Psychological distress and the belief that oral behaviours put a strain on the masticatory system in relation to the self‐report of awake bruxism: Four scenarios

• Published in: Journal of oral rehabilitation Vol. 51; no. 1; pp. 170 - 180
• Main Authors: Selms, Maurits K. A., Thymi, Magdalini, Lobbezoo, Frank
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-01-2024
• Subjects: Adult; Anxiety; awake bruxism; Bruxism - diagnosis; causal attribution belief; Dental disorders; Female; Humans; Jaw; Male; Mastication; Masticatory Muscles; Mental depression; Middle Aged; Muscle function; Muscles; Pain; psychological distress; Self Report; TMD pain; Wakefulness; TMD pain; causal attribution belief; awake bruxism; self-report; psychological distress
• ISSN: 0305-182X; 1365-2842
• DOI: 10.1111/joor.13460

Background
It is assumed that other factors than masticatory muscle activity awareness could drive the self‐report of awake bruxism.
Objectives
To investigate the extent to which the report of awake bruxism is associated with psychological distress, and with the belief that oral behaviours put a strain on the masticatory system among TMD‐pain patients.
Materials and Methods
The study sample consisted of 1830 adult patients with reported function‐dependent TMD pain. Awake bruxism was assessed through six items of the Oral Behaviors Checklist. Psychological distress was assessed by means of somatic symptoms, depression and anxiety. Causal attribution belief was measured with the question ‘Do you think these behaviours put a strain on your jaws, jaw muscles, and/or teeth?’
Results
Mean age of all participants was 42.8 (±15.2) years, 78.2% being female. Controlled for sex, positive, yet weak, correlations were found between awake bruxism and somatic symptom severity (rs = 0.258; p < .001), depression (rs = 0.272; p < .001) and anxiety (rs = 0.314; p < .001): patients with the highest scores reported approximately twice as much awake bruxism compared to those with minimal scores. Controlled for age and sex, a positive, moderate correlation was found between awake bruxism and causal attribution belief (rs = 0.538; p < .001). Patients who believed that performing awake oral behaviours put ‘very much’ a strain on the masticatory system reported four times more awake bruxism than patients who did not believe that these behaviours are harmful.
Conclusions
Based on the results and relevant scientific literature, the theoretical background mechanisms of our findings are discussed in four scenarios that are either in favour of the use of self‐report of awake bruxism being a representation of masticatory muscle activity awareness, or against it.