Santos Miotto de Amorim C.1, Fioranelli Vieira G.2, Ferreira Osses Firsoff E.2, Puliti E.2, Pasqual Marques A.1
1University of São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, São Paulo, Brazil, 2University of São Paulo, Department of Operative Dentistry, School of Dentistry, São Paulo, Brazil
Background: Bruxism is a repetitive jaw-muscle activity characterized by the clenching and/or grinding of the teeth, which can occur during the day and/or while sleeping. Although the prevalence of sleep and awake bruxism in the adults is approximately 8% and 20%, respectively, studies have indicated that between 85% and 90% of the population have possibly succumbed to episodes of bruxism throughout their lives.
It can be associated with morphological, pathophysiological and psychosocial features. Consequently, bruxism can cause masticatory and cervical muscle pain; headache; decrease pain thresholds in the orofacial and cervical muscles; change sleep quality and oral health; and increase anxiety, stress and depression. Although there are studies about bruxism and psychosocial symptoms, the majority presents small samples size, lack of information about bruxism type, heterogeneous assessment tools and the use of single clinical approach to the diagnosis of bruxism not allowing a distinction between the sleep and awake bruxism.
It can be associated with morphological, pathophysiological and psychosocial features. Consequently, bruxism can cause masticatory and cervical muscle pain; headache; decrease pain thresholds in the orofacial and cervical muscles; change sleep quality and oral health; and increase anxiety, stress and depression. Although there are studies about bruxism and psychosocial symptoms, the majority presents small samples size, lack of information about bruxism type, heterogeneous assessment tools and the use of single clinical approach to the diagnosis of bruxism not allowing a distinction between the sleep and awake bruxism.
Purpose: To evaluate symptoms of the muscle pain, sleep quality, oral health, anxiety, stress and depression in individuals with different severity degrees of the bruxism: moderate and severe.
Methods: Seventy-two individuals with bruxism were enrolled in the study, classified into: moderate (n=25) and severe (n=47) bruxism. The Visual Analogical Scale was used to assess pain intensity, algometer to pain threshold, the Pittsburgh Sleep Quality Index to sleep quality, Oral Health Impact Profile to oral health, State-Trait Anxiety Inventory to anxiety, Perceived Stress Scale to stress and the Beck Depression Inventory (BDI) was used to assess depression. Significance level considered was 5%.
Results: The results showed that individuals with severe bruxism relative to moderate form presented greater muscle pain intensity, sleep disorder, worse oral health, high anxiety level and dysphoria, with statistically significant differences (p 0.05).
Conclusion(s): The data suggests that individuals with bruxism present muscle pain, alterations in sleep quality and oral health, anxiety, stress and dysphoria. Individuals with severe bruxism, have more intense symptoms.
Implications: Numerous consequences of bruxism are not limited to dental problems and stomatognathic system, also include muscle pain, sleep disorder, poor oral health, moderate traits and high states of anxiety, stress perception and dysphoria, which can be associated with the increasing and significant number of seek for treatment for bruxism, especially the severe form, which indicates the need for health services focused on differentiated therapeutic approaches, such as physiotherapeutic interventions, with the objectives of preventing and/or controlling bruxism and its symptoms. Thus, this study is very important for physiotherapists daily practice in treatment of individuals with bruxism.
Funding acknowledgements: Coordination for the Improvement of Higher Education Personnel (CAPES) and National Council of Technological and Scientific Development (CNPq), Brazil.
Topic: Musculoskeletal
Ethics approval: Approved by the Ethics Committee of the School of Medicine, University of São Paulo (Protocol 209369/2013), Brazil. ClinicalTrials.gov: NCT01778881.
All authors, affiliations and abstracts have been published as submitted.
