Impact of the COVID-19 pandemic on facial pain, anxiety, depression, quality of life, and awake bruxism in sleep bruxism patients, occlusal splint users

Introduction: The COVID-19 pandemic may lead to increased risk of developing or worsening bruxism and facial pain. Objective: To evaluate the influence of pandemic on adults with Sleep Bruxism (BS), both sexes, rigid occlusal splint users. Methods: Longitudinal observational study conducted in adults, both sexes, with Possible BS (n= 50), mean age 35.95 ± 10.35 years, before (T1) and during (T2) COVID-19 pandemic, in person and remotely, respectively. Presence and intensity of pain (Visual Analog Scale) in the masseter and temporal muscles and temporomandibular joint (TMJ) region, anxiety and depression (HADS), quality of life (QoL) (WHOQOL - Brief) and Awake Bruxism (AB) were assessed. Student's t- test, Mann-Whitney U-test, Wilcoxon, Pearson's chi-square and Mc-Nemar tests were applied (p<0.05). Results: The frequency of subjects with masseter, temporal and TMJ pain was 72%, 22%, 42% at T1 and 44%, 26%, 60% at T2, respectively; AB was 78% at T1 and 70% at T2. At both times pain intensity was moderate, there was absence of anxiety and depression, and QoL was regular. At T2, the frequency of subjects with masseter pain decreased 28%, domains physical, psychological and QoL mean worsened (p<0.05). The other variables showed no difference between times (p>0.05). Conclusions: During the COVID-19 pandemic, the use of rigid occlusal splints contributed to pain control in masseter muscle; anxiety and depression were absent, QoL worsened, and AB frequency remained high.Introduction: The COVID-19 pandemic may lead to increased risk of developing or worsening bruxism and facial pain. Objective: To evaluate the influence of pandemic on adults with Sleep Bruxism (BS), both sexes, rigid occlusal splint users. Methods: Longitudinal observational study conducted in adults, both sexes, with Possible BS (n= 50), mean age 35.95 ± 10.35 years, before (T1) and during (T2) COVID-19 pandemic, in person and remotely, respectively. Presence and intensity of pain (Visual Analog Scale) in the masseter and temporal muscles and temporomandibular joint (TMJ) region, anxiety and depression (HADS), quality of life (QoL) (WHOQOL - Brief) and Awake Bruxism (AB) were assessed. Student's t- test, Mann-Whitney U-test, Wilcoxon, Pearson's chi-square and Mc-Nemar tests were applied (p<0.05). Results: The frequency of subjects with masseter, temporal and TMJ pain was 72%, 22%, 42% at T1 and 44%, 26%, 60% at T2, respectively; AB was 78% at T1 and 70% at T2. At both times pain intensity was moderate, there was absence of anxiety and depression, and QoL was regular. At T2, the frequency of subjects with masseter pain decreased 28%, domains physical, psychological and QoL mean worsened (p<0.05). The other variables showed no difference between times (p>0.05). Conclusions: During the COVID-19 pandemic, the use of rigid occlusal splints contributed to pain control in masseter muscle; anxiety and depression were absent, QoL worsened, and AB frequency remained high

Assessment of awake bruxism in undergraduate students, using Ecological Momentary Assessment, through WhatsApp

This study assessed awake bruxism (AB) in undergraduate students using WhatsApp and examined the association of this behavior with quality of life and anxiety. The sample was composed of 36 healthy young adults of both genders, with an average age of 20.74 years. AB behaviors (teeth contact, teeth clenching, teeth grinding and mandible bracing) and relaxed jaw muscles were reported with Ecological Momentary Assessment, through WhatsApp, 15 times a day, for 7 days, between 8:00 am and 7:00 pm. Quality of Life (QoL) and anxiety were assessed using the SF-36 and GAD-7 questionnaires, respectively. The Mann-Whitney U non-parametric, Pearson and Spearman correlation and Pairwise non-parametric multiple comparisons 2- to-2 tests were used. The frequency of AB was 40.7%. The most frequent AB behavior was teeth contact (23.1%). Higher frequency of AB occurred on weekdays (42.3%) compared to the weekend (35.5%) (p<0.05). There was a negative correlation of AB behaviors and mandible bracing with the QoL - emotional aspects domain (p<0.05) and positive correlation of mandible bracing with anxiety (p<0.01). There was no difference between genders for QoL, anxiety and AB behaviors (p>0.05). This study highlights the importance of AB and anxiety control to improve undergraduate students’ quality of life.This study assessed awake bruxism (AB) in undergraduate students using WhatsApp and examined the association of this behavior with quality of life and anxiety. The sample was composed of 36 healthy young adults of both genders, with an average age of 20.74 years. AB behaviors (teeth contact, teeth clenching, teeth grinding and mandible bracing) and relaxed jaw muscles were reported with Ecological Momentary Assessment, through WhatsApp, 15 times a day, for 7 days, between 8:00 am and 7:00 pm. Quality of Life (QoL) and anxiety were assessed using the SF-36 and GAD-7 questionnaires, respectively. The Mann-Whitney U non-parametric, Pearson and Spearman correlation and Pairwise non-parametric multiple comparisons 2- to-2 tests were used. The frequency of AB was 40.7%. The most frequent AB behavior was teeth contact (23.1%). Higher frequency of AB occurred on weekdays (42.3%) compared to the weekend (35.5%) (p<0.05). There was a negative correlation of AB behaviors and mandible bracing with the QoL - emotional aspects domain (p<0.05) and positive correlation of mandible bracing with anxiety (p<0.01). There was no difference between genders for QoL, anxiety and AB behaviors (p>0.05). This study highlights the importance of AB and anxiety control to improve undergraduate students’ quality of life

Efficiency of mixed and rigid occlusal stabilization splints: Randomized clinical trial

Abstract Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of a low-cost, mixed occlusal splint (MOS) compared to that of a rigid splint. A randomized clinical trial was performed on 43 adults of both sexes with possible sleep bruxism and satisfactory dental conditions. They were divided into rigid occlusal splint (ROS) (n = 23) and MOS (n = 20) groups. Masticatory muscle and temporomandibular joint (TMJ) pain intensity (visual analog scale), quality of life (WHOQOL-BREF), indentations in the oral mucosa, anxiety, and depression (HADS), number of days of splint use, and splint wear were evaluated. All variables were evaluated at baseline (T0), 6 months (T6), and 12 months (T12) after splint installation (T0), and splint wear was evaluated at T6 and T12. Student’s t-test, Mann–Whitney U test, non-parametric Friedman’s analysis of variance for paired samples and pairwise multiple comparisons, Pearson’s chi-square test, two-proportion z-test, non-parametric McNemar’s and Cochran’s Q, and Wilcoxon tests were used (p < 0.05). In both groups, there was a decrease in TMJ pain and pain intensity over time and improvements in the quality of life scores. At T6, there was a higher rate of splint wear in the MOS group than in the ROS group (p = 0.023). The MOS showed a higher rate of wear than the rigid splint but had similar results for the other variables. Therefore, the use of a mixed splint appears to be effective in controlling the signs and symptoms of sleep bruxism