Statement of problem
The relationship of awake bruxism with pain is still unclear.
The purpose of this clinical study was to evaluate awake bruxism behavior for 1 week in healthy young adults with ecological momentary assessment, assess its relationship with masticatory muscle tenderness, and the participation of endogenous analgesia.
Material and methods
A total of 150 healthy participants were provided with a smartphone application that sent 10 alerts at random intervals every day. The participants were instructed to report in real time which of the following awake bruxism behaviors best represented their current condition: relaxed jaw muscles, tooth contact, tooth clenching, tooth grinding, or jaw bracing. At baseline, participants underwent recordings of the pressure pain threshold and conditioned pain modulation of the masticatory muscles. Pressure pain threshold recording was also repeated on the last day of the study. A t test was used to compare the first and the last pressure pain threshold recording after 1 week with an ecological momentary assessment evaluation. The Pearson correlation test was performed to evaluate the correlation between variables (α=.05).
Overall compliance was 75.9%. The average frequency of relaxed jaw muscles was 54.5%, tooth contact 29.4%, jaw bracing 5.8%, tooth clenching 9.7%, and tooth grinding 0.6%. The average frequency of a distinct awake bruxism behavior was 45.5%. A statistically significant increase in pressure pain threshold values was found (P=.001; P=.001; P=.045 for right and left anterior temporalis and left masseter, respectively). No significant correlation was found between the frequency of awake bruxism behaviors, the pressure pain threshold, and conditioned pain modulation (P>.05).
The most prevalent behavior was tooth contact (29.4%). No relationship was found between awake bruxism behaviors and masticatory muscle tenderness or endogenous analgesia.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Prosthetic Dentistry
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Epidemiology of bruxism in adults: a systematic review of the literature.J Orofac Pain. 2013; 27: 99-110
- International consensus on the assessment of bruxism: report of a work in progress.J Oral Rehabil. 2018; 45: 837-844
- Bruxism defined and graded: an international consensus.J Oral Rehabil. 2013; 40: 2-4
- Current concepts of bruxism.Int J Prosthodont. 2017; 30: 437-438
- Role of psychosocial factors in the etiology of bruxism.J Orofac Pain. 2009; 23: 153-166
- Frequency of awake bruxism behaviours in the natural environment. A 7-day, multiple-point observation of real-time report in healthy young adults.J Oral Rehabil. 2018; 45: 423-429
- Sleep bruxism: current knowledge and contemporary management.J Conserv Dent. 2016; 19: 383-389
- Ecological momentary assessment (EMA) in behavioral medicine.Annals of Behavioral Medicine. 1994; 16: 199-202
- Smartphone-based evaluation of awake bruxism behaviours in a sample of healthy young adults: findings from two University centres.J Oral Rehabil. 2021; 48: 989-995
- Awake bruxism frequency and psychosocial factors in college preparatory students.Cranio. 2020; 14: 1-7
- Ecological momentary assessment and intervention principles for the study of awake bruxism behaviors, Part 1: general principles and preliminary data on healthy young Italian adults.Front Neurol. 2019; 10: 169
- Ecological momentary assessment in health psychology.Health Psychol. 1998; 17: 3-5
- Capturing momentary, self-report data: a proposal for reporting guidelines.Ann Behav Med. 2002; 24: 236-243
- Ecological momentary assessment (EMA) in studies of substance use.Psychol Assess. 2009; 21: 486-497
- Smartphone-based application for EMA assessment of awake bruxism: compliance evaluation in a sample of healthy young adults.Clin Oral Investig. 2020; 24: 1395-1400
- Nonfunctional tooth contact in healthy controls and patients with myogenous facial pain.J Orofac Pain. 2007; 21: 185-193
- The association of self-reported awake bruxism with anxiety, depression, pain threshold at pressure, pain vigilance, and quality of life in patients undergoing orthodontic treatment.J Appl Oral Sci. 2020; 28e20190407
- Relationship between bruxism and temporomandibular disorders: a systematic review of literature from 1998 to 2008.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109: e26-e50
- Jaw muscle soreness after tooth-clenching depends on force level.J Dent Res. 2010; 89: 717-721
- Quantitative sensory testing in the German research network on neuropathic pain (DFNS): standardized protocol and reference values.Pain. 2006; 123: 231-243
- Reliability of mechanical sensitivity mapping in the orofacial region of healthy Chinese individuals: Towards standardized assessment of somatosensory function.J Oral Facial Pain Headache. 2018; 32: 400-408
- Quantitative sensory testing of periauricular skin in healthy adults.Sci Rep. 2020; 10: 3728
- Pressure algometry.Aust J Physiother. 2007; 53: 207
- Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions—A taskforce report.J Oral Rehabil. 2011; 38: 366-394
- Deficiency in endogenous modulation of prolonged heat pain in patients with irritable bowel syndrome and temporomandibular disorder.Pain. 2009; 143: 172-178
- Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states.Curr Opin Anaesthesiol. 2010; 23: 611-615
- Conditioned pain modulation in temporomandibular disorders (TMD) pain patients.Exp Brain Res. 2014; 232: 3111-3119
- Conditioned pain modulation in populations with chronic pain: a systematic review and meta-analysis.J Pain. 2012; 13: 936-944
- Differential Diagnosis and Management of TMDs. Guidelines for Assessment, Diagnosis, and Management.6th ed. Quintessence, Chicago2018: 143-207
- Quantitative sensory testing: a comprehensive protocol for clinical trials.Eur J Pain. 2006; 10: 77-88
- Recommendations on practice of conditioned pain modulation (CPM) testing.Eur J Pain. 2015; 19: 805-806
- Sympathetic nervous system activity during skin cooling in humans: relationship to stimulus intensity and pain sensation.J Physiol. 1992; 454: 359-371
- Neurosensory assessment in patients with total reconstruction of the temporomandibular joint.Int J Oral Maxillofac Surg. 2014; 43: 1096-1103
- Contact heat-evoked temporal summation: tonic versus repetitive-phasic stimulation.Pain. 2006; 122: 295-305
- Pressure pain threshold in the detection of masticatory myofascial pain: an algometer-based study.J Orofac Pain. 2005; 19: 318-324
- Perceived stress and bruxism in university students.BMC Res Notes. 2016; 9: 514
- The effect on timing of self-monitoring behavior on reducing cigarette consumption.J Behav Ther & Exp Psychiat. 1974; 5: 301-303
- Sleep bruxism and pain.Dent Clin North Am. 2018; 62: 657-663
- Relationships between craniofacial pain and bruxism.J Oral Rehabil. 2008; 35: 524-547
- Symptoms in different severity degrees of bruxism: a cross-sectional study.Fisioter Pesq. 2016; 23: 423-430
- Symptoms and physiological responses to prolonged, repeated, low-level tooth clenching in humans.Headache. 2015; 55: 381-394
- Quantitative sensory responde of the SCM muscle on sustained low level activation simulating co-contractions during bruxing.Arch Oral Biol. 2018; 86: 87-93
Published online: April 15, 2023
Publication stageIn Press Corrected Proof
Funding: Supported by the National Council for Scientific and Technological Development (CNPq), Brazil [Finance Code 001; MSc Scholarship of Dyanne Medina Flores; Process 99729118.6.0000.5417].
© 2023 by the Editorial Council for The Journal of Prosthetic Dentistry.