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ABSTRACT Background Objective Methods Results Conclusion Clinically, data on the association of early‐life secondhand smoke (SHS) exposure with sleep bruxism and dental problems are scarce.To examine whether the relationship between early‐life SHS exposure with sleep problems, sleep bruxism, and dental problems in children.Within the scope of this study, questionnaires were applied to the volunteer parents of 710 children, aged 5–12 years old. The questionnaire applied in this study named as Children's Sleep Habits Questionnaire (CSHQ) and consists of seven subscales and a total of 33 items. The questionnaire was completed retrospectively by any parent, and the presence of sleep bruxism was questioned during the anamnesis. Afterward, the presence of dental decay and tooth wear was evaluated during intraoral and radiographic examinations. Dental decay and tooth wear were scored with the DMFT/deft index and tooth wear index of Smith & Knight, respectively.The presence of sleep bruxism was significantly higher in children with parasomnia (p = 0.01; p < 0.05). The presence of tooth wear in children with sleep bruxism was found to be statistically significant (p = 0.032; p < 0.05). It was observed that the presence of sleep bruxism was higher in the children of individuals who smoked at home (p = 0.027; p < 0.05).Sleep bruxism, untreated dental decay and exposure to early‐life secondhand smoke may have a negative impact on children's sleep habits and characteristics. [ABSTRACT FROM AUTHOR]

Aims: Edentulous patients can also suffer from sleep bruxism (SB), just like dentate patients. This study aims to evaluate the prevalence and severity of SB in edentulous patients using the definitive method. Methods: Twenty‐three edentulous patients underwent treatment with new conventional complete dentures. Definitive SB was evaluated using the Bruxoff (portable electromyography device) while sleeping at home. The prevalence of SB was assessed by the Bruxmeter software, where SB was evaluated as "absent" (score zero), "light" (<2 episodes), "moderate" (between 2 and 4 episodes), or "severe" (>4 episodes). The prevalence was expressed with descriptive statistics in percentage using the number of detected cases out of the total number of patients. Results: Eighteen patients (78.26%) were diagnosed with SB. The severity of SB was 55.5%, 5.5%, and 39% for the light, moderate, and severe scores, respectively. Conclusions: Almost 8 out of 10 edentulous patients have SB. Approximately half of the SB‐detected patients showed moderate to severe severity of bruxism as measured by a commercial, at‐home device. [ABSTRACT FROM AUTHOR]

The co-occurrence of bruxism, temporomandibular disorders (TMDs), and headache is common in patients. However, there is conflicting evidence regarding whether this association is simply a result of their high prevalence or whether there are indeed causal relationships. This review provides an overview of the current state of research while taking into account the controversies surrounding research methods, particularly in definitions and diagnostic standards. Bruxism—defined as repetitive jaw muscle activity during sleep or wakefulness—is not a painful disorder but may—particularly in co-occurrence with TMD—worsen preexisting headache. It seems important to differentiate between sleep and awake bruxism because of different impact on pathophysiological processes in different primary headache disorders such as migraine and tension-type headache. Temporomandibular disorder is a heterogenous entity with both myofascial and arthrogenous types of pain in addition to nonpainful disorders. Research suggests a correlation between TMD pain and migraine, as well as between awake bruxism and tension-type headache. However, psychosocial factors may act as confounders in these relationships. Determining causality is challenging because of the limited number of experimental and clinical studies conducted on this topic. The main finding is an apparent lack of consensus on the definition and assessment criteria for bruxism. Treatment wise, it is important to differentiate all 3 conditions because treatment of one condition may have an effect on the other 2 without proving causality. For future research, it is crucial to establish greater consistency and applicability in diagnostic procedures and definitions. In addition, more experimental and clinical studies investigating the question of causality are needed. [ABSTRACT FROM AUTHOR]

Objective: To consider the possible role of the vagus nerve (VN) in the pathophysiology of sleep bruxism (SB) and introduce a multimodal protocol of transcutaneous auricular stimulation of the VN in the treatment of SB patients. Methods: Ten patients with SB underwent four sessions of electric transcutaneous auricular vagus nerve stimulation (ta-VNS) in specific auricular areas. The patients were advised to manually stimulate the same areas between sessions. Masticatory muscle activity and sleep parameters were measured by a polysomnography (PSG) before and after the treatment. Heart rate variability (HRV) parameters were measured during each stimulation. Results: PSG analysis revealed a statistically significant reduction in tonic SB index and tonic contraction time. HRV parameters showed a statistically significant increase in mean values of the vagal tone after each session of stimulation. No side effect was reported. Conclusion: The stimulation of the VN might have a role in the treatment of SB. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objective Methods Results Conclusion TikTok contains many videos about bruxism that may help raise the level of awareness on the topic. However, the quality of these videos' information represents the greatest concern.The present cross‐sectional analysis aimed to systematically assess the reliability and educational suitability of TikTok videos as a source of information on bruxism.TikTok was searched for relevant videos uploaded until 6 March 2024, using the hashtags #bruxism, #grindingteeth and #jawclenching. Independent pre‐calibrated operators conducted video inclusion and data collection, noting videos' characteristics, source, popularity, content, reliability (assessed through the DISCERN scoring system) and educational value (assessed through the Global Quality Score [GQS]). The Kruskal–Wallis test was adopted to compare videos from different sources. Videos with low and high educational value were compared using the Mann–Whitney U‐test. Tests were considered significant when the p‐value was < 0.05.A total of 105 bruxism videos were analysed. Most videos covered bruxism management and clinical features, and more than 60% were uploaded by healthcare professionals. According to the DISCERN and GQS scoring, the videos' reliability and educational value were judged to be very poor and low, respectively, but on average they were higher for videos uploaded by healthcare professionals compared to those uploaded by laypeople. When comparing videos with high educational value to those with low educational value, differences were found in popularity, content and reliability.The present results suggest the need for greater control of information disseminated on social media to fulfil its potential role in educating laypeople about bruxism. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objectives Methods Results Conclusion Recently, the Standardised Tool for the Assessment of Bruxism (STAB) has been developed for use in clinical and research settings.The aim of the present study is to describe the process of forward and back translation and pilot testing of the STAB into Italian.The English version of the STAB was adopted as a template for translation into other languages, according to a step‐by‐step procedure led by the expert STAB bruxism panel and mother tongue experts in the field. In detail, the translation team was made up of 12 subjects: three study coordinators, two forward translators, two back‐translators and five expert panellists.Following the translation process, a pilot test in patients, dentists and dental students was performed using the ‘probing’ method (i.e., subjects were questioned by the examiners about the perceived content and interpretation of the items) with the aim to assess the comprehensibility of the questions and response options, and the feasibility of the tool.This paper describes the translation process of the STAB and provides the outcomes of the pilot testing phase and the face validity assessment. The preliminary results suggest that, from a global point of view, the STAB reflects the characteristics required in clinical and research settings.Thanks to the translation process, the Italian version of the STAB can be assessed on‐field and introduced in the clinical and research field to get deeper into the study of bruxism epidemiology in Italy. [ABSTRACT FROM AUTHOR]

Background: Academic procrastination (AP), a common behavior among students, is influenced by factors such as fear of failure, task aversiveness, anxiety, and stress. Self-generated stress (SGS) refers to the subjective experience of tension that occurs in response to an existing situation. Individuals often overestimate the difficulty and attainability of a task, resulting in increased stress and extended stress duration. SGS can worsen mental and physical health problems, including bruxism. Therefore, this study investigates the possible underlying connections by examining the relationship between AP, SGS, and self-reported (SR) bruxism in medical and dental students. Methods: The present cross-sectional study was undertaken among a sample of 379 students pursuing medical and dentistry degrees in Turkey. The questionnaire, including the Academic Procrastination Scale-Short Form, SR bruxism Scale, and SGS Scale, was administered to the students. According to the responses given to the SR bruxism Scale, 3 types of SR bruxism groups were created as sleep, awake, and compound. A comparative analysis was conducted on AP, SGS, and SR bruxism among medical and dental students. Furthermore, the associations among AP, SGS, and SR bruxism were assessed using the utilization of correlation tables and regression analysis. Results: The prevalence of awake bruxism was higher among dental students (46.6%) compared to medical students (34.7%), suggesting a faculty-dependent trend. A significant positive correlation was observed between SGS and AP (r = 0.212, p < 0.001). Median AP values differed significantly based on awake bruxism (p = 0.007) and compound bruxism (p = 0.013), but not sleep bruxism (p = 0.352). SGS exhibited statistically significant differences across all SR bruxism types: sleep (p < 0.001), awake (p < 0.001), and compound (p < 0.001). Multiple regression analysis identified SGS as a significant risk factor for SR bruxism, with a one-unit increase in stress score elevating the SR bruxism risk by 1.086 times. Conclusions: This study revealed that self-generated stress significantly increases the risk for the development of SR bruxism. A significant relationship was found between academic procrastination and self-generated stress, and this relationship was particularly associated with an increased risk for the development of compound and awake bruxism. Stress-reducing therapy methods should be recommended for students to both increase academic success by reducing academic procrastination and prevent the negative effects of stress-related SR bruxism. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Conclusion To investigate the frequency of bruxism, factors associated with bruxism and sleep disorders in patients diagnosed with depressive disorder and anxiety disorder who use antidepressants.A total of 273 patients diagnosed with anxiety disorder or depression who had been using antidepressants for at least 1 month were included, along with 273 healthy control groups. The patient and control groups completed a sociodemographic data form, Epworth Daytime Sleepiness Scale (EDSS), Pittsburgh Sleep Quality Index (PSQI) and a bruxism questionnaire. Additionally, the clinician confirmed the diagnosis of bruxism through a clinical interview.Bruxism was detected in 73.3% of the patient group and 28.2% of the control group (p < 0.001). The most commonly used antidepressants among patients were selective serotonin reuptake inhibitors (SSRIs) such as escitalopram and sertraline. Within the patient group, individuals with bruxism had higher family history rates of teeth grinding (p = 0.034), PSQI scores (p < 0.001) and EDSS scores (p < 0.001) compared to those without bruxism. Positive correlations were found between the presence of bruxism and PSQI (p < 0.001) scores as well as EDSS scores (p < 0.001) in both the patient group and all participants. Regression analysis conducted on the entire sample revealed that family history rates of teeth grinding (p < 0.001), antidepressant use (p < 0.001) and PSQI score (p = 0.004) were associated with bruxism.The findings from this study suggest that a majority of patients diagnosed with depressive or anxiety disorders may experience bruxism, particularly those using SSRI‐type antidepressants. Furthermore, individuals with bruxism may have poor sleep quality and excessive daytime sleepiness tendencies. [ABSTRACT FROM AUTHOR]

Background: Sleep apnea and nocturnal bruxism belong to sleep disorders that can affect the quality of life. The aim of this study was to investigate the effects on patients with moderate sleep apnea and nocturnal bruxism of Botox injection as monotherapy or associated with wearing thermoformed occlusal splints and to determine the patients' satisfaction degree after the applied treatments. Methods: The selected patients for study were divided into two groups: in the first group, the patients (n = 18) treatment consisted of injecting Botox (Allergan) into the masseter muscle as monotherapy; in the second group, the patients (n = 18) benefited from associated therapy, Botox injections in masseter muscle, and the wear of thermoformed occlusal splints. At baseline, at three weeks, at three months, and six months after the effectuation of therapies, the monitoring sessions were realized. Results: The associated therapy presented better results in decreasing the studied symptoms than the monotherapy. Both therapies improved patient satisfaction. Conclusions: The applied therapies for treating the specific symptomatology in moderate sleep apnea and sleep bruxism were efficacious. Patient satisfaction was very good in both groups after the applied treatments, but the associated therapy presented better results than monotherapy. [ABSTRACT FROM AUTHOR]

Background: Sleep‐related bruxism (SB) is the habit of grinding or clenching the teeth during sleep, mediated by the non‐peripheral central nervous system. Purpose: The objectives of this cross‐sectional study were to evaluate associations between SB, microarousals and oxyhaemoglobin desaturations and to compare the frequency of SB and microarousals in sleep stages, in an apnoeic population. Methods: Two hundred and forty individuals composed the sample, who underwent a single full‐night polysomnography. Self‐reports and clinical inspections were not considered for assessing SB. The polysomnographic assessment of SB was performed using electrodes placed on masseter muscles and chin. SB was defined as more than two events of rhythmic masticatory muscle activity per hour of sleep. Microarousals were considered when there were abrupt changes in electroencephalogram frequencies, without complete awakening, lasting from 3 to 15 s. Oxyhaemoglobin desaturations were defined as significant drops (≥3%) in basal oxygen saturations. With these data, SB, microarousals and oxyhaemoglobin desaturations were evaluated and submitted to statistical analysis. Results: Statistically significant differences were observed between bruxers and non‐bruxers when comparing the rates of microarousals (p <.001) and oxyhaemoglobin desaturations (p =.038). There was a higher number of SB and microarousals in NREM (non‐rapid eye movement) two sleep stage (p < 0.001). Bruxers had a greater risk of higher numbers of microarousals (OR = 1.023; p =.003), which did not occur for oxyhaemoglobin desaturations (OR = 0.998; p =.741). Conclusions: A higher number of microarousals presents relationship with SB; associations between SB and oxyhaemoglobin desaturations remained inconclusive; higher frequency of SB and microarousals was observed in NREM 2 sleep stage. [ABSTRACT FROM AUTHOR]

Objective: 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. Methods: 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. Results: 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). Conclusion: 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. [ABSTRACT FROM AUTHOR]

Background: Chronic painful temporomandibular disorders (TMD), awake bruxism and sleep bruxism are often comorbid with post‐traumatic stress disorder (PTSD), but the implications for treatment are unknown. Objective(s): To explore the effects of PTSD treatment on these conditions. We hypothesized that chronic painful TMD, pain intensity, pain interference, awake bruxism and sleep bruxism would decrease after evidence‐based trauma‐focused treatment and that this decrease would be maintained at the 6‐month follow‐up. Methods: Individuals referred for PTSD treatment were assessed for chronic painful TMD (temporomandibular disorder pain screener), pain intensity, pain interference (Graded Chronic Pain Scale 2.0), awake bruxism and sleep bruxism (oral behaviours checklist) pre‐, post‐treatment and at the 6‐month follow‐up. Hypotheses were tested using the Friedman test, followed by a post hoc Wilcoxon signed‐rank test. Effect sizes (Cohen's r) are reported. Barely any pain interference was reported, therefore these outcomes were not analysed. Results: In individuals with chronic painful TMD (n = 98), pain intensity, awake bruxism and sleep bruxism decreased across the three time points. Post hoc tests showed that chronic painful TMD (r = 0.59), pain intensity (r = 0.28), awake bruxism (r = 0.51) and sleep bruxism (r = 0.35) decreased between pre‐ and post‐treatment. Between pre‐treatment and the 6‐month follow‐up, chronic painful TMD (r = 0.58), awake bruxism (r = 0.30) and sleep bruxism (r = 0.39) decreased as well. Conclusion: The results provide preliminary support for a trauma‐sensitive approach for patients with chronic painful TMD and PTSD and suggest that trauma‐focused treatment may be beneficial for chronic painful TMD, awake bruxism and sleep bruxism in patients with PTSD and chronic painful TMD. [ABSTRACT FROM AUTHOR]

Purpose: 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′. Methods: 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. Results: 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. Conclusion: 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. [ABSTRACT FROM AUTHOR]

Objective: To systematically review the literature regarding the concordance of sleep bruxism (SB) between monozygotic (MZ) and dizygotic (DZ) twins. Methods: The registration for this systematic review was accomplished in the International Prospective Register of Systematic Reviews (PROSPERO, No. CRD42021251751). As of July 2022, four databases were searched, including PubMed, Scopus, Embase, and Web of Science, as well as the grey literature in Google Scholar and OpenGrey. Observational studies evaluating SB in MZ and DZ twins of any age and sex were included. For the evaluation of the risk of bias, the Joanna Briggs checklist was utilized. The certainty of evidence was assessed via the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Pooled and subgroup meta-analyses were performed to estimate concordance of SB ​​between twins (p < 0.05). Results: In total, 3,155 records were identified. In the qualitative analysis, eleven studies were included; of these, seven were included in the meta-analysis. The majority of the articles exhibited a low risk of bias (63.6%). Greater SB concordance was observed between MZ twins than between DZ twins in the analysis of general concordance (OR = 1.47; 95% CI = 1.07–2.02) and also positive concordance (OR = 1.53; 95% CI = 1.29–1.81). Within the subgroup analyses, the significance of the findings remained only for the reported/self-reported SB regarding general concordance (OR = 1.44; 95% CI = 1.07–1.95) and positive concordance (OR = 1.55; 95% CI = 1.28–1.88). Low certainty of the evidence was observed for the general concordance analysis, while moderate certainty was observed for the positive concordance. Conclusion: There was a higher concordance of SB in MZ twins compared to DZ twins, indicating a possible genetic influence on the condition's occurrence. [ABSTRACT FROM AUTHOR]

Objective: Sleep bruxism (SB) is a repetitive rhythmic and nonrhythmic activity. It can be a comorbid condition for other disorders, such as sleep breathing disorders (SBD). However, a clear causal link between these factors is yet to be established. Moreover, this relationship is even more unknown in children. Thus, this systematic review aimed to determine the relationship between SB and SBD in children and teenagers and consolidate the current knowledge about the possible association between both phenomena at the pediatric age. Materials and Methods: Advanced searches were performed in five electronic databases with the last search updated on February 1, 2023. The methodological quality of the selected studies was analyzed using the quality assessment tool for experimental bruxism studies. Results: Twenty‐nine of 6378 articles were selected for detailed analyses. Most articles found a comorbid relationship between SB and SBD, though no study analyzed a temporary relationship. Due to the heterogeneity of the studies, a meta‐analysis could not be performed. Conclusion: Despite the limitations of this systematic review, it can be concluded that there is an association between SB and SBD in children. However, the level of evidence is low. [ABSTRACT FROM AUTHOR]

Objectives: Noncarious cervical lesions (NCCLs) are multifactorial and can be caused by the anatomical structure of the teeth, erosion, abrasion and abnormal occlusion. The aim of this case–control study was to explore the risk factors for NCCLs. Methods: Cone‐beam computed tomography was used to determine whether a wedge‐shaped defect existed at the cementoenamel junction. We compared 63 participants with NCCLs with 63 controls without NCCLs, matched for sex, age (±1 year) and toothbrushing‐related factors (e.g., type of bristle and brushing patterns, frequency and strength). All participants were asked to complete a questionnaire about self‐administered daily diet habits and health condition. Univariate and multivariate logistic regression analyses were conducted to determine the risk factors for NCCLs. Results: Significant variables in the univariate analysis (i.e., p <.2) included frequency of carbonated beverage consumption, sella‐nasion‐point B angle (SNB) and Frankfort‐mandibular plane angle (FMA). Multivariate logistic regression demonstrated that the consumption frequency of carbonated beverages (odds ratio [OR] = 3.147; 95% confidence interval [CI], 1.039–9.532), FMA (OR = 1.100; 95% CI, 1.004–1.204) and SNB (OR = 0.896; 95% CI, 0.813–0.988) was independent influencing factors. The area under the receiver operating characteristic curve (AUC) value of regression Model 1 (established with the frequency of carbonated beverage consumption, FMA, SNB and sleep bruxism) was 0.700 (95% CI, 0.607–0.792; p <.001), and that of regression Model 2 (established using the frequency of carbonated beverage consumption, FMA and SNB) was 0.704 (95% CI, 0.612–0.796; p <.001). Conclusions: The consumption frequency of carbonated beverages and FMA was risk factors for NCCLs; the higher the frequency of carbonated beverage consumption and FMA, the higher was the probability of NCCLs. SNB was a protective factor for NCCL occurrence; the larger the SNB, the lower was the probability of NCCL occurrence. These findings have further clarified the aetiology of NCCLs and provided clinicians with valuable insights into strategies for preventing the loss of dental tissue. [ABSTRACT FROM AUTHOR]

Background: Although biofeedback with contingent electrical stimulation (CES) has demonstrated the reduction effect on sleep bruxism (SB), the relationship between the actual applied CES intensity and efficacy remains uncertain. Objective: This study aimed to investigate whether the reduction of bruxism events and jaw muscle symptoms could vary according to the intensity of CES and in probable sleep bruxers. Methods: Twenty probable sleep bruxers were initially screened for bruxer confirmation based on a 2‐week recording of SB events with a portable electromyography recorder (BUTLER®GrindCare®, GC4). A 3‐week recording was conducted without CES using a GC4, followed by another 3‐week recording with CES. At baseline and before and after the CES (+) session, clinical muscle symptoms were assessed using a 0–10 numerical rating scale (NRS). The relationships between the actual applied CES intensity and the number of SB events/hour, as well as the NRS of clinical muscle symptoms, were analysed. Results: The actual applied CES intensity was positively correlated with the reduction rate of the number of SB events/hour (R =.643, p =.002), as well as with the reduction rate of NRS for pain, unpleasantness, fatigue, tension and stiffness (R >.500, p <.011). Conclusion: Higher CES elicited a more robust reduction in SB events and clinical muscle symptoms, in probable bruxers. Prior to selecting CES biofeedback as a management option for SB, it would be beneficial to assess the tolerance threshold of CES in each bruxer in order to predict the effectiveness of CES in probable sleep bruxers. [ABSTRACT FROM AUTHOR]

Background: Polysomnography (PSG) is the gold standard for sleep bruxism (SB) assessment, it is expensive, not widely accessible, and time‐consuming. Objective: 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. Methods: One hundred and three subjects underwent simultaneous examinations using PRPG (NOX T3, NOX Medical) and PSG (NOX A1, NOX Medical) in a sleep laboratory. Results: 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. Conclusion: 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. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of self-reported bruxism, awareness of bruxism's adverse effects, and bruxism management among Thai undergraduate dental students. Methods: An online self-reported questionnaire was designed and tested for validity and reliability and then distributed to dental students at 12 universities in Thailand from September 2020 to January 2021. Results: There were 464 respondents (338 females and 126 males) with an average age of 21.42 ± 2.06 years. The prevalence of self-reported awake and sleep bruxism was 35.78% and 37.28%, respectively, and 19.40% had both awake and sleep bruxism. Awareness scores were higher for dentists than for patients (p< 0.001). Only 12.14% of sleep bruxers still wear an occlusal splint for bruxism management. Conclusion: The prevalence of self-reported awake and sleep bruxism was high among Thai dental students. They are well aware of the adverse effects of bruxism with inappropriate management of the condition. [ABSTRACT FROM AUTHOR]

Background: Bruxism has a multifactorial etiology, including the influence of sleep characteristics and chronotypes. Aim: To identify the pathways that influence the occurrence of probable sleep bruxism (PSB) and probable awake bruxism (PAB) in adolescents. Design: A total of 403 adolescents, aged 12–19 years, participated in the study. Parents/caregivers filled out a questionnaire about sociodemographic issues and the adolescent's health conditions, and the adolescents about sleep characteristics, occurrence of bruxism (based on previous study and the International Consensus of Bruxism), and chronotype (Circadian Energy Scale). Clinical examinations were performed. Statistical analysis included descriptive analysis and path analysis. Results: PSB and PAB are related to each other, with moderate and positive correlation (β =.390). Poor sleep quality and higher household income had a direct effect on both PSB (β = −.138; β =.123, respectively) and PAB (β = −.155; β =.116, respectively). Chronotype had a direct effect on PSB, in such a way that adolescents with a morningness chronotype tend to have PSB (β = −.102). Adolescents that drool on the pillow (β =.184) and/or have agitated sleep (β =.104) tend to have PSB. Conclusion: Poor sleep quality, household income, morningness chronotype profile, drooling on the pillow, and agitated sleep influence the paths taken by PSB. PAB was influenced by the quality of sleep and family income. [ABSTRACT FROM AUTHOR]

Background: The aetiology of Sleep bruxism includes specific personality traits, related to perfectionism. Aim: To investigate the relationship between probable sleep bruxism (PSB) and personality traits in children and their parents, determining whether children with PSB and their parents are more perfectionists. Design: This case–control study included 104 children aged 8–9 years, 52 cases and 52 controls. A clinical examination was performed on the children who completed the Big Five Personality Questionnaire (BFQ‐NA) and the Child Perfectionism Inventory. Parents completed a bruxism diagnostic questionnaire according to the AASM criteria, BFQ and Frost multidimensional perfectionism scale questionnaires. t‐Tests for independent samples and multivariate logistic regression models were used for statistical analysis. Results: A significant relationship between PSB and a self‐demanding personality (OR = 1.11, p =.01), restless sleep (OR = 4.41, p =.004), and a family history of clenching and grinding teeth (OR = 3.07, p =.0006) was found in a binary logistic regression model. When adjusted, only restless sleep showed a significant relationship with PSB (p =.03, OR 3.32, 95% CI 1.13–9.81). Conclusion: Children whose parents reported as clenching or grinding their teeth while asleep in the previous 6 months, and who were found to have abnormal dental wear, had significantly more nightmares, sleep disruption, daytime sleepiness, family history of bruxism, and tended to be more perfectionist. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Aim: 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. Aim: 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. Results: No statistically significant difference was found between bruxism symptoms and RLS severity (p>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. [ABSTRACT FROM AUTHOR]

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This review delves into the complex facets of sleep bruxism (SB), concentrating on its diagnosis, epidemiology, orofacial consequences, comorbidities including sleep disorders, and management strategies. Diverse studies have highlighted the difficulties associated with accurately diagnosing SB, the shifting perceptions surrounding it, variations in prevalence based on age and SB definitions, insights obtained from polysomnography, current knowledge on orofacial impact, and approaches to management. Notably, the association between SB and sleep disorders, especially obstructive sleep apnea, and its possible physiological roles are examined. This review underscores the necessity of a balanced appreciation for SB, accentuating the need for comprehensive evaluations and tailored management strategies. It emphasizes the continual reshaping of SB concepts and the critical need for further research to differentiate between physiological and pathological manifestations of SB, with the goal of optimizing treatment methods.

Background: 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. Objectives: To evaluate the incidence of sleep bruxism (SB) and dental wear in children and adolescents. Materials and Methods: 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). Results: 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. Conclusions: In this population, children with SB remained with this behaviour and showed higher dental wear over the years. [ABSTRACT FROM AUTHOR]

Purpose: To assess (1) whether an occlusal splint (OS) or mandibular advancement splint (MAS) allowed better sleep quality and was more comfortable in individuals with sleep bruxism (SB); and (2) the relationship between sleep quality, comfort, and reduction in RMMA related to SB. Materials and Methods: Polysomnographic data from 21 SB subjects (mean ± SD age 25.6 ± 4.5 years) collected in two previous studies were compared. Morning self-reports on sleep quality and comfort of the oral device, polysomnographic data, and RMMA index data from no-device nights were compared to nights using an OS or MAS. The reduction ratio of the RMMA index was calculated for both devices. A responder to the oral device was identified when the RMMA index was less than 2 and when it showed a reduction of at least 50% from the no-device control night. Results: Self-reports for sleep quality and comfort of the oral device showed a mild advantage of the OS when compared to the MAS (r2 = 0.47, r2 = 0.32; P = .01). In responders, the MAS induced a greater reduction in the RMMA index (P = .03) than the OS. Conclusions: In the short term, the comfort of the oral device seemed to influence sleep quality in SB individuals. However, despite the slightly higher degree of comfort offered by the OS, the MAS induced a greater effect on the RMMA index. [ABSTRACT FROM AUTHOR]

Background/purpose: Various biofeedback stimulation techniques for managing sleep bruxism (SB) have recently emerged; however, the effect of the successive application of vibratory feedback stimulation has not been clarified. This study aimed to elucidate the effect of vibration feedback stimulation via an oral appliance (OA) on SB. Materials and methods: This prospective, single-arm, open-label intervention study included 20 participants diagnosed with “definite” SB who wore a specially designed OA for 98 nights at home. A force-based SB detection system triggered a vibrator attached to the OA. Vibratory stimulation was withheld during the first 3-week adaptation period (weeks 1–3), applied during the 9-week stimulation period (weeks 4–12), and withheld again during the post-stimulation period (weeks 13–14). The number and duration of SB events per hour of sleep were calculated based on piezoelectric signals recorded with the OA-based vibration feedback device and compared between weeks 3 and 4, 8, 12, and 14 and between weeks 12 and 14 using the Friedman test (post-hoc test with Bonferroni correction). Results: The duration of SB events significantly decreased after vibratory stimulation (weeks 3 versus 4, 8, and 12: P

Abstract Background Isaacs’ syndrome, also known as neuromyotonia or peripheral nerve hyperexcitability, is a rare disorder that affects the peripheral nervous system. Clinical findings include cramps, fasciculations, and myokymia; however, there are few reports of dental treatment for trismus. Case presentation A patient with trismus due to Isaacs’ syndrome experienced swelling and pain in the gingiva surrounding his right lower first molar. He was diagnosed with chronic apical periodontitis by a dentist near his home. However, the patient was informed that dental treatment and medication could not be administered because of the presence of Isaacs’ syndrome, and he visited the Geriatric Dentistry and Perioperative Oral Care Center at Kyushu University Hospital 2 weeks later. The patient’s painless mouth-opening distance (between incisors) was 20 mm at that time, and medication, including amoxicillin capsules and acetaminophen, was administered because the dental extraction forceps or endodontic instruments were difficult to insert into the oral cavity for treatment. Two months after his initial visit, the patient visited us complaining of pain in the same area. However, he had recently undergone plasmapheresis treatment in neurology to alleviate limited mouth opening and systemic myalgia, resulting in a pain-free mouth-opening distance of approximately 35 mm. During this temporary period in which he had no restriction in mouth opening, we performed tooth extraction and bridge restoration on the mandibular right first molar and created an oral appliance for sleep bruxism. Conclusions Plasmapheresis therapy transiently reduced trismus, rendering dental interventions feasible, albeit temporarily. This case report underscores the importance of close collaboration between neurologists and dentists who encounter similar cases while furnishing valuable insights to inform dental treatment planning.

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. [ABSTRACT FROM AUTHOR]

Summary The objective of the current study was to evaluate the clinical utility of bruxism episode index in predicting the level of masticatory muscle pain intensity. The study involved adults (n = 220) recruited from the Outpatient Clinic of Temporomandibular Disorders at the Department of Experimental Dentistry, Wroclaw Medical University, during the period 2017–2022. Participants underwent medical interview and dental examination, focusing on signs and symptoms of sleep bruxism. The intensity of masticatory muscle pain was gauged using the Numeric Rating Scale. Patients identified with probable sleep bruxism underwent further evaluation through video‐polysomnography. Statistical analyses included the Shapiro–Wilk test, Spearman's rank correlation test, association rules, receiver operating characteristic curves, linear regression, multivariate regression and prediction accuracy analyses. The analysis of correlation and one‐factor linear regression revealed no statistically significant relationships between bruxism episode index and Numeric Rating Scale (p > 0.05 for all analyses). Examination of receiver operating characteristic curves and prediction accuracy indicated a lack of predictive utility for bruxism episode index in relation to masticatory muscle pain intensity. Multivariate regression analysis demonstrated no discernible relationship between bruxism episode index and Numeric Rating Scale across all examined masticatory muscles. In conclusion, bruxism episode index and masticatory muscle pain intensity exhibit no correlation, and bruxism episode index lacks predictive value for masticatory muscle pain. Clinicians are advised to refrain from employing the frequency of masticatory muscle activity as a method for assessing the association between masticatory muscle pain and sleep bruxism. [ABSTRACT FROM AUTHOR]

Summary: It has been suggested that sleep bruxism may interrupt sleep continuity, hence potentially influencing sleep quality. The aim of this study was to systematically review the relationship between possible, probable, and definite sleep bruxism and sleep quality in otherwise healthy individuals. A systematic search on sleep bruxism and sleep quality was performed in seven databases until 19 December 2022. Eligible articles were screened, and quality assessment was performed via the Joanna Briggs Institute Scale. Of 3681 articles screened, 13 were included in this study. Of these, six evaluated the relationship between sleep quality and possible sleep bruxism, three with probable sleep bruxism, and four with definite sleep bruxism. An association between poor sleep quality and sleep bruxism was found among those individuals diagnosed with possible and probable sleep bruxism. However, the studies conducted in individuals with definite sleep bruxism failed to demonstrate any association. With more reliable measures to evaluate sleep bruxism, a relationship between sleep bruxism and sleep quality was not evident. [ABSTRACT FROM AUTHOR]

Summary: Rhythmic masticatory muscle activity (RMMA) is a periodic muscle activity that characterises sleep bruxism (SB) events. These can occur as a single event, in pairs, or in clusters. Since RMMA episodes often occur in clusters and the relevance of this occurrence is unknown, we conducted a study to investigate the effect of RMMA clusters on sleep fragmentation and the severity of orofacial muscle pain. This study involved a secondary analysis using data from 184 adult subjects with orofacial muscle pain who underwent definitive polysomnography (PSG) for sleep bruxism diagnosis. Self‐reported orofacial muscle pain (OFMP) was assessed using the numeric rating scale, and additional evaluation of side‐to‐side equivalence (symmetry) was described using a binary system. Among the 184 participants, 60.8% (n = 112) did not exhibit clusters and among the 72 participants with clusters, 36.1% (n = 26) and 63.9% (n = 46) were in the high and low RMMA frequency groups, respectively. The high SB group had significantly three times more phasic RMMA events than the noncluster group. A total of 89.67% (n = 165) of subjects reported orofacial muscle pain. While there was no difference in the severity of OFMP among groups, a significant decrease in symmetry between the severity of temporal muscle pain on the left and right sides was noted in the cluster group compared with the noncluster group. Clustering of RMMA events is associated with sleep fragmentation. The asymmetry of temporal muscle pain is related to the presence of RMMA clusters in sleep bruxism. [ABSTRACT FROM AUTHOR]

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). [ABSTRACT FROM AUTHOR]

Background: Most of the respiratory events in adults with obstructive sleep apnea (OSA) occurs in supine position. It has been reported that the contraction of masseter muscles is dependent on the occurrence of arousals rather than on the occurrence of respiratory events. Objectives: This study had two aims: (1) to compare the rhythmic masticatory muscle activity (RMMA) index in supine position (RMMA_sup) and in non‐supine positions (RMMA_nsup) in adults with OSA; and (2) to determine the associations between RMMA index in both supine position and non‐supine positions on the one hand, and several demographic and polysomnographic variables on the other hand. Methods: One hundred OSA participants (36 females and 64 males; mean age = 50.3 years (SD = 10.5)) were selected randomly from among patients with a full‐night polysomnographic recording. RMMA_sup index and RMMA_nsup index were compared using Mann–Whitney U‐test. Multivariate linear regression analyses were used to predict RMMA index both in supine and non‐supine positions based on several demographic and polysomnographic variables. Results: In patients with OSA, the RMMA_sup index was significantly higher than the RMMA_nsup index (p <.001). RMMA_sup index was significantly associated with the arousal index (p =.002) and arousal index in supine position (p <.001). RMMA_nsup index was only significantly associated with the arousal index in non‐supine positions (p =.004). Conclusion: Within the limitations of this study, RMMAs occur more frequently in supine position than in non‐supine positions in patients with OSA. In both sleep positions, RMMAs are associated with arousals. [ABSTRACT FROM AUTHOR]

Objective: The objective of this commentary is to advocate for a holistic, ontology‐based definition of bruxism. The intention is to synthesise the best aspects of current definitions into a structured ontological model, thereby refining and enhancing a comprehensive understanding of the full spectrum of bruxism. Materials and Methods: The commentary elaborates on the process of integrating these insights into a hierarchical ontology that aligns with ontological principles. Settings and Sample Population: Not directly applicable as this is a commentary. Results/Conclusion: The proposed ontology‐based definition of bruxism aims to clarify communication within the medical community and advance research by enabling a comprehensive ontology‐based classification of bruxism. By aligning with ontological principles, this approach aspires to act as a catalyst for further research, discussion and consensus in the field. [ABSTRACT FROM AUTHOR]

The aim of the present manuscript is to give a narrative overview for clinicians summarizing the knowledge concerning a phenomenon that they may frequently come across in both children and adults: sleep (SB) and awake (AB) bruxism. Indeed, prevalence rates in adults range from 8 % to 16 % for SB and 22 % to 30 % for AB, whilst in children they raise up to 40 %. The complex relationship between bruxism, the most common underlying primary and/or comorbid conditions, and the potential clinical consequences for both AB and SB in children and adults will be considered. In addition, in view of the fact that over the last few decades the demand for orthodontic treatment at all ages has increased, the correlation between bruxism-related masseter muscle activity (MMA) and the use of orthodontic appliances (i.e., fixed appliances and clear aligners) is also discussed, along with the proposal of some clinical recommendations. [ABSTRACT FROM AUTHOR]

To evaluate the effects of low doses of botulinum toxin type A (BoNT-A) to control pain in patients with sleep bruxism (SB), awake bruxism (AB), and temporomandibular disorder (TMD) during 180 days. Overall sample of thirty-five patients with chronic pain related to TMD, SB, and AB received a single dose of 20 U of BoNT-A in masseter and temporalis muscles. The pain was assessed with a visual analog scale (VAS) before and after 15, 30, 60, 90, and 180 days of the application. The three clinical conditions experienced decrease in pain after 15 days of treatment (p < 0.0001); the maximum pain relief persisted for up to 90 days after BoNT-A application in patients with SB and AB and 15 days for patients with TMD. A low dose of BoNT-A may be effective for controlling chronic pain related to SB and AB, but TMD pain reduction was short-lived. [ABSTRACT FROM AUTHOR]

Various biofeedback stimulation techniques for managing sleep bruxism (SB) have recently emerged; however, the effect of the successive application of vibratory feedback stimulation has not been clarified. This study aimed to elucidate the effect of vibration feedback stimulation via an oral appliance (OA) on SB. This prospective, single-arm, open-label intervention study included 20 participants diagnosed with "definite" SB who wore a specially designed OA for 98 nights at home. A force-based SB detection system triggered a vibrator attached to the OA. Vibratory stimulation was withheld during the first 3-week adaptation period (weeks 1–3), applied during the 9-week stimulation period (weeks 4–12), and withheld again during the post-stimulation period (weeks 13–14). The number and duration of SB events per hour of sleep were calculated based on piezoelectric signals recorded with the OA-based vibration feedback device and compared between weeks 3 and 4, 8, 12, and 14 and between weeks 12 and 14 using the Friedman test (post-hoc test with Bonferroni correction). The duration of SB events significantly decreased after vibratory stimulation (weeks 3 versus 4, 8, and 12: P < 0.001, P = 0.026, and P = 0.033, respectively) and then significantly increased upon cessation of vibratory stimulation after the stimulation period (weeks 12 versus 14: P < 0.001). Contingent vibratory stimulation through an OA-based vibration feedback device may suppress SB-related masticatory muscle activity continuously for 9 weeks and may be an effective alternative for managing SB. [ABSTRACT FROM AUTHOR]

Aim. The aim of this research is to evaluate dental wear in a group of patients with self-reported sleep bruxism. Materials and methods. The study group consisted of a number of 37 patients, women and men, aged between 25 and 57 years, who self-reported bruxism during sleep. Results and discussion. Sextant III recorded the lowest mean and sextant V the highest mean for tooth wear grading scores. 91.9% of the participants presented generalized dental wear. The mild degree of tooth wear was most frequently encountered at sextant III, moderate wear was most frequently encountered at sextant V, and severe wear at sextant II and V. Conclusions. The most frequent score of dental wear recorded was represented by score 2. Most of the patients with self-reported bruxism in sleep presented generalized dental wear. The majority of patients recorded a moderate level of dental wear. [ABSTRACT FROM AUTHOR]