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

Abstract

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.

Analysis of definite awake bruxism using a portable electromyography device

“…In parallel, recent studies investigating subjective measurements of awake bruxism using questionnaires have reported a prevalence of self-reported awake bruxism of around 30% [1]. In a systematic review [22], the prevalence rates of "possible" awake bruxism were reported to be 32.08% and 16.16% in convenience and population-based samples, respectively.…”

“…Some studies have investigated the prevalence of awake bruxism using questionnaires and real-time self-reports about awake bruxism via a smartphone application. Bracci et al conducted a questionnaire survey to investigate the prevalence of awake bruxism and found that the prevalence of self-reported awake bruxism was as high as 30% across populations [1]. Using a real-time self-report smartphone application, Stanisic et al reported a significant difference in the frequency of awake bruxism between young adults and parents, and a moderate correlation between awake bruxism and stress [2].…”