Instrumental assessment of the association between sleep and awake bruxism in a general dental practice

Assessment of the association between sleep bruxism (SB) and awake bruxism (AB) in a general dental practice.

Thirty patients (aged 20-78 years, mean age 44.3 years, SD 13.3 years) with regular dental recall appointments at a general dental practice were included.The exclusion criteria were as follows: refusal to participate; trauma; pregnancy/lactation; medication; age below 18 years; edentulism; orthodontic treatment; and patients with untreated dental problems (e.g. caries).SB was assessed by means of self-report and outpatient polygraphy (SOMNOtouch™RESP, Fa. Somnomedics, Randersacker, Germany) over the course of one night. AB in the same patients was assessed using self-report and the 'Bruxapp' self-observation app (Ecological Momentary Assessment, EMA). This assessment was carried out in the same week in which the patients used the polygraphic device. The following parameters were assessed clinically: the presence of temporomandibular disorders, diagnosed in accordance to the Diagnostic Criteria for Temporomandibular Disorders; tooth wear; and tongue/cheek impressions. The null hypothesis was that no significant correlation exists between the frequency of AB and the duration of SB events, as assessed via EMA, anamnesis and polygraphy. Statistical analysis was carried out using the McNemar's change test, the chi-square test, the Mann-Whitney U test and Pearson's correlation (IBM SPSS Statistics version 30.0.0).

The duration of all SB events was significantly correlated with teeth clenching, based on the percentage of EMA (p = 0.05, correlation coefficient r = 0.35). The null hypothesis was therefore rejected. Based on the overall duration of SB events, a significant difference was observed for subjects with and without TMD (p=0.03). No significant association was found between the duration of SB events and tooth wear or tongue and cheek impressions.

Awake clenching was significantly correlated with the overall duration of SB events. These findings suggest that an association may exist between SB and AB.

In subjects presenting SB, AB should also be assessed, and vice versa, as SB and AB appear to be correlated.