The intensity of awake bruxism episodes is increased in individuals with high trait anxiety
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ORIGINAL ARTICLE
The intensity of awake bruxism episodes is increased in individuals with high trait anxiety Madonna Rofaeel 1 & Jeffrey Chi-Fai Chow 1 & Iacopo Cioffi 1 Received: 7 September 2020 / Accepted: 16 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives Trait anxiety is associated with an increased occurrence of awake bruxism episodes, a behavior characterized by clenching of the teeth contributing to temporomandibular disorders in some individuals. Here we measured the activity of the masseter and the intensity and duration of spontaneous wake-time tooth clenching episodes in healthy individuals with different levels of trait anxiety (TA). Materials and methods Two hundred fifty-five individuals completed a web survey. Using their TA scores, we allocated them in low (< 20th percentile of the TA score distribution), intermediate (between 20th and 80th ), and high (> 80th) TA groups. We analyzed the electromyographic (EMG) activity of the right masseter during a 15-min silent reading task in forty-three individuals with low (n = 12), intermediate (n = 17), and high TA (n = 14). We tested between-group differences in EMG activity of the masseter, as well as postural activity—the muscular activity that maintains mandibular posture, and amplitude and duration of spontaneous tooth clenching episodes. Results The activity of the masseter (mean ± SEM %maximum voluntary contraction/MVC) was greater in the high TA (10.23 ± 0.16%MVC) than the intermediate (8.49 ± 0.16%MVC) and low (7.97 ± 0.22%MVC) TA groups (all p < 0.001). Postural activity did not differ between groups (all p > 0.05). The EMG amplitude of tooth clenching episodes was greater in the high TA (19.97 ± 0.21 %MVC) than the intermediate (16.40 ± 0.24%MVC) and low (15.48 ± 0.38 %MVC) TA groups (all p < 0.05). The cumulative duration of clenching episodes was not different between groups (p = 0.390). Conclusions Increased TA is associated with both increased masseter muscle activity and intensity of wake-time tooth clenching episodes. Clinical relevance TA may contribute significantly to masticatory muscle overload. Keywords Masseter . Trait anxiety . Awake bruxism . Tooth clenching . Surface electromyography . Temporomandibular joint disorders
Introduction Awake bruxism—an oral behavior characterized by repetitive or sustained tooth contact (i.e., tooth clenching) and/or by bracing or thrusting of the mandible [1]—is important to identify clinically as it could contribute to the onset of painful temporomandibular disorders (TMD) and dental wear [1–3] in some individuals.
* Iacopo Cioffi [email protected] 1
Centre for Multimodal Sensorimotor and Pain Research, Faculty of Dentistry, University of Toronto, 123 Edward St, Room 501, Toronto, ON M5G 1E2, Canada
There is substantial evidence indicating that oral behaviors and awake bruxism are affected by mood states, such as anxiety [1, 4–8]. Anxiety is a temporary state characterized by feelings of unease, worry, tension, and stress in face o
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