Frequency of awake bruxism behaviours in the natural environment. A 7‐day, multiple‐point observation of real‐time report in healthy young adults

Abstract

The aim of this study was to assess awake bruxism (AB) behaviours in a sample of healthy young adults using a smartphone-based application for a real-time report (ie, ecological momentary assessment [EMA], also called experience sampling method [ESM]). Forty-six dental students used a smartphone application that sent 15 alerts at random intervals during the day for 1 week to collect AB self-reports. They had to answer on time by tapping on the display icon that refers to their current condition of jaw muscles: relaxed; teeth contact; teeth clenching; teeth grinding; jaw clenching without teeth contact (ie, bracing). The average frequency of relaxed jaw muscles, as a percentage of answers over the 7 days, was 71.7%. Teeth contact (14.5%) and jaw clenching (10.0%) were the most frequent AB behaviours. No significant gender differences were detected. Interindividual differences were quite relevant, but the overall frequency was in general only moderately variable from day-to-day. Coefficient of variation (CV) was low for the condition "relaxed jaw muscles" (0.44). At the individual level, teeth contact was the most prevalent behaviour, with a 39.1%-52.2% proportion of subjects reporting it at least once a day. During a 7-day observation period, the frequency of real-time report of AB behaviours in a sample of healthy young adults was 28.3%. The low daily variability in the average frequency value for the relaxed jaw muscles condition suggests that EMA may be a reliable strategy to get deeper into the epidemiology of oral behaviours. This investigation introduced EMA principles to the study of AB and provided data on the frequency of AB behaviours in young adults that could be compared to populations with risk/associated factors and possible clinical consequences.

The bruxism construct: From cut‐off points to a continuum spectrum

“…An accurate definition of awake bruxism behaviours and the calibration of the examiners who introduce the EMA strategy to patients are a reasonable strategy to provide the most solid evidence on the topic. In support of this, a recent paper showed a very low coefficient of intra‐individual variability for the absence of AB over one week …”

“…As for AB, recent findings suggest that healthy volunteers engage in some awake bruxism behaviours (ie, teeth clenching, jaw bracing, teeth grinding, teeth contact) in 28.3% of real‐time answers to EMA stimuli over one week . However, the huge amount of observations that can be gathered with EMA‐based real‐time collection (ie, number of patients x number of reports/day x number of observation days) proved challenging, leaving researchers with a huge database to analyse.…”

“…EMA approaches may enlighten some issues, but their agreement with real‐time EMG activity should be tested in the near future . The recently gathered data in healthy young adults at the general population level should constitute a comparison parameter for future studies on selected populations with purported associated factors and/or clinical consequences …”

Towards a Standardized Tool for the Assessment of Bruxism (STAB)—Overview and general remarks of a multidimensional bruxism evaluation system

“…by means of ecological momentary assessment . Nonetheless, only preliminary data on young adults are available on this approach, thus making it too early to speculate about any reference normality values …”

Patient‐based experiences with the use of an ambulatory electromyographic device for the assessment of masticatory muscle activity during sleep

“…A smartphone app utilising the ecological momentary assessment (EMA) method was recently introduced for the study of awake bruxism . This too, seems a promising tool for future awake bruxism research .…”