) in Combination with Sleep Bruxism and Painful Temporomandibular Disorder (TMD).

This cross-sectional longitudinal observational study aimed to clarify the question of whether painful temporomandibular disorders (TMD) in psychiatrically confirmed patients hospitalised for post-traumatic stress disorder (PTSD) therapy after using splint therapy (ST) show long-term therapeutic effects in the case of functional disorders. One hundred fifty-three (153) inpatients (123 male and 20 female soldiers, age 35.8 ± 9.2 years, 26.6 ± 2.2 teeth) with confirmed PTSD (Impact of Event Scale - Revised ≥33), grade 3 to 4 chronic pain according to von Korff's Chronic Pain Scale and the research diagnostic criteria of painful TMD (RDC-TMD) were recorded. All participants received a maxillary occlusal splint that was worn at night. Control check-ups of the therapeutic effect of the splint were conducted for up to 9 years during psychiatric follow-ups. TMD pain worsened in 22 (14.4%) patients within the first 6 weeks and led to the removal of the splint. The pain intensity (PI) at BL was reported to be a mean of VAS 7.7 ± 1.1. Six weeks after ST (n = 131), the average PI was recorded as VAS 2.6 ± 1.3. Based on the last examination date of all subjects, the average PI was recorded as 0.7 ± 0.9. Seventy-two (72) patients used a second stabilisation splint in the maxilla after 14.4 ± 15.7 months, and 38 patients used between 3 and 8 splints during their psychiatric and dental treatment time (33.7 ± 29.8 months). The presented data shows that therapeutic pain reduction remained valid in the long term despite continued PTSD. The lifespan of a splint seems to be dependent on individual factors. Long-term splint therapy appears to be accepted by the majority of patients with PTSD and painful TMD.

Sleep Disorders &amp; Bruxism – Trigeminal Cardiac Reflex a Missing Link!

The trigeminal cardiac reflex (TCR) is a unique and powerful brainstem reflex that has received a great deal of research interest. Sleep bruxism (SB) is sleep disorder that affects the TCR as well as other brainstem reflexes via stimulation of the brainstem; at the level of the gasserion ganglion (GG). TCR play an important role in sleep bruxism while an exaggerated form of this reflex could be responsible for sleep disorders. This paper will discuss the unusual relationship of Trigeminal cardiac reflex – bruxism – sleep disorders.