Keywords
Prevalence
Hospitals
Psychiatry
Wakefulness
Metrica
How to Cite
Abstract
Bruxism is a masticatory muscle activity that can occur during sleep and/or wakefulness, characterized by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible. Aim: Evaluate the prevalence of probable awake bruxism (PAB) and its association with signs and symptoms of temporomandibular disorders (TMD) in psychiatric patients. Methods: The sample was comprised of 123 participants of both genders, between 18 and 65 years old. Of these 73 were inpatients at 3 psychiatric hospitals (experimental group) and 50 healthy individuals (control group). All of them were evaluated through a clinical inspection, to observe the presence of clinical signs of bruxism (tooth wear, buccal and labial mucosa and/or tongue indentations, masseter muscle hypertrophy) and a questionnaire to assess the presence of TMD signs and symptoms. Information about current use of medication and reason for hospitalization were also collected. Results: There was no statistical difference regarding the prevalence of probable awake bruxism between experimental (85%) and control (74%) groups. However, a higher prevalence of clinical signs of bruxism and TMD signs and symptoms was observed in psychiatric patients diagnosed with probable awake bruxism. For the experimental group, the association of PAB with the reason for hospitalization and the use of psychotropic drugs were not statistically significant. The presence of masseter hypertrophy, tongue indentation, buccal mucosa indentation, tooth wear and TMD signs and symptoms appears to be associated with the presence of PAB and psychiatric disorders. Conclusions: The prevalence of awake bruxism in psychiatric patients about 85%. The presence of TMD signs and symptoms appears to be associated with the presence of PAB in psychiatric patients.
References
1. Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. International consensus on the assessment of bruxism: report of a work in progress. J Oral Rehabil. 2018 Nov;45(11):837-44. doi: 10.1111/joor.12663.
2. Lobbezoo F, van der Zaag J, van Selms MK, Hamburger HL, Naeije M. Principles for the management of bruxism. J Oral Rehabil. 2008 Jul;35(7):509-23. doi: 10.1111/j.1365-2842.2008.01853.x.
3. Torales J, Barrios I, González I. Oral and dental health issues in people with mental disorders. Medwave. 2017 Sep;17(8):e7045. doi: 10.5867/medwave.2017.08.7045.
4. Scrivani SJ, Keith DA, Kaban LB. Temporomandibular disorders. N Engl J Med. 2008 Dec;359(25):2693-705. doi: 10.1056/NEJMra0802472.
5. Leeuw R, Klasser GD, editors. Orofacial pain: guidelines for assessment, diagnosis, and management. 6th ed. Quintessence; 2018.
6. Winocur E, Hermesh H, Littner D, Shiloh R, Peleg L, Eli I. Signs of bruxism and temporomandibular disorders among psychiatric patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Jan;103(1):60-3. doi: 10.1016/j.tripleo.2006.03.019. Epub 2006 Jun 6.
7. Alhaffar BA, Abbas G, Latifeh Y, Hamadah O. The oral manifestations of psychiatric disorders. Oral Health Dent Manag. 2018 Aug;17(4):1-6.
8. Lobbezoo F, Naeije M. A reliability study of clinical tooth wear measurements. J Prosthet Dent. 2001 Dec;86(6):597-602. doi: 10.1067/mpr.2001.118892.
9. Yoshizawa S, Suganuma T, Takaba M, Ono Y, Sakai T, Yoshizawa A, et al. Phasic jaw motor episodes in healthy subjects with or without clinical signs and symptoms of sleep bruxism: a pilot study. Sleep Breath. 2014 Mar;18(1):187-93. doi: 10.1007/s11325-013-0868-6. Epub 2013 Jun 18.
10. Lavigne GJ, Rompré PH, Montplaisir JY. Sleep bruxism: validity of clinical research diagnostic criteria in a controlled polysomnographic study. J Dent Res. 1996 Jan;75(1):546-52. doi: 10.1177/00220345960750010601.
11. Bayar GR, Tutuncu R, Acikel C. Psychopathological profile of patients with different forms of bruxism. Clin Oral Investig. 2012 Feb;16(1):305-11. doi: 10.1007/s00784-010-0492-9. Epub 2011 Jan 8.
12. Hilgenberg-Sydney PB, Lorenzon AL, Pimentel G, Petterle RR, Bonotto D. Probable awake bruxism - prevalence and associated factors: a cross-sectional study. Dental Press J Orthod. 2022 Aug;27(4):e2220298. doi: 10.1590/2177-6709.27.4.e2220298.oar.
13. Wetselaar P, Vermaire EJH, Lobbezoo F, Schuller AA. The prevalence of awake bruxism and sleep bruxism in the Dutch adult population. J Oral Rehabil. 2019 Jul;46(7):617-23. doi: 10.1111/joor.12787.
14. Agerberg G, Carlsson GE. Functional disorders of the masticatory system. I. Distribution of symptoms according to age and sex as judged from investigation by questionnaire. Acta Odontol Scand. 1972 Dec;30(6):597-613. doi: 10.3109/00016357209019791.
15. Jensen R, Rasmussen BK, Pedersen B, Lous I, Olesen J. Prevalence of oromandibular dysfunction in a general population. J Orofac Pain. 1993 Spring;7(2):175-82.
16. Winocur E, Uziel N, Lisha T, Goldsmith C, Eli I. Self-reported bruxism - associations with perceived stress, motivation for control, dental anxiety and gagging. J Oral Rehabil. 2011 Jan;38(1):3-11. doi: 10.1111/j.1365-2842.2010.02118.x.
17. Jovanović S, Gajić I, Mandić B, Mandić J, Radivojević V. [Oral lesions in patients with psychiatric disorders]. Srp Arh Celok Lek. 2010 Sep-Oct;138(9-10):564-9. Serbian. doi: 10.2298/sarh1010564j.
18. Bracci A, Lobbezoo F, Häggman-Henrikson B, Colonna A, Nykänen L, Pollis M, et al. Current knowledge and future perspectives on awake bruxism assessment: expert consensus recommendations. J Clin Med. 2022 Aug;11(17):5083. doi: 10.3390/jcm11175083.
19. Ivkovic N, Mladenovic I, Petkoci S, Stojic D. TMD chronic pain and masseter silent period in psychiatric patients on antidepressive therapy. J Oral Rehabil. 2008 Jun;35(6):424-32. doi: 10.1111/j.0305-182X.2007.01819.x.
20. Winocur E, Gavish A, Voikovitch M, Emodi-Perlman A, Eli I. Drugs and bruxism: a critical review. J Orofac Pain. 2003 Spring;17(2):99-111.
21. Melo G, Dutra KL, Rodrigues Filho R, Ortega AOL, Porporatti AL, Dick B, et al. Association between psychotropic medications and presence of sleep bruxism: a systematic review. J Oral Rehabil. 2018 Jul;45(7):545-54. doi: 10.1111/joor.12633.
22. Przystańska A, Jasielska A, Ziarko M, Pobudek-Radzikowska M, Maciejewska-Szaniec Z, Prylińska-Czyżewska A, et al. Psychosocial predictors of bruxism. Biomed Res Int. 2019 Oct;2019:2069716. doi: 10.1155/2019/2069716.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Caroline Vidal Paseto, Antonio Adilson Soares de Lima, Ricardo Ramussen Petterle, Priscila Brenner Hilgenberg-Sidney