The prevalence of bruxism and oral parafunction activities among Israeli juveniles with autism spectrum disorder: A preliminary study during the COVID-19 pandemic.

OBJECTIVE: To evaluate the prevalence of oral habits, bruxism, and Temporomandibular Disorders (TMD) injuvenileswithautisticspectrumdisorder(ASD). METHODS: Data included 165 juveniles diagnosed with ASD, allocated to younger group aged 6 21 (n=86) and older group aged 13-21 (n=79). RESULTS: Sleep bruxism was reported by 26.7% in the younger group and by 5% in the older group. Awake bruxism was reported by 22% and 17.7%, respectively. Oral habits were reported by 43% of all participants, with similar rate in both groups. TMD related p ain was low in both groups (6.3% and 7% respectively). The influence of the COVID 19 pandemic on oral parafunction was moderate in the younger group (17.4%) and mild in the older group (8.6%), influence on bruxism was mild in both groups (5.8% and 2.5%, respectively). CONCLUSION: The prevalence of bruxism and oral parafunctions was similar to the reported in the literature for the general population.

Bruxism in Children and Adolescents and its Association with Some Possible Aetiological Factors.

Bruxism is a nocturnal parafunctional activity represented by grinding and clenching of the teeth. Bruxism is considered to be the most harmful of the parafunctional activities of the stomatognathic system, being responsible for tooth wear, periodontal lesions and joint and/or muscle lesions. This study consists of a group of 189 children (111 male and 78 female) that responded correctly and completely to a questionnaire that contained nine items assessing sleep bruxism. According to our research, there was a statistically significant association between bruxism and headache (p<0.0001), tooth/gingival sensitivity (p<0.0001), muscle stiffness, presence of stress (p<0.0001), and vicious habits. Within the limits of this study, parafunctional phenomena such as nocturnal bruxism interest an important percentage, over 60%, involving children of both genders in relatively equal proportions.

Oral behaviors in young adults: a multidimensional evaluation of the influence of personality, coping, and distress.

OBJECTIVES: This study explored the relationship of oral parafunction to the psychological variables of personality, coping, and distress. Correlates of sleeping/waking-state oral activities with the different psychological factors were also examined, along with psychological predictors for high parafunction. MATERIALS AND METHODS: Young adults from a large private university were enrolled. The frequency of oral behaviors was appraised with the oral behavior checklist (OBC), and participants were stratified into low and high parafunction (LP/HP) groups following the DC/TMD. Personality traits, coping styles, and psychological distress were assessed with the Big Five Personality Inventory-10 (BFI-10), brief-COPE Inventory (BCI), and Depression, Anxiety, Stress Scales-21 (DASS-21) correspondingly. Statistical evaluations were performed using the chi-square/Mann-Whitney U tests, Spearman's correlation, and logistic regression analyses (α = 0.05). RESULTS: Among the 507 participants (mean age 22.2 ± 1.5 years), 84.6% and 15.4% had low and high parafunction respectively. While personality profiles did not vary substantially, the HP group exhibited significantly greater emotion-focused/dysfunctional coping, general distress, depression, anxiety, and stress scores than the LP group. Associations between OBC and the various psychological variables were weak when significant or insignificant. Neuroticism and dysfunctional coping were moderately correlated to general distress, depression, anxiety, and stress (rs = 0.44-0.60/0.45-0.51). Multivariate analyses indicated that high parafunction was predicted by dysfunctional coping style (OR = 2.55) and anxiety (OR = 1.33). CONCLUSIONS: Dysfunctional coping was the main risk factor for high parafunction, increasing its odds by about 2.5 times. CLINICAL RELEVANCE: Oral parafunction appears to be a dysfunctional coping response to psychological distress.

Bruxism an issue between the myths and fact / Bruxismo, un problema entre los mitos y los hechos

Abstract Is our goal in this paper to discuss the current concepts about bruxism, a topic that has been a matter of discussion on the dental field for many years. Recent International efforts have been made to challenge bruxism old definitions; this has derivate to a consensus and an actual new concept that defines bruxism as a behavior instead of a disorder. As a behavior, it is explained in this review how it can have negative health consequences, can be innocuous and how new research support that bruxism can even be a protective factor. Different etiological factors are reviewed in this paper as well the influence of external and internal mechanism related to medications, emotional stress, systemic factors, and potential pharmacological pathways. Moreover, it is briefly summarized the role of oral appliances on sleep bruxism. Finally, clinical considerations and recommendation for the dental professional regarding sings that should be notice during the exam are part of this overview.

Resumen Es nuestro objetivo en este artículo discutir los conceptos actuales sobre el bruxismo, un tema que ha sido motivo de discusión en el campo odontológico durante muchos años. Se han hecho esfuerzos internacionales recientes para desafiar las viejas definiciones de bruxismo; esto ha derivado en un consenso y en la actualidad un nuevo concepto que define al bruxismo como un comportamiento en lugar de un trastorno. Como conducta, se explica en esta revisión cómo puede tener consecuencias negativas para la salud, puede ser inocuo y cómo nuevas investigaciones avalan que el bruxismo puede incluso ser un factor protector. En este artículo se exponen diferentes factores etiológicos, así como la influencia de mecanismos externos e internos relacionados como: medicamentos, estrés emocional, factores sistémicos y posibles vías farmacológicas. Además, se resume brevemente el papel de los aparatos orales en el bruxismo del sueño. Finalmente, se presentan consideraciones clínicas y la recomendación para el profesional en odontología con respecto a los signos que deben ser observados durante el examen clínico son parte de esta revisión.

Logistic regression analysis of the relationship between abnormal dental occlusion and temporomandibular disorders in lower grade college students / 口腔疾病防治

Objective @#To investigate the influence of abnormal occlusion factors on the incidence of temporomandibular disorders (TMDs) in junior college students and to provide an etiological basis for the prevention and treatment of TMDs.@*Methods @# We examined the temporomandibular joint (TMJ) and dental occlusion in 754 lower grade college students (male 354, female 400) at Zunyi Medical University (Zhuhai campus). A questionnaire was also administered. We analyzed the correlation between TMD and the other three factors (static abnormal occlusion, dynamical abnormal occlusion and oral parafunctional activity) from the perspective of multivariate unconditioned logistic regression and univariate unconditioned logistic regression with dummy variables.@*Results @#The prevalence of TMD was 31.7%. The incidence of TMD was significantly (P<0.05) associated with sleep bruxism (OR=2.070), clenching (OR=2.553), diurnal (OR=2.642) and anterior teeth overbite (OR=1.228). Univariate unconditioned logistics regression analysis by dummy variables was used to analyze the incidence of TMD at different deep overbites (mild, OR=1.558; moderate, OR=2.189; severe, OR=3.236; P<0.05). @*Conclusion@#The risk factors for TMD in lower grade college students included anterior teeth occlusion, sleep bruxism, clenching, and diurnal treatment. Worse deep overbite might increase the risk of TMD.

Cultural equivalence, reliability and utility of the Portuguese version of the Oral Behaviours Checklist.

BACKGROUND: Oral behaviors (OBs) must be assessed as part of a biobehavioural evaluation for patients with temporomandibular disorders (TMD). OBJECTIVES: The aims of this study were: to translate and culturally adapt the Oral Behaviors Checklist (OBC) into Portuguese; to evaluate its basic psychometric properties; and to assess the utility of the Portuguese OBC. METHODS: The Portuguese translation, cross-cultural equivalence, and two studies (Pre-field test, N = 8, and field test, N = 45) of the OBC adhered to official guidelines of the International RDC/TMD Research Consortium (now, INfORM). In the formal test (N = 120) the Portuguese RDC/TMD was used for TMD diagnosis. RESULTS: Translation and cultural equivalence of the OBC into Portuguese was reviewed and approved by an expert panel. In the field test, item agreement between English and Portuguese OBC versions was very good (weighted Kappa ≥ 0.934). Test-retest reliability of the OBCS umScore was excellent intra-class correlation coefficient ((ICC) = 0.998, P < 0.001). As an initial probe into validity using parallel forms, comparison of the sleep bruxism and awake clenching questions included in the RDC/TMD with the corresponding OBC questions yielded excellent (Kappa = 0.932) and very good (k = 0.850), respectively, convergent validity as well as excellent (that is, poor agreement, kappa = 0.013) discriminant validity for these specific OBs. The mean OBCS umScore was significantly lower for the healthy group, compared to the painful TMD group (ANOVA, P = 0.037). CONCLUSIONS: The Portuguese translation of the OBC exhibits cross-cultural equivalence for use in Portugal, and the instrument performs with acceptable psychometric properties. The validity of the parafunction construct requires additional research in both Portuguese and other languages.

The Role of Stress in the Etiology of Oral Parafunction and Myofascial Pain.

Oral parafunction during waking comprises possible behaviors that can be measured with a comprehensive checklist or behavioral monitoring. Multiple studies lead to largely consistent findings: stressful states can trigger parafunctional episodes that contribute to myofascial pain. However, this simple causal pathway coexists with at least 3 other pathways: anxiety and stress are potent direct contributors to pain, pain results in maladaptive behaviors such as parafunction, and parafunction may be a coping response to potential threat coupled with hypervigilance and somatosensory amplification. Awake parafunction remains an important risk factor for myofascial pain onset and overuse models alone of causation are insufficient.

Clinical characterization of women with burning mouth syndrome in a case-control study.

OBJECTIVE: Burning mouth syndrome (BMS) is a chronic orofacial pain disorder that is defined by a burning sensation in the oral mucosa. The aim of this study was to investigate the underlying factors, clinical characteristics and self-reported oral and general health factors associated with BMS. MATERIAL AND METHODS: Fifty-six women with BMS (mean age: 67.7) and their age-matched controls were included in the study. A general questionnaire, an OHRQL index and BMS-specific questionnaires were used. Each subject underwent an oral examination. RESULTS: The mean severity of the BMS symptoms (VAS, 0-100) was 66.2 (SD 19.7). Overall, 45% of the patients reported taste disturbances. More of the patients than the controls rated their general health, oral health and life situation as 'less satisfactory'. The patients also reported more frequently on-going medications, diseases/disorders, xerostomia, allergy and skin diseases. Except for more bruxofacets among the patients, there were no significant differences regarding signs of parafunction. In a multiple logistic regression analysis, xerostomia and skin diseases showed the strongest prediction for BMS and no significant effect was found for medication, allergy or bruxofacets. CONCLUSIONS: Skin diseases and xerostomia but not parafunction were strongly associated with BMS. Our findings provide the basis for additional studies to elucidate the causal factors of BMS.

Hábito parafuncional e disfunção temporomandibular, uma questão de gênero? / Oral parafunction and temporomandibular disorders, a matter of gender?

Introdução: as disfunções temporomandibulares (DTM) são caracterizadas por dor na região da articulação temporomandibular e região pré auricular, nos músculos mastigatórios, limitação da mobilidade articular e ruídos articulares. Fatores biomecânicos, neuromuscular, biopiscossocial e neurobiológico podem contribuir para esta disfunção. Objetivo: o propósito deste trabalho foi demonstrar a associação de hábitos parafuncionais entre os gêneros portadores da DTM. Método: realizou-se um estudo transversal com 150 sujeitos com questões estruturadas sobre hábitos parafuncionais e o Índice Anamnésico de Fonseca para classificação da DTM. Resultado e discussão: dos sujeitos tinham como pratica o habito parafuncional, 70% apresentavam algum grau de DTM sendo 82% destes do sexo feminino (p< 0,05); os hábitos orais mais prevalentes foram roer unha (34%) e mascar chicletes (30%). Considerações finais: as diferenças fisiológicas e de os papéis ocupados na sociedade deveexplicar associação do hábito parafuncional com o gênero feminino.

Introduction: Temporomandibular disorders (TMD) are characterized by pain in the region of the temporomandibular joint and pre-auricular region, in the masticatory muscles, limitation of joint mobility and articular noises. Biomechanical, neuromuscular, biopisco-social and neurobiological factors may contribute to this dysfunction. Objective: the purpose of this study was to demonstrate the association of oral parafunction among patients genres of Temporomandibular Disorders (TMD). Method: we conducted a cross-sectional study with 150 subjects with structured questions about parafunctional habits and the Fonseca Anamnesic Index for TMD classification. Results and Discussion: the subjects had to practice the parafunctional habit, 70% had some degree of TMD and 82% of females (p <0.05). The most prevalent oral habits were nailbiting (34%) and chewing gum (30%). Final remarks: physiologicaldifferences and the roles occupied in society should explain the association parafunctional habit with females.

Jaw disorders in the pediatric population.

PURPOSE: This article will review the etiology, risk factors, history, and physical assessment of temporomandibular joint disorders (TMDs). In particular, this article discusses the role of the pediatric provider in diagnosing and beginning the initial treatment of TMDs, as well as the appropriate treatment plans. It also reveals some of the controversies regarding etiology and treatment of TMDs, as well as the paucity of research specific to TMDs in pediatrics. DATA SOURCES: A computerized search in PubMed and Ovid Medline, from 2006 to 2012, was conducted. A few seminal articles were included that were published before 2006. Hand searching was also performed, which included a few articles between 2012 and 2015. CONCLUSIONS: Although TMDs are mostly found in adults, it is also a finding in pediatrics, which increases in prevalence during adolescence. More research specific to pediatric patients with TMDs needs to be conducted so that pediatric-specific care can be provided. IMPLICATIONS FOR PRACTICE: TMD is a condition found in the pediatric population, and it is important for providers to take an adequate history and physical examination that incorporates the temporomandibular joint (TMJ) and muscles of mastication. It is also critical that providers begin initial education and management, followed by appropriate referrals.

Relationship between self-reported sleep bruxism and pain in patients with temporomandibular disorders.

The aim of this study was to evaluate the association between self-reported sleep bruxism and the age, gender, clinical subtypes of temporomandibular disorders (TMD), pain intensity and grade of chronic pain in patients previously diagnosed with TMD. Thousand two-hundred and twenty patients of the Andalusian Health Service were examined using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire. The inclusion and exclusion criteria were those included in the RDC/TMD criteria. The bruxism diagnosis was drawn from the question, 'Have you been told, or do you notice that you grind your teeth or clench your jaw while sleeping at night?' in the anamnestic portion of the questionnaire. A bivariate analysis was conducted, comparing the presence of perceived parafunctional activity with age (over age 60 and under age 60), gender, different subtypes of TMD, pain intensity, grade of chronic pain and presence of self-perceived locked joints. The overall prevalence of self-reported sleep bruxism (SB) was 54.51%. A statistically significant association was found between the presence of SB and patients under age 60, women, greater pain intensity, greater pain interference with activities of daily living, and the axis-I groups affected by both muscular and articular pathology. There is a statistically significant association between self-reported sleep bruxism and women under age 60 who have painful symptoms of TMD. There is also a positive association between this parafunctional habit and the presence of chronic pain. However, more studies that cover larger samples and differentiate between sleep bruxism and awake bruxism are needed.

Parafunciones y caries dentales en preescolares de comunidades pehuenches / Parafunctions and decay in preschool children from pehuenches communities

Introducción: las parafunciones bucales son consideradas uno de los factores causales de los trastornos temporomandibulares que han tomado mucha relevancia en las últimas décadas, especialmente en poblaciones infanto-juveniles, aunque la evidencia en preescolares es escasa y nula en grupos indígenas. El objetivo del presente estudio es determinar la prevalencia de parafunciones bucales y presencia de caries en preescolares de comunidades pehuenches, de la comuna de Alto Biobio, la más pobre de Chile, así como su posible relación con características etnodemográficas y socioeconómicas. Métodos: se tomó una muestra que estuvo conformada por 71 niños de 2 a 5 años los cuales asisten a jardín infantil. Se contó con la autorización de las autoridades locales y el consentimiento informado de los padres. Se evaluaron variables socio-etnodemográficas, presencia de caries en dientes temporales (índice ceod) de acuerdo con los criterios de la Organización Mundial de la Salud y la presencia de 8 parafunciones bucales: succión digital, de objetos, de mamadera, de chupete, labial, interposición lingual, onicofagia y respiración bucal mediante encuesta a las educadoras de los jardines. Resultados: el 9,86 por ciento de preescolares estaba libre de caries y el ceod fue 6,83 ± 4,65, lo que aumenta con la edad, 2,8 (a los 2 años) y 8,23 (a los 5 años). El promedio de parafunciones bucales por preescolar fue 1,73 ± 1,06, significativamente mayor en mujeres, pehuenches y preescolares de extrema pobreza. La prevalencia para alguna de las 8 parafunciones bucales fue de 90,86 por ciento y 77,46 por ciento para las asociadas a succión. Las más prevalentes son succión de mamadera y labial (26,76 por ciento), onicofagia (29,58 por ciento) y succión digital (47,89 por ciento). Conclusiones: la presencia de caries en estos preescolares es muy alta, mientras que la prevalencia de parafunciones bucales es similar a otras poblaciones, lo que afecta más a preescolares de extrema pobreza y pehuenches, posiblemente relacionado con las condiciones de vulnerabilidad social de la comuna. Estos resultados resaltan la urgencia de implementar medidas promocionales, preventivas y terapéuticas en esta población(AU)

Introduction: Oral parafunctions are considered one of the causal factors of temporomandibular disorders and have gained importance in recent decades, especially in child and young populations, although evidence is scarce in the preschool children and nonexistent in the indigenous groups. The objectives of this study were to determine the prevalence of oral parafunctions and the presence of caries in pehuenche preschool children, from Alto Biobio commune , the poorest one in Chile, as well as the possible association of the ethnodemographic and the socioeconomic characteristics. Methods: A sample comprised 71 children from 2 to 5 years attending kindergarten; the permission of local authorities and the informed consent of parents were granted. Socio-ethno-demographic variables, decay presence in primary teeth (dmft index) according to WHO criteria and the presence of 8 oral parafunctions: finger sucking, object sucking, sucking on bottle, pacifier and lip sucking, tongue thrust, onychophagia and mouth breathing, were all evaluated through a survey made to kindergarten educators. Results: Of the studied children, 9.86 percent were caries-free and the dmft index was 6.83 ±4.65, increasing with the age, hence, it was 2.8 at age 2 and 8.23 at age 5. Oral parafunctions average was 1.73 ±1.06 per child, significantly higher in women, pehuenches and extremely poor children. Prevalence for any of the 8 oral parafunctions was 90.86 percent and for those associated with non-nutritive sucking was 77.46 percent. The most prevalent were bottle and labial sucking (26.76 percent), onychophagia (29.58 percent) and finger sucking (47.89 percent). Conclusions: Decay presence in these preschool children is very high, whereas the prevalence of oral parafunctions is similar to that of other populations, affecting more children in extreme poverty setting and pehuenches. All this is possibly related to the social vulnerability of the commune. These results highlighted the urgent need of implementing preventive, promotional and therapeutic strategies in this population(AU)