Evaluation of correlation among sleep bruxism and depression levels, chronic pain and nonspecific physical symptoms according to axis II of the Research Diagnostic Criteria/ Temporomandibular disorders

Resumo

Sleep Bruxism (SB) is considered as a parasomnia
and defined as a stereotyped movement disorder characterized by
grinding (eccentric), hitting or shaking (central) of teeth while sleeping
unconsciously, and classified according to their etiology in primary
(idiopathic) or secondary (associated with medical or psychiatric
conditions) of multifactorial etiology. Certain risk factors such as
alcohol/tobacco, caffeine, use of certain medications, conditions
associated with sleep, psychological factors, among others, may trigger
or enhance certain oral parafunctions. Objective: The present study
aimed to observe statistically the existence of a possible correlation
between SB and psychological aspects studied by the Research
Diagnostic Criteria/Temporomandibular disorders (RDC/TMD):
chronic pain, depression, nonspecific physical symptoms (NSPS)
including pain, NSPS excluding pain. Material and methods: 50
patients with SB and 49 patients without SB were assessed, aged
between 18 and 70 years at the TMD/Orofacial Pain Clinics of
the School of Dentistry, Federal University of Juiz de Fora. These individuals were investigated by RDC Axis II on the severity levels
of chronic pain, depression, nonspecific physical symptoms (NSPS)
including pain, NSPS excluding pain, to verify the correlation of
these variables with the SB. Results: There was a statistically
significant correlation between BS and chronic pain severity (p =
0.001), and SB and NSPS including pain (p = 0.026), and SB and
NSPS excluding pain (p = 0.018). There was no significant correlation
between SB and depression. Regarding the severity of chronic pain,
there was a higher prevalence of grade 2 (79.60%) in patients with
BS and grade 1 (52%) in the patients without SB. According to the
other assessed levels, a greater severity of psychological aspects
evaluated by RDC/TMD were seen in patients with BS and more
normal levels in patients without SB. Conclusion: Levels of chronic
pain severity, nonspecific physical symptoms with or without pain
(somatization) appeared as aspects involved in sleep bruxism. These
findings emphasize the importance of an accurate assessment of
the parafunction etiology for each case, which often requires a
multidisciplinary approach.