Adaptive Stress Coping in Awake Bruxism

Abstract

Numerous studies have analyzed the relationship between psychological factors and bruxism. However, the data are often obscured by the lack of precise diagnostic criteria and the variety of the psychological questionnaires used. The purpose of this study is to determine the association between awake bruxism and psychological factors (anxiety, depression, sociability, stress coping, and personality traits). With this aim, 68 participants (13 males) completed a battery of psychological questionnaires, a self-reported bruxism questionnaire, and a clinical examination. Based on their scores on the bruxism questionnaire and the clinical examination, subjects were divided into two groups. Subjects who met the criteria for “probable awake bruxism” were assigned to the case group (n = 29, five males). The control group (n = 39, nine males) was composed of subjects who showed no signs or symptoms of bruxism in the examination nor in the questionnaire. The probable awake bruxism group presented significantly higher levels of trait and state anxiety, symptoms of somatization, and neuroticism than the control group. Despite this, and when their problem coping strategies were considered, awake bruxers showed higher levels in Positive Reappraisal (p < 0.05), a strategy generally considered as adaptive. In conclusion, although awake bruxers in our study showed larger levels of anxiety, somatization, and neuroticism, they also displayed more adapted coping strategies, while according to previous data TMD patients (which generally also present high levels of anxiety, somatization and neuroticism) might tend to present less adaptive coping styles. Thus, awake bruxism may play a positive role in stress coping, which would be compatible with the hypothesis of mastication as a means of relieving psychological tension. This finding should be further confirmed by future research comparing TMD patients with definitive awake bruxers and controls and using larger and more representative samples.

Psychosocial and Behavioral Factors in Awake Bruxism—Self-Report versus Ecological Momentary Assessment

“…This may be due to stress that many dental students experience during their studies [ 31 , 32 ]. Soto-Goni et al [ 33 ] showed that subjects with awake bruxism show larger levels of anxiety, somatization, and neuroticism but also display more adapted coping strategies than TMD patients. The authors suggested that AB may play a positive role in stress coping, which would be compatible with the hypothesis of mastication as a means of relieving psychological tension.…”

Association between self-reported bruxism and academic performance in university students.

“…13 Another study showed that participants with awake bruxism had significantly higher levels of trait and state anxiety. 44 These results indicate that awake bruxism would play a role in reducing stress and anxiety, since certain people who perceive situations as threatening or stressful display this behavior more frequently. 45 A statistically significant association between sleep bruxism and anxiety was found, coinciding with findings from a Finnish study, where it was concluded that anxiety would be acting as a risk factor for sleep bruxism.…”

The usage of botulinum in the treatment of masticatory muscles hyperactivity

“…Surprisingly, it has been proven that the mere occurrence of bruxism symptoms can also bring positive side effects in certain medical conditions. For example, patient with gastro-esophageal reflux will have a significantly decreased risk of teeth wear due to an increased salivation caused by bruxism [7].…”

“…Although it is reported that such hyperactivity of masticatory muscles varies in etiology, the prevalence of both types of bruxism significantly decreases with age [6]. A study among young college students demonstrated that 37.9% of them struggle with awake bruxism and 31.8% of them also deal with sleep bruxism [7].…”