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This article is part of the Research Topic

Orofacial Pain, Bruxism, and Sleep

Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.00443

Awake and Sleep Bruxism among Israeli Adolescents

 Ephraim Winocur1, 2*,  Tal Messer2, 3, Ilana Eli2, 3,  Alona Emodi Perlman2, 3,  Ron Kedem4, Shoshana Reiter5 and  Pessia Friedman Rubin2, 3
  • 1Department of Oral Rehabilitation, School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Israel
  • 2The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Israel
  • 3The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Israel
  • 4Israel Defense Forces Medical Corps, Israel
  • 5Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Israel

Introduction: Sleep and awake bruxism are potential risk factors for oral hard tissue damage, failure of dental restorations and/or temporomandibular disorders. Identifying the determinants of sleep and awake bruxism among adolescents will enable development of preventive interventions for those at risk.
Objectives: To determine emotional, behavioral and physiological associations of sleep and awake bruxism among Israeli adolescents.
Methods: 2,993 Israeli high school students, from five different high schools in Israel, were approached in the classroom and requested to complete online questionnaires on sleep and awake bruxism, emotional aspects, smoking, alcohol consumption, oral habits, facial pain and masticatory disturbances. The final study sample concerning awake and sleep bruxism included 2,347 participants.
Results: 1,019 (43.4%) participants reported not experiencing any form of bruxism (neither sleep nor awake), 809 (34.5%) reported awake bruxism, 348 (14.8%) reported sleep bruxism and 171 (7.3%) reported both sleep and awake bruxism. Multivariate analyses (Generalised Linear Model with a binary logistic dependent variable) showed that one of the prominent variables affecting the occurrence of sleep bruxism was anxiety (mild, moderate and severe anxiety, Odds Ratios (OR) of 1.38, 2.08 and 2.35, respectively). Other variables associated with sleep bruxism were stress (each point in the stress scale increased the risk of SB by 3.2%), temporomandibular symptoms (OR=2.17) and chewing difficulties (OR=2.35). Neck pain showed a negative association (OR=0.086). Multivariate analyses for awake bruxism showed an effect of moderate anxiety (OR=1.6). Other variables associated with awake bruxism were stress (each point in stress scale increased the risk of AB by 3.3%), high and low levels of facial pain (OR=2.94 and 1.53, respectively), creaks (OR= 1.85) and oral habits (OR= 1.36). Sleep bruxism was found to be a predictor for awake bruxism, and vice versa. In both cases ORs were 8.14 .
Conclusions: Among adolescents, sleep and awake bruxism are associated with emotional aspects as well as with facial pain symptoms and/or masticatory system disturbances. Awareness is recommended to decrease potential risks to teeth, dental restorations and the masticatory system.

Keywords: adolescents, Anxiety, stress, Alcohol consumption, TMD symptoms, sleep & awake bruxism, Oral habit

Received: 29 Jan 2019; Accepted: 10 Apr 2019.

Edited by:

Massimiliano Valeriani, Bambino Gesù Children Hospital (IRCCS), Italy

Reviewed by:

Marco Carotenuto, Università degli Studi della Campania Luigi Vanvitelli Caserta, Italy
Yohannes W Woldeamanuel, MD, School of Medicine, Stanford University, United States  

Copyright: © 2019 Winocur, Messer, Eli, Emodi Perlman, Kedem, Reiter and Friedman Rubin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Ephraim Winocur, Department of Oral Rehabilitation, School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Ramat, Israel, winocur@tauex.tau.ac.il