Sleep bruxism is highly prevalent in adults with obstructive sleep apnea: a large-scale polysomnographic study

Li, Deshui; Kuang, Boyuan; Lobbezoo, Frank; Vries, Nico de; Hilgevoord, A.A.J.

doi:10.5664/jcsm.10348

Cited by 19 publications

(15 citation statements)

References 51 publications

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“…14 A relationship has been noted between SB and ob structive sleep apnea syndrome and simple snoring. 36,37 However, these confounding factors could not be distin guished, since a polysomnographic examination was not performed in this study. Moreover, the subject's symp toms fluctuated because of the nature of bruxism and TMD, which can also be considered a limitation of this study.…”

Section: Limitations and Strengthsmentioning

confidence: 93%

Investigation of the relationship between probable sleep bruxism, awake bruxism and temporomandibular disorders using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)

Karaçay¹,

Şahbaz²

2023

Dent. Med. Probl.

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Background. The causal relationship between bruxism and temporomandibular disorders (TMD) is not clear.Objectives. The present study investigated which TMD are associated with probable sleep bruxism (SB) and awake bruxism (AB) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). The study further evaluated the association between probable SB and AB and TMD. Material and methods.A total of 143 patients were selected -bruxers (SB and AB) and non-bruxers. A diagnosis of probable bruxism was made after a physical examination and when the symptoms were detected. The patients were evaluated using DC/TMD. From among Axis I assessment instruments, the TMD Pain Screener, the Symptom Questionnaire and the Clinical Examination Form were used. Moreover, the Graded Chronic Pain Scale (GCPS) (v. 2), the Jaw Functional Limitation Scale-8 (JFLS-8), the Patient Health Questionnaire-4 (PHQ-4), and the Oral Behaviors Checklist (OBC) were applied within the scope of Axis II.Results. Diagnoses of muscle disorders and disk displacement with reduction were significantly more frequent in the SB and AB groups than in non-bruxers. A diagnosis of arthralgia was significantly more prevalent in the AB group than in non-bruxers. The JFLS-8 scores and the TMD Pain Screener scores were higher in the AB group than in the SB group and in non-bruxers. Distress levels, and the GCPS and OBC scores were higher in the SB and AB groups as compared to non-bruxers. The results of binary logistic regression analysis showed that only the OBC score was significantly higher in the TMD subgroup (OR (odds ratio) = 1.228; 95% CI (confidence interval): 1.014-1.488). Conclusions.Both SB and AB were associated with pain-related TMD and intra-articular joint disorders. The muscle disorders and disk displacement with reduction subtypes were associated with SB and AB. Unlike SB, AB was also associated with arthralgia. Bruxers (both SB and AB) displayed parafunctional habits. However, AB was associated with greater functional limitation of the jaw as compared to SB.

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Section: Limitations and Strengthsmentioning

confidence: 93%

Investigation of the relationship between probable sleep bruxism, awake bruxism and temporomandibular disorders using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)

Karaçay¹,

Şahbaz²

2023

Dent. Med. Probl.

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“…Therefore, a group of bruxism research experts worked on ing the recently published Standardised Tool for the Assessment of Bruxism (STAB) 18,31,32 and the Bruxism Screening tool (BruxScreen) 33 to better assess all bruxism behaviours.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12] The consequences of bruxism may be either neutral, which causes no harm for the individual's health; negative, such as muscle symptoms, possible temporomandibular disorders (TMD), damage to teeth or restorations [13][14][15] ; or even potentially positive, such as an increase in salivary flow rate in gastric oesophageal reflux disease or increased airway flow in obstructive sleep apnea. [16][17][18][19] The grading system of bruxism assessment is "possible" (selfreport), "probable" (self-report and/or clinical findings) and "definite" (self-report and/or clinical findings, and polysomnography for SB or electromyography for AB). 1 The assessment of AB is a rather new concept in bruxism research.…”

Section: Introductionmentioning

confidence: 99%

“…personality traits, stress) 7–12 . The consequences of bruxism may be either neutral, which causes no harm for the individual's health; negative, such as muscle symptoms, possible temporomandibular disorders (TMD), damage to teeth or restorations 13–15 ; or even potentially positive, such as an increase in salivary flow rate in gastric oesophageal reflux disease or increased airway flow in obstructive sleep apnea 16–19 …”

Section: Introductionmentioning

confidence: 99%

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Awake bruxism in temporomandibular disorders patients referred to tertiary care: A retrospective study on its assessment and TMD management

Nykänen

Lobbezoo

Kämppi

et al. 2023

J of Oral Rehabilitation

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BackgroundBruxism is defined as a repetitive jaw‐muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism can occur during sleep (sleep bruxism, SB) or during wakefulness (awake bruxism, AB). To date, the effect of AB on the purported negative consequences of bruxism has remained unclear.ObjectivesThe assessment of AB, its relation to temporomandibular disorders (TMD) treatment modalities, and their possible outcomes were investigated among TMD patients resistant to treatment in primary care and referred to a tertiary care clinic.MethodsThe records of 115 patients were studied. Patients were referred to the Head and Neck Centre, Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, for TMD treatment between 2017 and 2020. The data derived from the eligible patients' records included the following: background data (age and sex), referral data (reason and previous treatment), medical background (somatic and psychiatric), clinical and possible radiological diagnoses at a tertiary care clinic, treatment modalities for masticatory muscle myalgia, bruxism assessment, its possible treatment modalities and their outcomes, and overall management outcome. We analysed the outcomes of single treatment modalities and combined groups of modalities. For the demographic data, the Chi‐squared test and Fischer's Exact test were used to determine the associations between the categorical variables. A Sankey‐diagram was used to describe the flow of treatment.ResultsTemporomandibular joint‐pain‐dysfunction syndrome (K07.60) was the most frequent single reason to refer a patient to tertiary care (17.4%). At referral, men had myalgia (M79.1) significantly more often (p = .034) than women. Similarly, men had depression (p = .002) more often and other psychiatric diagnoses (p = .034). At tertiary care, the presence of AB was assessed in 53.9%, and self‐reported AB was recorded in 48.7%. In patients with possible AB, those who were prescribed neuropathic pain medication showed significantly less improvement in symptoms (p = .021) than those who underwent splint therapy (p = .009). Overall, half of the patients showed overall improvement in their TMD symptoms from the treatment combinations.ConclusionDespite several treatment modalities, only half of the patients showed improvement in their symptoms in the present study. A standardised assessment method encompassing all factors contributing to bruxism behaviours and their consequences is suggested.

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“…36,37 Indeed, whilst the past literature was very unspecific on this issue, 38,39 more recent evidence supports of a close association between AB and certain personality traits. [40][41][42][43] Other factors and comorbid conditions that may be of interest for a potential relationship with SB (e.g., obstructive sleep apnea, gastroesophageal reflux, medication or substance intake, neurological disorders, and genetic issues) [44][45][46][47][48][49][50][51][52][53][54] or to specific disorders with awake manifestations (e.g., ADHD, medications or substance assumption) 52,55 may also play a role, even if indirect.…”

Section: Introductionmentioning

confidence: 99%

Research routes on awake bruxism metrics: Implications of the updated bruxism definition and evaluation strategies

Lobbezoo

Colonna

Bender³

et al. 2023

J of Oral Rehabilitation

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BackgroundWith time, due to the poor knowledge on it epidemiology, the need to focus on awake bruxism as a complement of sleep studies emerged.ObjectiveIn line with a similar recent proposal for sleep bruxism (SB), defining clinically oriented research routes to implement knowledge on awake bruxism (AB) metrics is important for an enhanced comprehension of the full bruxism spectrum, that is better assessment and more efficient management.MethodsWe summarised current strategies for AB assessment and proposed a research route for improving its metrics.ResultsMost of the literature focuses on bruxism in general or SB in particular, whilst knowledge on AB is generally fragmental. Assessment can be based on non‐instrumental or instrumental approaches. The former include self‐report (questionnaires, oral history) and clinical examination, whilst the latter include electromyography (EMG) of jaw muscles during wakefulness as well as the technology‐enhanced ecological momentary assesment (EMA). Phenotyping of different AB activities should be the target of a research task force. In the absence of available data on the frequency and intensity of wake‐time bruxism‐type masticatory muscle activity, any speculation about the identification of thresholds and criteria to identify bruxers is premature. Research routes in the field must focus on the improvement of data reliability and validity.ConclusionsProbing deeper into the study of AB metrics is a fundamental step to assist clinicians in preventing and managing the putative consequences at the individual level. The present manuscript proposes some possible research routes to advance current knowledge. At different levels, instrumentally based and subject‐based information must be gathered in a universally accepted standardised approach.

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Sleep bruxism is highly prevalent in adults with obstructive sleep apnea: a large-scale polysomnographic study

Cited by 19 publications

References 51 publications

Investigation of the relationship between probable sleep bruxism, awake bruxism and temporomandibular disorders using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)

Investigation of the relationship between probable sleep bruxism, awake bruxism and temporomandibular disorders using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)

Awake bruxism in temporomandibular disorders patients referred to tertiary care: A retrospective study on its assessment and TMD management

Research routes on awake bruxism metrics: Implications of the updated bruxism definition and evaluation strategies

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