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The Association of Sleep Bruxism, Awake Bruxism, or Combined Sleep/Awake Bruxism and Temporomandibular Disorder
Purpose:
To assess the association of the role of sleep bruxism (SB), awake bruxism (AB), and combined SB/AB bruxism with temporomandibular disorder (TMD) subtypes.
Materials And Methods:
The participant sample (n = 1,463) comprised registered users of the Brazilian Public Health Care System (SUS). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I was used to classify TMD subtypes. The RDC/TMD Axis II was used to assess Graded Chronic Pain Scale (GCPS), depression, somatization with or without pain, sociodemographic data, pain history, and bruxism. Sleep quality was assessed with the Sleep Assessment Questionnaire (SAQ).
Results:
All three bruxer groups (SB, AB, and combined SB/AB) increased the risk of developing TMDs measured by the GCPS and muscle diagnoses, and AB increased the risk for disk displacements. The combined SB/AB group increased the risk (adjusted odds ratio; OR) for GCPS and muscle diagnoses by 3.8 and 4.1 times, respectively, while the AB group alone increased the risk for disk displacements by 1.8 times. The OR was adjusted for sleep quality and psychosocial variables-depression, somatization (physical symptoms) without pain, gender, income level, and employment-which were shown in the univariate analysis to differ among all bruxer groups.
Conclusions:
Bruxism increased the risk for TMD subtype development, but it varied among the three bruxism types assessed (SB, AB, or combined SB/AB), and it was also modulated by sleep and psychosocial variables. SB and AB, separately and in combination, contribute to TMD subtype development and must be assessed in all studies.
