Smartphone‐based evaluation of awake bruxism behaviours in a sample of healthy young adults: findings from two University centres

Abstract

A smartphone‐based ecological momentary assessment (EMA) strategy was used to assess the frequency of awake bruxism behaviours, based on the report of five oral conditions (ie relaxed jaw muscles, teeth contact, mandible bracing, teeth clenching and teeth grinding). One hundred and fifty‐three (N = 153) healthy young adults (mean ± SD age = 22.9 ± 3.2 years), recruited in two different Italian Universities, used a dedicated smartphone application that sent 20 alerts/day at random times for seven days. Upon alert receipt, the subjects had to report in real‐time one of the above five possible oral conditions. Individual data were used to calculate an average frequency of the study population for each day. For each condition, a coefficient of variation (CV) of frequency data was calculated as the ratio between SD and mean values over the seven recording days. Average frequency of the different behaviours over the seven days was as follows: relaxed jaw muscle, 76.4%; teeth contact, 13.6%; mandible bracing, 7.0%; teeth clenching, 2.5%; and teeth grinding, 0.5%. No significant differences were found in frequency data between the two University samples. The relaxed jaw muscles condition was more frequent in males (80.7 ± 17.7) than in females (73.4 ± 22.2). The frequency of relaxed jaw muscles condition over the period of observation had a very low coefficient of variation (0.27), while for the different awake bruxism behaviours, CV was in a range between 1.5 (teeth contact) and 4.3 (teeth grinding). Teeth contact was the most prevalent behaviour (57.5–69.7). Findings from this investigation suggest that the average frequency of AB behaviours over one week, investigated using EMA‐approach, is around 23.6%.

Current Knowledge and Future Perspectives on Awake Bruxism Assessment: Expert Consensus Recommendations

“…So far, most available data have been collected in populations of healthy young students, who reported teeth contact as the most frequent behavior over seven days (13.6% in the largest study conducted so far) [ 50 ]. Interestingly, the fact that teeth grinding is rarely reported in any study populations from different countries is a promising finding to explore for discriminating AB from SB in terms of etiology, muscle behaviors, and possible consequences.…”

“…Concerning the fluctuations over time, it is interesting to note a very low coefficient of daily variation over one week for the non-AB (i.e., relaxed) muscle condition (0.27–0.44) [ 48 , 50 ]. This means that the frequency of AB behaviors as a whole in a population of healthy young adults does not change relevantly from one day to another in a short-time span.…”

“…Concerning reliability, a recent study suggested that, once adequate information was given to the clinicians who prescribed the use of smartphone-EMA and to the patients who use it, no significant differences in reported AB prevalence were found between two university samples of healthy students [ 50 ]. In particular, identical instructions on how to use the application were provided to both study populations, with the same supporting educational materials (viz., slides, images, and videos) presented by the same investigators.…”

Ecological Momentary Assessment of Awake Bruxism Frequency in Patients with Different Temporomandibular Disorders

“…Until now, EMA has been used to investigate the frequency of AB in healthy young adults—specifically university students [ 10 , 13 , 14 , 15 , 16 , 17 ], pre-college students [ 18 ], and patients undergoing orthodontic treatment [ 19 ]—and only a single study has evaluated it on the general population [ 20 ]. These studies elucidated the report of AB in otherwise healthy young adults and are considered standpoints for future comparison with selected populations of patients with purported bruxism risk factors and/or consequences [ 1 ].…”

Monitoring of awake bruxism by intelligent app

“… 44 Muscle relaxation can be recognized by the individual, also clenching of teeth, 45 can be a good reference to evaluate the behavior of AB to be a conscious and controlled activity, 46 other authors indicate that the use of SMEs provides reliability in the monitoring of AB, the reason lowers the influence of natural fluctuation that the population presents regardless of age or gender. It is recommended to conduct future research that considers long-term monitoring of AB, the hypothesis should be tested that the manifestations of AB: relaxed jaw muscles (non-contact teeth), teeth in contact (sander in fixed position), mandibular clenching (no contact between teeth), dental clenching (strong contact in fixed position), dental grinding and area of pain (temporary, interciliary, temple, preauricular, auricular, mandibular angle, mentonian, neck, frontal, infra and supraorbital, clinical consequences such as temporo mandibular joint dysfunction, regional myalgias 47 are determined. Continuing with the technological line, the effectiveness of an email-based registration and recovery system should be studied if the individual detects non-functional diurnal contact or muscle contracture, an effective strategy for the treatment of temporo mandibular disorders.…”