Analysis of the correlation between bruxism and sleep and mood disorders: a case-control study

Background and Purpose: Bruxism is a repetitive jaw-muscle activity characterized by
clenching or grinding of the teeth and/or by bracing or thrusting of the mandible.
Aim of this study was to evaluate the correlation between bruxism and sleep, anxiety and
stress disorders.

Materials and Methods: 502 post-pubertal patients (304 females; 198 males), with a mean
age of 26,5 years, were seen in the Department of Orthodontics of the University of Rome ‘Tor
Three questionnaire were submitted to all patients.
The first questionnaire was a translated version of the OBC (Oral Behavior Checklist) in
Italian, which was expanded by means of specific items assessing the quality of sleep.
The second and the third one were a translated and reduced version of SCL-90 (Symptoms
Checklist-90) and PSS (Perceived Stress Scale) to evaluate anxiety and stress.
Subjects who achieved a score equal or greater than 2 in the following items: “sleep bruxism”,
“awake bruxism” and “clenching” were classified as cases (365).
Those who have scored less than 2 in the same items have been used as controls (127, 10
The statistical test of Pearson Chi-Square was the chosen tool to quantify the significance of
the data and it was calculated with the SPSS 23.0 software.

Results: There is an increase in mouth breathing in cases compared to controls. All these
results have statistical significance: p<0,001.
There is also an increase in sleepiness and snoring in cases compared to controls although
these differences are not statistically significant.
About the mood, positivity to anxiety and stress is found more in cases than in controls. For
stress, this difference is statistically significant with p<0,045.

Conclusions: Mouth breathing, sleepiness and snoring are possible signs referring to OSA and
bruxism and OSA are both arousal-related phenomena.
But the association between bruxism and these signs is not just limited to this, in fact a
correlation between bruxism and diseases of the upper airways has been demonstrated.
It is better to focus on this group of patients in order to identify the causes of the symptoms
and individualize the therapy.
Moreover, the higher anxiety and stress score in people with bruxism show that the analysis
of psych-social-economic factors is essential to better appraise the impact of this condition on
the quality of life.

Koumoulis A, Fusaroli D, Vinjolli F.

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