ARTICLEPainful temporomandibular disorder, sleep bruxism, anxiety symptoms and subjective sleep quality among military firefighters with frequent episodic tension-type headache. A controlled study.Desordens temporomandibulares dolorosas, bruxismo do sono, sintomas de ansiedade e qualidade subjetiva do sono em bombeiros militares com cefaleia do tipo tensional episódica frequente. Estudo controlado. The serious political, economic and moral crisis that affects Brazil, especially the state of Rio de Janeiro, with violence and neglect of public institutions, is reflected in the life and work of our population.Studies have indicated that the activities of military firefighters have direct correlations with occupational stress, high risk of back injuries, dangerous working conditions, complaints of anxiety and depression, irregular work shifts and consequent changes in sleep patterns 1,2,3 . Anxiety symptoms and changes in sleep patterns have been correlated with the presence of headaches and temporomandibular disorders (TMDs) 4,5,6,7 . Some studies have described associations of this nature in the profession of military firefighter [1][2][3] . Also, in these professionals, deficiencies in ABSTRACTObjective: To investigate associations of temporomandibular disorders (TMDs), bruxism, anxiety and sleep quality among military firefighters with frequent episodic tension-type headache (FETTH). Methods: The sample comprised two groups (80 individuals): controls (mean age 35.2 years) and study group (mean age 38.5 years). Headache was diagnosed in accordance with the ICHD-III. The Research Diagnostic Criteria for TMDs were used to classify the TMDs; bruxism was diagnosed in accordance with the International Classification of Sleep Disorders; anxiety was classified using the Beck Anxiety Inventory; and sleep quality was assessed using the Pittsburgh Sleep Quality Index. In the statistical models, we used a significance level of 95%. Results: Associations were found between participants with FETTH and TMDs (p < 0.001) and anxiety (p = 0.002).Poor quality of sleep (p = 0.687) and bruxism (p = 0.670) were not risk factors. Conclusion: The study found that TMDs and anxiety among firefighters were associated with FETTH.Keywords: tension-type headache; temporomandibular joint disorders; bruxism; surveys and questionnaires. Palavras-chave: cefaleia do tipo tensional; transtornos da articulação temporomandibular; bruxismo;inquéritos e questionários.

Objective To assess the presence of bruxism and anxiety among military firefighters with frequent episodic tension-type headache and painful temporomandibular disorders (TMDs). Methods The sample consisted of 162 individuals aged 18 to 55 years divided into four groups. Headache was diagnosed in accordance with the International Classification of Headache Disorders-III. The Research Diagnostic Criteria for Temporomandibular Disorders questionnaire was used to classify TMDs and awake bruxism; sleep bruxism was diagnosed in accordance with the International Classification of Sleep Disorders-3; and anxiety was classified using the Beck Anxiety Inventory. In statistical models, a significance level of 95% was used. The chi-square test was used to assess anxiety. Results Associations were found among frequent episodic tension-type headache, painful TMDs, awake bruxism and anxiety (p < 0.0005). Sleep bruxism was not a risk factor (p = 0.119) except when associated with awake bruxism (p = 0.011). Conclusion Anxiety and awake bruxism were independent risk factors for developing frequent episodic tension-type headache associated with painful TMDs; only awake bruxism was a risk factor for frequent episodic tension-type headache with non-painful TMDs.