To what extent is bruxism associated with musculoskeletal signs and symptoms? A systematic review

Abstract

The aim of the present systematic review was to answer the overall research question: “To what extent is bruxism associated with musculoskeletal signs and symptoms?”. The review was performed in accordance with the PRISMA guidelines. A PubMed search of articles published until 23 November 2017 was conducted. The search string included both MeSH terms and text words. Results were presented in categories according to study design, study population (eg, adults, children), bruxism sub‐type (awake, sleep), assessment methods for bruxism and musculoskeletal symptoms (self‐report, validated test) and type of outcome (pain, non‐painful musculoskeletal symptoms). It could be concluded that bruxism is to some extent associated with musculoskeletal symptoms, even though the evidence is conflicting and seems to be dependent on many factors, such as age, whether the bruxism occurs during sleep or wakefulness, and also the quality of the diagnostic methodology regarding bruxism and musculoskeletal signs and symptoms. The literature does not support a direct linear causal relationship between bruxism and such symptoms, but points more in the direction of a multifaceted relationship dependent on the presence of other risk factors. Pain is by far the most commonly assessed symptom, whereas non‐painful musculoskeletal symptoms have generally not been systematically evaluated. In the light of recent findings indicating that non‐painful symptoms may precede TMD pain, it is suggested to increase the scientific focus on non‐painful musculoskeletal symptoms in future studies. Also, future studies should use validated methods for case definition and outcome assessments.

The association of self-reported awake bruxism with anxiety, depression, pain threshold at pressure, pain vigilance, and quality of life in patients undergoing orthodontic treatment

“…1,2 Until now, the possible relationship between bruxism and symptoms of temporomandibular disorders is still controversial in the literature due to the complexity of etiology and diagnostic of both disorders. [3][4][5] The hypothesis often discussed is the possible positive relationship between either awake or sleep bruxism and craniofacial pain is still a commonly held view in the clinical practice [3][4][5] , and sometimes even presented as a real and simple cause/effect relationship. In line with the perspective that painrelated temporomandibular disorders (TMD) must be envisaged within a biopsychosocial model of illness, and efforts to understand painful temporomandibular disorders along with other chronic pain conditions in a biopsychosocial context have been made.…”

“…In line with the perspective that painrelated temporomandibular disorders (TMD) must be envisaged within a biopsychosocial model of illness, and efforts to understand painful temporomandibular disorders along with other chronic pain conditions in a biopsychosocial context have been made. [5][6][7][8] This implies that the association between bruxism and painful temporomandibular disorders has become much more complex. 5 Orthodontists should be aware of the presence of general and awake bruxism in particular and their possible implications during an orthodontic treatment, such as the excessive use of the jaw and possible association with dental structure (e.g., dental wear and restoration failures), TMJ, and masticatory muscle damage.…”

“…[5][6][7][8] This implies that the association between bruxism and painful temporomandibular disorders has become much more complex. 5 Orthodontists should be aware of the presence of general and awake bruxism in particular and their possible implications during an orthodontic treatment, such as the excessive use of the jaw and possible association with dental structure (e.g., dental wear and restoration failures), TMJ, and masticatory muscle damage. 9 Therefore, this study evaluates whether the presence of awake bruxism was associated with the occurrence of temporomandibular dysfunction symptoms, pain threshold at pressure, pain vigilance, oral health-related quality of life (OHRQoL), and anxiety and depression symptoms in patients undergoing orthodontic treatment.…”

Associations between sleep bruxism and (peri-)implant complications: lessons learned from a clinical study

“…Longitudinal cohort studies using instrumental assessments of sleep bruxism on bruxism-complication-related topics, such as temporomandibular disorders 20 and tooth wear 21 are, to the best of our knowledge, absent in either published, or unpublished 22 form. It is interesting to speculate on the reason behind the absence of such studies in a research field that otherwise receives ample attention.…”

Can Orofacial Structures Affect Tooth Morphology?

“…Besides that, it was concluded that bruxism is somehow associated with musculoskeletal symptoms. There is no support for a linear causal relationship, but the literature points more to a multifactorial relationship [51].…”