Is There Association Between Stress and Bruxism? A Systematic Review and Meta-Analysis

Abstract

This systematic review and meta-analysis aimed to investigate a possible association between stress and bruxism in humans. This study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines under the code CRD42020188862, and the searches were performed on the following databases: PubMed, Scopus, Web of Science, Cochrane, LILACS, OpenGrey, and Google Scholar. This systematic review evaluated observational studies in adult humans with and without stress to verify the association between bruxism and the presence of stress. The risk of bias was evaluated through the Joanna Briggs Institute Critical Appraisal Tools for Analytical Cross-Sectional Studies. In quantitative analysis, the Odds Ratio (OR) and their 95% confidence interval (CI) were calculated through a fixed-effect model. Furthermore, a summary of the overall strength of evidence was presented using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). A total of 1,458 studies were identified, and six were included in this systematic review. Two studies included were classified with a low risk of bias, and the others were classified with a moderate risk of bias. In three articles, a meta-analysis was performed and showed an association between these two factors (OR 2.07 [1.51, 2.83], p < 0.00001, I2 = 45%). Besides that, a low certainty of the evidence was detected among this association. Stressed individuals show a higher chance of presenting bruxism when compared to healthy individuals. Despite the low heterogeneity found in the quantitative analysis among the articles reporting an association between stress and bruxism, further studies with similar methods are necessary to understand this relationship better.

Associations between Bruxism, Stress, and Manifestations of Temporomandibular Disorder in Young Students

“…The involvement of psychosocial factors, especially stress and anxiety in the production of bruxism, is also discussed in other studies [25,27,28,53,54,[60][61][62]. Chemelo et al conducted a meta-analysis review and concluded that stressed people have a greater predisposition to bruxism [10]. Another representative study associating bruxism with stress was conducted in 2018 by Kuhn et al [28], also based on a review of the literature from 2007-2016.…”

“…Later, through experimentally generated interferences, Rugh demonstrated that occlusal corrections did not modify the parafunctional bruxism episodes [4]. Other factors have also been considered: genetics [4], alcohol or tobacco consumption, drugs, or specific medications [5], MS disorder [6], systemic factors (neurological, mental, and even neurotransmitter disorders) [7][8][9], and psychosocial factors (stress, anxiety) [10][11][12], but no clear implications have been found. Therefore, the role of main factors was left to the newly investigated psychosocial and behavioral factors, such as levels of stress and type of personality.…”

“…Over time, bruxism has also been considered a manifestation of temporomandibular disorder [1,[14][15][16][17], a sleep disorder [7,18], a behavioral disorder, more commonly associated with stress [10,19,20] or even a movement disorder [21].…”

The Rapid Screening for Somatosensory Tinnitus Tool: a Data-Driven Decision Tree Based on Specific Diagnostic Criteria

“…As part of our decision tree, bruxism is mainly important to diagnose ST in case the simultaneous change in tinnitus and neck/jaw pain is less clear and patients do not show regular increase in suboccipital muscle tension. It seems logical not to include bruxism too early in the decision tree to avoid false positives, since bruxism is significantly related to the presence of excessive stress (Chemelo et al 2020; Lavigne et al 2008), which in turn affects tinnitus in general (Elarbed et al 2021; Mazurek et al 2019).…”

The Relationship between Stress and Masticatory Muscle Activity in Female Students

“…Stress is linked to neurological disorders tension headaches and migraine [4][5][6]. It is generally accepted that mental stress causes increase muscular tension in different parts of the body [7,8], but the research data are so far inconclusive [9,10]. The American Psychological Association notes that muscle tension is a reflex response to stress and protects body from injury or pain [11].…”