Relationship Between Bruxism and Depression: Systematic Literature Review and Meta-analysis

To assess the association between depression in individuals with different bruxism classifications (ie, unspecified bruxism, sleep bruxism [SB], and/or awake bruxism [AB]), as well as to assess this association among different depression and bruxism assessment methods, bruxism types, and the changes of this association between 2002 and 2025.

A systematic review search following the PRISMA guidelines was performed in PubMed/MEDLINE, Embase, and Brazilian Dentistry Oral Science. Observational (ie, cross-sectional, case-control, and cohort) studies published since 2002 with a young adult population (18 to 59 years old) and with no restriction regarding diagnostic method for both depression and bruxism were included. Articles selected for systematic review and meta-analysis underwent quality and heterogeneity evaluation.

In total, 48 articles were included in the systematic review and 26 in the meta-analysis. Depression levels were found to be higher using standardized mean differences (SMDs) in all types of bruxism assessed in the literature, regardless of the diagnostic method used for bruxism or depression, with the exception of electromyography for the diagnosis of SB, which was nonsignificant. The positive association found in most studies remained positive over time (2002 to 2025), without significant changes. Subjects with bruxism (ie, unspecified, SB, and/or AB) had 2.84 times the odds of having depression than those without bruxism.

Assessment of depression and other psychologic conditions should be considered in the multidisciplinary management of both SB and AB. Both SB and AB must be reported and assessed, separately and in combination, in all association studies with depression.