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Teeth Grinding: Is Emotional Stability related to Bruxism?

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Angelina R Sutin at Florida State University
Angelina R Sutin
Antonio Terracciano
Antonio Terracciano
Antonio Terracciano
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Luigi Ferrucci
Luigi Ferrucci
Luigi Ferrucci
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Paul Costa at Duke University Medical Center
Paul Costa
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Abstract

This study examines the association between personality traits and bruxism, the repetitive grinding or clenching of teeth. Community-dwelling participants (N = 470) had a comprehensive oral examination by a dentist and completed a dental history and personality questionnaires. Consistent with the literature on state anxiety and depression as antecedents of bruxism, Neuroticism-related traits were associated with self-reported teeth grinding. These traits were also associated with other oral complaints often associated with anxiety (jaw clicks, difficulty chewing food, and dry mouth), but not with more general oral health complaints (unhealthy gums, bleeding gums, and canker sores) or with dentist-assessed occlusal wear or tongue indentations. This study provides evidence for the association between Neuroticism and bruxism and other stress-related oral health symptoms.
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Teeth Grinding: Is Emotional Stability related to Bruxism?
Angelina R. Sutin, Antonio Terracciano, Luigi Ferrucci, and Paul T. Costa Jr.
National Institute on Aging, NIH, DHHS
Abstract
This study examines the association between personality traits and bruxism, the repetitive grinding
or clenching of teeth. Community-dwelling participants (N = 470) had a comprehensive oral
examination by a dentist and completed a dental history and personality questionnaires. Consistent
with the literature on state anxiety and depression as antecedents of bruxism, Neuroticism-related
traits were associated with self-reported teeth grinding. These traits were also associated with other
oral complaints often associated with anxiety (jaw clicks, difficulty chewing food, and dry mouth),
but not with more general oral health complaints (unhealthy gums, bleeding gums, and canker sores)
or with dentist-assessed occlusal wear or tongue indentations. This study provides evidence for the
association between Neuroticism and bruxism and other stress-related oral health symptoms.
Keywords
Emotional Stability; Bruxism; Teeth Grinding; Personality; Anxiety
Bruxism is the clinical term for the grinding or clenching of teeth while asleep (Lavigne,
Khoury, Abe, Yamaguchi, & Raphael, 2008). The consequences of chronic bruxism are many,
ranging from a sore jaw, facial pain, and irritating one’s sleeping partner, to exposing the inner
layers of teeth from the repetitive wearing away of enamel, tooth loss, hearing loss, and
temporomandibular joint disorder. While this relatively common sleep disorder is thought to
have a complex etiology, many have noted psychological antecedents. In particular, bruxism
seems to be more severe during periods of heightened stress and anxiety. The extent to which
bruxism is associated with stable individual differences in the tendency to experience negative
emotions, however, have yet to be investigated.
The grinding of teeth has long been held as one physical manifestation of stress and anxiety.
For example, individuals who grind their teeth tend to report more symptoms of anxiety and
depression than non-bruxers (Gungormus & Erciyas, 2009; Manfredini, Landi, Romagnoli, &
Bosco, 2004). And, compared to non-bruxers, those who grind their teeth tend to report greater
life stress and are more likely to suffer from DSM-defined depression and anxiety disorders
(Ohayon, Li, & Guilleminault, 2001). Even in rats, experimentally inducing emotional stress
leads to brux-like symptoms, compared to controls (Rosales et al., 2002).
The association between bruxism and acute symptoms of anxiety and depression, as well as
its relation to mood disorders raises the possibility that, in non-clinical populations, teeth
grinding may also be associated with stable individual differences in the tendency to experience
negative emotions (i.e., Neuroticism-related personality traits). Although most research has
focused on acute anxiety and depression, there is some evidence that trait somatic anxiety and
muscular tension are associated with chronic bruxism (Kampe, Edman, Bader, Tagdae, &
Address correspondence to: Angelina R. Sutin, Ph.D., Laboratory of Personality and Cognition, National Institute on Aging, NIH, DHHS,
251 Bayview Blvd., Baltimore, MD 21224, 410-558-8691, sutina@mail.nih.gov.
NIH Public Access
Author Manuscript
J Res Pers. Author manuscript; available in PMC 2011 June 1.
Published in final edited form as:
J Res Pers. 2010 June ; 44(3): 402–405. doi:10.1016/j.jrp.2010.03.006.
NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript
Karlsson, 1997). In the present research, we examine whether the two subscales of the Guilford-
Zimmerman Temperament Scale (GZTS) most closely related to Neuroticism, Emotional
Stability and Objectivity, are associated with bruxism. In addition to self-reported teeth
grinding, we also test whether dentist-assessed physical evidence of damage that is commonly
attributed to bruxism, occlusal wear and tongue indentations, are associated with these two
traits.
Because individuals high in Neuroticism-related traits tend to report more somatic complaints
in general (Costa & McCrae, 1987), we also examine whether Emotional Stability and
Objectivity are associated with other oral health complaints often associated with anxiety (jaw
clicks, difficulty chewing food, and dry mouth) and to more general oral health complaints
(unhealthy gums, bleeding gums, and canker sores). That is, if Neuroticism-related traits lead
individuals to report more complaints in general, we should see associations across different
aspects of subjective oral health. Emotional Stability and Objectivity may, however, correlate
more strongly with anxiety-related oral manifestations than with general oral complaints.
Finally, we examine whether these traits are associated with other dentist-assessed measures
of the health of the teeth and gums.
Method
Participants
Participants were community-dwelling volunteers drawn from the Baltimore Longitudinal
Study of Aging (BLSA), an ongoing multidisciplinary study of aging. A total of 470
participants (43% female; mean age = 55.67 [SD = 16.79]) completed a dental history
questionnaire and had at least one personality assessment. Of these participants, a total of 385
participants (41% female; mean age = 55.80 [SD = 16.53]) also underwent the dental
examination.
Dental assessment
Participants completed a detailed history of oral-hygiene habits, dental treatment, and
subjective complaints. Here we focus on subjective complaints. First, participants were asked
whether they grind their teeth at night. Response options were no, yes, occasionally, not sure,
and not applicable. In addition to bruxism, we examined a number of subjective complaints
that are typically associated with anxiety, including jaw clicks, difficulties chewing food, and
dry mouth, as well as more general oral health complaints, including unhealthy gums, bleeding
gums, and canker sores. Specifically, participants were asked, “Does your jaw ever make a
clicking sound?” (jaw clicks) “Do you have any difficulties chewing food?” (difficulty
chewing), “Do you feel that your mouth is frequently dry?” (dry mouth), “Do you feel that
your gums are healthy?” (reversed scored; unhealthy gums), “Do your gums bleed on
brushing?” (gums bleed), and “As an adult, do you ever get canker sores in your
mouth?” (canker sores). Items were scored as the presence (1) or absence (0) of these
complaints. Correlations among these subjective measures ranged from −.08 (ns) for dry mouth
and gums bleed to .20 (p < .05) for unhealthy gums and gums bleed.
Participants also underwent a comprehensive oral examination by a professional dentist (Baum,
1981). In the present research we focus primarily on the presence and severity of occlusal wear
and evidence of tongue indentations. Occlusal wear refers to the wearing down of enamel which
can result from excessive pressure from the clenching or grinding of teeth. Tongue indentations
are evidence of biting that can also result from teeth grinding. The dentist noted whether any
occlusal wear present was slight, moderate, or severe, and the presence or absence of tongue
indentations.
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We also examined a number of other dentist assessments of oral health: the gingival index,
which is an assessment of the severity of gingivitis (gum inflammation), the DMFT index,
which is the number of decayed, missing, or filled teeth in the mouth, the number of teeth with
moderate to severe erosion, and the number of filled cavities. Correlations among these dentist
assessments ranged from −.33 (p < .05) for tongue indentations and the DMFT index to .27
(p < .05) for coronal restorations and the DMFT index.
Personality assessment
The GZTS (Guilford, Zimmerman, & Guilford, 1976) is a factor-based personality
questionnaire consisting of 300 items, 30 for each of the 10 GZTS scales. For each item,
participants chose between “yes,” “no,” and “?.” Any scale with more than three “?” responses
was considered missing, a procedure suggested by Guilford and colleagues. Therefore, small
variations in the number of participants will be seen in the analyses for different scales. Raw
scores ranged from 0 to 30.
The GZTS scales are valid and reliable (Guilford et al., 1976). Internal consistency coefficients
range from 0.75 to 0.87 (median = 0.80). In the BLSA, the structural stability of the GZTS has
been shown across age, cohort, and time-of-measurement (McCrae, Costa, & Arenberg,
1980). Retest stability coefficients for men ranged from 0.64 to 0.78 (median = 0.68) over an
average interval of 16 years, and retest coefficients for women ranged from 0.68 to 0.78 over
an average interval of 11 years (median = 0.71) (Terracciano, McCrae, & Costa, in press).
Personality (GZTS) was collected during regularly scheduled visits, for men starting in October
1958, and for women in January 1978, and continuing until May 2002. In the present research,
because the personality assessment was generally not completed at the same time as the dental
examination, we ran all of our analyses twice – once with the participant’s first assessment of
personality and again with each individual’s average score across all available personality
assessments between 1958 and 2002.
Results
Self-reported bruxism
Consistent with the estimated 20% prevalence in the general population (Lavigne et al.,
2008), approximately 22% of the current sample reported that they grind their teeth at night,
whereas 67% of participants reported that they did not. The remaining 11% either were not
sure, bruxed occasionally, or did not have teeth; these participants were not included in the
analyses. Controlling for sex, age at the dental exam, and education, participants who scored
higher on either Emotional Stability or Objectivity were less likely to report that they grind
their teeth (see Table 1). The findings were similar for the mean across all assessments of
Emotional Stability and Objectivity (see Table 1). Thus, participants who scored higher on
Neuroticism-related traits were more likely to report that they are bruxers.
Physical evidence of bruxism
We next turn to evidence of physical damage caused by bruxism: occlusal wear and tongue
indentations. Approximately 66% of the sample had moderate or severe occlusal wear and
approximately 50% of the sample had tongue indentations. In contrast to the self-reported
bruxism, neither Emotional Stability nor Objectivity was associated with either occlusal wear
or tongue indentations (see Table 1).
Other traits
For the sake of comparison, we report the significant associations between bruxism and the
other eight scales of the GZTS. The first assessment of Sociability, but not the mean of
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assessments, was associated with less self-reported teeth grinding (OR = .98, 95% CI = .95–.
99 and .97, 95% CI = .93–1.01, ns). Sociability was also associated with less occlusal wear
(OR = .96, 95% CI = .94–.99 and OR = .95, 95% CI = .91–.99, respectively, for first and mean
assessment). In addition, both the first assessment and the mean across assessments of
Friendliness were also associated with self-reported teeth grinding (OR = .97, 95% CI = .95–.
99 and OR = .94, 95% CI = .90–.99, respectively). Tongue indentations were not associated
with any of the GZTS traits.
Other markers of oral health
Finally we examined the association between the Neuroticism-related traits and other
subjective and objective markers of oral health. In the present study, 20% of participants
reported jaw clicks, 13% reported difficulty chewing food, 20% reported dry mouth, 23%
reported unhealthy gums, 22% reported that their gums bleed, and 50% reported canker sores.
Both Emotional Stability and Objectivity were associated with anxiety-related oral health
complaints: Participants who scored low on these traits were more likely to report that their
jaw makes a clicking sound, that they had difficulty chewing food, and that they often had a
dry mouth (see Table 2). Both Emotional Stability and Objectivity, however, were unrelated
to the more general oral somatic complaints we assessed: unhealthy gums, bleeding gums, and
canker sores. Finally, neither Emotional Stability nor Objectivity was associated with dentist-
assessed gingivitis (median r = .00, ns), the DMFT index (median r = .01, ns), or the number
of teeth with moderate to severe erosion (median r = −.02, ns). The first assessment of
Objectivity correlated positively with the number of filled cavities (r = .11, p < .05); this
association did not replicate across the mean of Objectivity assessments or with Emotional
Stability (median r = .05, ns).
Discussion
In this study we examined whether two traits related to Neuroticism, Emotional Stability and
Objectivity, were associated with self-reported and physical evidence of teeth grinding. Both
traits were associated with bruxism: Individuals who scored high on either Emotional Stability
or Objectivity were less likely to report that they grind their teeth. These two traits were also
associated with other anxiety-related oral symptoms, but were unrelated to more global, self-
reported oral complaints. Neither trait, however, was related to the physical damage to teeth
or the tongue often attributed to bruxism, nor were they related to dentist-assessed health of
the teeth and gums.
Although psychological factors are routinely implicated in teeth grinding, previous research
has focused primarily on state anxiety, depression, and life stress, rather than on stable
individual differences in the tendency to experience negative emotions. Limited evidence from
small samples suggests that the association between trait anxiety and bruxism starts in
childhood (Restrepo, Vásquez, Alvarez, & Valencia, 2008) and persists into adulthood (Kampe
et al., 1997). Much of this research, however, has relied on pathological bruxism, rather than
the more common teeth grinding found in the general population. The present research supports
the association between Neuroticism-related traits and bruxism in a community-dwelling
sample.
Individuals high on Neuroticism-related traits consistently report more somatic complaints
than individuals low on Neuroticism. The association, however, between Neuroticism and
physical illness is much weaker than its association with somatic complaints; this discrepancy
suggests that trait Neuroticism biases symptom reporting (Costa & McCrae, 1987). The present
research is consistent with this argument: Participants high on Neuroticism-related traits
reported that they grind their teeth, but there was no physical evidence to support their self-
reported bruxism.
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Yet, in the current study, the association between the Neuroticism-related traits and subjective
oral health was limited to symptoms commonly associated with stress and anxiety, not to
complaints more generally. Specifically, in addition to bruxism, individuals suffering from
anxiety also often report other oral-related symptoms, including difficulties with chewing/
swallowing food and dry mouth (American Psychiatric Association, 1994), and jaw-related
problems are often associated with bruxism (Lavigne et al., 2008). Individuals high on
Neuroticism-related traits may report more oral complaints because they do indeed suffer more
from physical manifestations of anxiety. If the findings in the current study were solely due to
the biased symptom reporting characteristic of these individuals, then Emotional Stability and
Objectivity should also have been associated with more general oral health complaints, such
as bleeding gums. They were not.
In addition, there is now growing evidence that Neuroticism is not all bark, but does indeed
have some bite. For example, Neuroticism is associated with higher circulating levels of
physiological biomarkers of inflammation (Sutin et al., in press) and even mortality
(Terracciano, Löckenhoff, Zonderman, Ferrucci, & Costa, 2008). Both inflammation and
mortality are objective measures untainted by self-report biases. The failure to find physical
evidence of bruxism in the current study may be due more to our dental measures than to a
lack of association. The use of occlusal wear as a marker of bruxism has been criticized because
the magnitude of wear on a tooth is affected by many factors, including enamel density and
saliva quality (Lavigne et al., 2008). And indeed, in the current study, self-reported teeth
grinding was unrelated to either occlusal wear (r = .09, ns) or tongue indentations (r = .08,
ns). Other measures of bruxism, such as spousal reports or electronic monitoring devices that
can measure the occurrence and severity of teeth grinding, may be more valid measures than
observed physical damage to the teeth and tongue.
Interestingly, we did find congruence between self-reported bruxism and physical damage for
one of the other traits on the GZTS: Those high on Sociability were less likely to report suffering
from teeth grinding and, likewise, their teeth had less occlusal wear. This effect, however, may
be driven more by those low on Sociability. Low-sociable individuals have low tolerance for
social interaction, may become anxious when forced to be around other people, and are often
characterized as shy or timid (Guilford et al., 1976). Although Sociability is most strongly
related to the Gregariousness facet of Extraversion (Terracciano, McCrae, & Costa, 2006), it
is also has a strong negative correlation with the Self-Consciousness facet of Neuroticism. As
such, this social discomfort may contribute to the psychological stress that can lead to bruxism.
The present research has several strengths, including a relatively large community-dwelling
sample and dentist-assessed physical evidence of bruxism. Several limitations, however, need
to be addressed in future research. First, as mentioned above, additional objective measures of
bruxism are needed to ensure accurate evidence of teeth grinding; our dental assessment did
not specifically target bruxism damage. Second, measures of both state and trait negative
emotionality will help to clarify the role of stable traits versus environmental stressors as
antecedents of bruxism. Finally, although our community sample is an improvement over the
clinical samples typically used in bruxism research, participants were generally well-educated
and in good health. These participants may have better oral hygiene habits and better access
to dentists that would minimize damage due to bruxism. Future research on personality and
bruxism would benefit from more representative samples. Despite these limitations, we offer
the first evidence that bruxism is associated with not just acute symptoms of anxiety and
depression, but also with stable traits that measure susceptibility to negative emotions in a non-
clinical community population.
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Acknowledgments
This research was supported entirely by the Intramural Research Program of the NIH, National Institute on Aging.
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Sutin et al. Page 7
Table 1
Logistic Regressions Predicting Self-reported Grinding, Occlusal Wear, and Tongue Indentations from
Neuroticism-related Personality Traits
Traits Self-reported grinding Occlusal wear Tongue indentations
Emotional Stability
First assessment .97 (.95–.99)*.99 (.96–1.01) 1.00 (.98–1.02)
Mean .94 (.90–.99)*.99 (.95–1.03) .99 (.95–1.03)
Objectivity
First assessment .97 (.95–.99)*.99 (.97–1.02) 1.02 (.99–1.04)
Mean .94 (.89–.99)*.98 (.93–1.04) 1.04 (.99–1.10)
Note. ns range from 390 to 418 for self-reported grinding, ns range from 355 to 380 for occlusal wear, and ns range from 341 to 369 for tongue
indentations. The logistic regressions control for sex, age at dental exam, and education.
*p < .05.
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Sutin et al. Page 8
Table 2
Logistic Regressions Predicting Anxiety-related and General Oral Health Complaints from Neuroticism-related Personality Traits
Traits Anxiety-related General
Jaw clicks Difficulty chewing Dry mouth Unhealthy gums Gums bleed Canker sores
Emotional Stability
First assessment .97 (.95–.99)*.97 (.94–.99)*.97 (.95–.99)*.98 (.96–1.01) 1.00 (.98–1.02) 1.01 (.99–1.03)
Mean .93 (.89–.98)*.91 (.87–.96)*.95 (.91–.99)*.97 (.92–1.01) 1.00 (.96–1.04) 1.02 (.98–1.05)
Objectivity
First assessment .99 (.96–1.01) .98 (.95–1.01) .95 (.93–.98)*.99 (.97–1.02) 1.00 (.98–1.02) 1.00 (.98–1.02)
Mean .95 (.89–1.00) .93 (.87–.99)*.88 (.83–.94)*.99 (.93–1.04) 1.00 (.95–1.05) 1.00 (.95–1.04)
Note. ns range from 385 to 414 for jaw clicks, ns range from 436 to 470 for difficulty chewing, ns range from 394 to 420 for dry mouth, ns range from 351 to 380 for unhealthy gums, ns range from 349 to 377
for gums bleed, ns range from 431 to 465 for canker sores. The logistic regressions control for sex, age at dental exam, and education.
*p < .05.
J Res Pers. Author manuscript; available in PMC 2011 June 1.
... Estima-se que cerca de 20% da população apresente bruxismo diurno, enquanto cerca de 10% manifeste bruxismo noturno. Geralmente, as pessoas que sofrem de bruxismo diurno tendem a apertar os dentes, enquanto no bruxismo noturno tanto o aperto quanto o ranger ocorrem simultaneamente (Sutin et al., 2010;Aguilera, Brown, Perico, 2017). ...
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  • Mar 2025
  • PAK J MED SCI
Objective: To identify psychiatric symptoms and diagnoses in pediatric burn intensive care patients and to retrospectively evaluate their relationship with the severity of the burn injury. Methods: Eighty-five cases for whom psychiatric consultation was requested in the Pediatric Burn Intensive Care Unit, Ankara Child Health, Hematology, and Oncology Training and Research Hospital between January 2013 to January 2017 were included. The relationships between clinical data from burn assessments and psychiatric symptoms were analyzed retrospectively. Results: Psychiatric pathology was identified in 57 cases admitted to the burn intensive care unit. Among the cases with identified psychiatric pathology, it was found that 50.8 % (n=29) received a diagnosis of acute stress disorder, while 40.3 % were diagnosed with post- traumatic stress disorder (n=23). In the comparison of cases with and without psychiatric pathology, no significant relationship was found with the percentage of burn surface area. The frequency of post-traumatic stress disorder was 14 times higher in cases with teeth grinding (p=0.022). Conclusion: Psychiatric pathology can also emerge in cases with a small burn area. Therefore, the significant role of child psychiatry in the treatment of children hospitalized in burn centers should not be overlooked, and awareness of this process should be increased. doi: https://doi.org/10.12669/pjms.41.4.11307 How to cite this: Kulice EC, Senel E, Akcay E, Dinc GS. Psychiatric evaluation: an important component of multidisciplinary approach in pediatric burns . Pak J Med Sci. 2025;41(4):1164-1169. doi: https://doi.org/10.12669/pjms.41.4.11307 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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... A significant association was found between emotional stress and bruxism, although no significant difference was found in the effect of type of work (office work or patrol) on the occurrence of bruxism. Sutin et al. (16) concluded that 22% of subjects developed bruxism during sleep, 67% were confirmed nonbruxists and for 11% no positive or negative result can be confirmed. People with emotional stability did not report bruxism, while those with high neuroticism scores showed a greater predisposition to bruxism. ...
The Relationship between Bruxism and Types of Personality. Α Literature Review
Article
Full-text available
  • Feb 2025
Bruxism is a parafunctional habit with a multifactorial etiology, involving a variety of contributing factors. This study aims to investigate the relationship between personality traits and the manifestation of bruxism. Through a thorough review of the literature and an analysis of keywords such as "bruxism," "personality," "psychopathological profile," "craniomandibular disorders," and "stress," the study examines how different personality characteristics are associated with bruxism. The review's findings indicate that bruxism is not merely a physical condition but is closely linked to psychological, social, and behavioral factors within the broader framework of personality traits. Notable correlations were found between bruxism and factors such as anxiety, neuroticism, and intense emotional states like frustration and anger. Conversely, emotional stability seems to provide a protective effect against the development of bruxism. Insights into these psychosocial factors can significantly enhance therapeutic approaches and contribute to preventing the worsening of bruxism.
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... Two studies conducted on adult subjects demonstrated an association between high tongue-to-tooth pressure and the presence of tongue indentation. [20][21][22] This higher pressure was found in subjects who reported bruxism activity 21,23 and was more prominent in subjects with large tongues. 20 However, the examination of bruxism relies on the subject's report (self-report) without any confirmation by polysomnography or electromyography, which are the gold standard for examining sleep and awake bruxism. ...
Intra- and Extraoral Signs of Probable Bruxism (Scoping Review)
Article
Full-text available
  • May 2022
Bruxism is a repetitive masticatory muscle activity that has received attention in dental literature for its association with dental restoration failures, orofacial pain, neurological disease, and obstructive sleep apnea. As a determining factor in the diagnosis, parameters regarding the type and classification of intraoral and extraoral signs of probable bruxism are needed. This study aimed to identify the intraoral and extraoral signs of bruxism in the literature. A literature search was performed in the National Library of Medicine (PubMed) to identify all the articles published assessing intra and extraoral signs of bruxism. The selected articles were then screened and structurally read by three persons and summarized in PICO tables. Out of 551 initially retrieved references, 39 articles met the inclusion criteria and were thus included in the scoping review. The studies were divided into six categories based on the type of oral signs: buccal mucosa ridge (n=4), masseter hypertrophy (n=3), tongue indentation (n=4), tooth fracture (n=5), torus mandibularis (n=3), and tooth wear (n=20). This study concluded that the available studies utilize various methods in subjective and clinical data collection. Buccal mucosa ridge, tongue indentation, and torus mandibularis were common in subjects with bruxism. The association of masseter hypertrophy and tooth fracture with bruxism is not conclusive. Although studies on tooth wear in bruxism subjects are the most prevalent among other oral signs, no study has been able to establish a direct link between bruxism and tooth wear.
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... The possible association between bruxism and short-term signs of depression and anxiety as well as its link to mood disorders suggests that grinding teeth may also be connected to a person's way of experiencing unpleasant emotions (36). A significant association between bruxism and personality traits was not seen in the present study. ...
The relationship between personality traits, dental anxiety, and self-reported bruxism among health professional students: A cross-sectional study
Article
Full-text available
  • Nov 2023
Introduction: Dental anxiety proves to be the hurdle for dental care, making self-awareness among the population more crucial. Similarly, bruxism has also been reported to be due to stress, but the pathophysiology has not been clearly understood. The current research aims to explore the association of personality traits with bruxism and dental anxiety among health professional students. Methods: A total of 120 dental and medical students were included in our study. All the participants received three different questionnaires: The “modified dental anxiety scale” questionnaire to measure dental anxiety, the “modified bruxism assessment questionnaire” to assess the presence of bruxism, and “the big five inventory” to identify the personality trait. The collected data were statistically evaluated with significance at p < 0.05. Results: Comparison of dental anxiety among professional students showed significantly (p < 0.001) higher anxiety among medical than dental students. Analyzing the prevalence of bruxism revealed awake bruxism to be significantly (p < 0.05) higher in males than females. On analyzing the relation between personality traits and dental anxiety, a positive correlation was seen between the neuroticism type of personality (r = 0.193, p < 0.05) and dental anxiety, especially in females. Conclusion: The prevalence of self-reported awake bruxism was higher among male students, indicating the necessity for more investigation to ascertain the influence of various psychological factors. The correlation between dental anxiety and neuroticism type of personality trait points out the importance of identifying these individuals in a clinical setting and implementing strategies to reduce anxiety and enhance motivation for treatment.
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... 37 In addition to acute anxiety symptoms, susceptibility to negative emotions is also a risk factor for bruxism. 38 Zofia Maciejewska Zaniec et al. found that the gene mutation associated with stress coping may be related to the susceptibility to awake bruxism. 39 In addition, a study found that patients with sleep bruxism had higher levels of oxidative stress than healthy controls. ...
A worldwide bibliometric analysis of the research trends and hotspots of bruxism in adults during 1991-2021
Article
  • Aug 2023
  • J ORAL REHABIL
Background and objectives: With the increasing attention to bruxism, the research on bruxism is increasing rapidly. However, there is still a lack of systematic bibliometric analysis in the field of bruxism in adults. This study aimed to comprehensively explore and visualize the global trends and research hotspots in the field of bruxism in adults during 1991-2021. Methods: The study searched the literature published during 1991-2021 in the Web of Science Core Collection database without language restrictions. VOSviewer, CiteSpace and Microsoft Excel were applied to analyse the authors, institutions, journals, countries, cited references, keywords and other information of the included publications, and construct visualized cooperation networks. Results: A total of 878 articles were finally included. The top two most productive authors in the past 30 years were Lobbezoo F and Manfredini D. ACTA-Amsterdam, Univ Sao Paulo, Univ Helsinki, Univ Padua, Univ Montreal, et al. were prominent institutions in this field. Journal of Oral Rehabilitation made outstanding contributions in this field. The United States produced the most documents in this field, followed by Brazil. Both countries and authors cooperated closely around the world. The two most cited articles focused on the definition, assessment and classification of bruxism. In recent years, diagnostic criteria and stress have begun to receive a lot of attention. Conclusion: From 1991 to 2021, the attention to bruxism in adults continued to increase. Diagnostic criteria and stress may be potential research hotspots in this field. This study references relevant scholars on development trends and research hotspots.
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Anterior aesthetics without dysfunction: a case report. Part 2: the prosthodontic conversion
Article
  • Mar 2025
Marketing cosmetic dentistry is financially fashionable. Anterior aesthetic reconstructions are an art form showcasing the dental technician's skill. There is a perceived concern that anterior reconstructions that do not consider the functional features of the mutually protected occlusion may, in susceptible patients, lead to dysfunction with its possible consequences. Part 1 described a case in which severe anterior tooth wear was restored using compomers for the palatal surfaces, and composites anteriorly to provide acceptable aesthetics. The compomers were used so the patient could relatively easily fashion this ‘softer’ material during parafunction. This provided a pattern of anterior guidance within the patient's ability to adapt. Once adequate time was allowed to ensure the guidance was not dysfunctional, it was copied and replicated onto an incisal guidance table for future use. This article deals with the conversion of the guidance to fixed prosthodontic work. CPD/Clinical Relevance: Transfer of anterior guidance; telescopic crowns and planning for failure.
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Prevalence of Oral Normal Variances in Cigarette Factory Workers in Lamongan, Indonesia
Article
Full-text available
  • Jan 2024
Objective This study aims to observe the distribution of oral normal variances in cigarette factory workers. An essential aspect of diagnosing oral mucosal lesions is differentiating between abnormalities and normal oral variances. Workers from cigarette factories tend to neglect their oral health because of their occupational environment. Lack of awareness in identifying oral mucosal conditions led to poor oral health of cigarette factory worker. Materials and Methods A cross-sectional study; the sample population included 101 cigarette factory workers who participated in oral screening. The predictor variables in this study included all oral normal variances. Results The prevalence of oral normal variances in this study was as the following: torus palatinus (62.38%), crenated tongue (51.49%), coated tongue (46.53%), linea alba buccalis (37.62%), fissured tongue (25.74%), prominent Stensen's duct (17.82%), lingual varix (9.90%), ankyloglossia (4.95%), torus mandibularis (3.96%), Fordyce's spots (1.98%), frictional keratosis (1.98%), and macroglossia (0.99%). Conclusion Top three common normal oral variances among cigarette factory workers are torus palatinus followed by crenated tongue and coated tongue.
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Sleep Bruxism in Children: A Narrative Review
Article
  • Sep 2023
Sleep bruxism, characterized by involuntary grinding or clenching of the teeth and/or by bracing or thrusting of the mandible during sleep, is common in children. Sleep bruxism occurs while the patient is asleep. As such, diagnosis can be difficult as the affected child is usually unaware of the tooth grinding sounds. This article aims to familiarize physicians with the diagnosis and management of sleep bruxism in children. A search was conducted in May 2023 in PubMed Clinical Queries using the key terms “Bruxism” OR “Teeth grinding” AND “sleep”. The search strategy included all observational studies, clinical trials, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. According to the International classification of sleep disorders, the minimum criteria for the diagnosis of sleep bruxism are (1) the presence of frequent or regular (at least three nights per week for at least three months) tooth grinding sounds during sleep and (2) at least one or more of the following (a) abnormal tooth wear; (b) transient morning jaw muscle fatigue or pain; (c) temporary headache; or (d) jaw locking on awaking. According to the International Consensus on the assessment of bruxism, “possible” sleep bruxism can be diagnosed based on self-report or report from family members of tooth-grinding sounds during sleep; “probable” sleep bruxism based on self-report or report from family members of tooth-grinding sounds during sleep plus clinical findings suggestive of bruxism (e.g., abnormal tooth wear, hypertrophy and/or tenderness of masseter muscles, or tongue/lip indentation); and “definite” sleep bruxism based on the history and clinical findings and confirmation by polysomnography, preferably combined with video and audio recording. Although polysomnography is the gold standard for the diagnosis of sleep bruxism, because of the high cost, lengthy time involvement, and the need for high levels of technical competence, polysomnography is not available for use in most clinical settings. On the other hand, since sleep bruxism occurs while the patient is asleep, diagnosis can be difficult as the affected child is usually unaware of the tooth grinding sounds. In clinical practice, the diagnosis of sleep bruxism is often based on the history (e.g., reports of grinding noises during sleep) and clinical findings (e.g., tooth wear, hypertrophy and/or tenderness of masseter muscles). In childhood, sleep-bruxism is typically self-limited and does not require specific treatment. Causative or triggering factors should be eliminated if possible. The importance of sleep hygiene cannot be over-emphasized. Bedtime should be relaxed and enjoyable. Mental stimulation and physical activity should be limited before going to bed. For adults with frequent and severe sleep bruxism who do not respond to the above measures, oral devices can be considered to protect teeth from further damage during bruxism episodes. As the orofacial structures are still developing in the pediatric age group, the benefits and risks of using oral devices should be taken into consideration. Pharmacotherapy is not a favorable option and is rarely used in children. Current evidence on the effective interventions for the management of sleep bruxism in children is inconclusive. There is insufficient evidence to make recommendations for specific treatment at this time.
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Intra-individual Change in Personality Stability and Age
Article
Full-text available
  • Feb 2010
The stability of individual differences in personality traits is typically examined at the group level with test-retest correlations across two assessments. For 684 subjects (age range 17-76) we computed individual coefficients from three sequential assessments to evaluate intra-individual (i.e., within-person) change in stability over time. For both trait and profile (ipsative) stability, results indicate that intra-individual stability increases up to age 30 and then plateaus. Neither demographic variables (sex, ethnicity, education, and secular trends), nor the standing on the five major dimensions of personality, were predictors of change in trait stability. Contrary to results from studies of adolescents, personality "maturity" was unrelated to personality stability in adulthood. These findings support the notion that personality stability plateaus early in adulthood.
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High Neuroticism and Low Conscientiousness Are Associated with Interleukin-6
Article
Full-text available
  • Dec 2009
  • PSYCHOL MED
High Neuroticism and low Conscientiousness are frequently implicated in health-risk behaviors, such as smoking and overeating, as well as health outcomes, including mortality. Their associations with physiological markers of morbidity and mortality, such as inflammation, are less well documented. The present research examines the association between the five major dimensions of personality and interleukin-6 (IL-6), a pro-inflammatory cytokine often elevated in patients with chronic morbidity and frailty. A population-based sample (n=4923) from four towns in Sardinia, Italy, had their levels of IL-6 measured and completed a comprehensive personality questionnaire, the NEO-PI-R. Analyses controlled for factors known to have an effect on IL-6: age; sex; smoking; weight; aspirin use; disease burden. High Neuroticism and low Conscientiousness were both associated with higher levels of IL-6. The findings remained significant after controlling for the relevant covariates. Similar results were found for C-reactive protein, a related marker of chronic inflammation. Further, smoking and weight partially mediated the association between impulsivity-related traits and higher IL-6 levels. Finally, logistic regressions revealed that participants either in the top 10% of the distribution of Neuroticism or the bottom 10% of conscientiousness had an approximately 40% greater risk of exceeding clinically relevant thresholds of IL-6. Consistent with the literature on personality and self-reported health, individuals high on Neuroticism or low on Conscientiousness show elevated levels of this inflammatory cytokine. Identifying critical medical biomarkers associated with personality may help to elucidate the physiological mechanisms responsible for the observed connections between personality traits and physical health.
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Evaluation of the Relationship between Anxiety and Depression and Bruxism
Article
Full-text available
This study examined the relationship between anxiety, depression and bruxism in 99 patients with temporomandibular disorders (TMD). Patients were divided into two groups: 58 patients with bruxism and 41 without bruxism. Symptoms of TMD were evaluated according to the Craniomandibular Index. The psychological condition of patients was assessed using the Beck Depression Inventory (BDI), the Hospital Anxiety Depression Scales (HADS) and the Hamilton Anxiety Rating Scale (HAMA). The mean anxiety and depression scores (HADS and HAMA) for patients with bruxism were statistically significant higher in patients with bruxism compared with those without bruxism. Thus, there may be an association between bruxism and higher levels of anxiety and/or depression in patients with TMD.
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Neuroticism, Somatic Complaints, and Disease: Is the Bark Worse than the Bite?
Article
Full-text available
  • Jul 1987
Perhaps because negative emotions are frequently expressed in physiological reactions, psychosomatic theories have often identified Neuroticism and its component traits (including anxiety, anger, and depression) as causal influences on the development of disease. These views are apparently supported by correlations between physical symptom reports and measures of Neuroticism in males. Data from 347 adult women in the Baltimore Longitudinal Study of Aging replicate this finding for total physical complaints and for most body systems. However, analyses of mortality in the literature and in the present article show no influence of Neuroticism, suggesting that symptom reporting may be biased by Neuroticism-related styles of perceiving and reporting physiological experiences. Researchers in this area are urged to employ objective measures of medical status, and to be alert to possible biases of self-selection and selective perception in interpreting associations between Neuroticism and disease.
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Constancy of Adult Personality Structure in Males: Longitudinal, Cross-sectional and Times-of-measurement Analyses
Article
Full-text available
  • Dec 1980
  • J Gerontol
Constancy or change in adult personality organization can be assessed by comparing the factor structure of personality instruments at different ages, and some studies have reported cross-sectional differences in structure. The present study compares the factor structure of the Guilford-Zimmerman Temperament Survey scales longitudinally in three administrations 6 years apart and cross-sectionally in three age cohorts. Additional analyses compare first administration data collected in two successive decades to test for variation in structure resulting from cultural change over that period. Subjects were 769 male volunteers in the Baltimore Longitudinal Study of Aging, aged 17 to 97 at the time of the first administration. Three varimax-rotated principal components were extracted in each of eight analyses. Results show no systematic evidence of variation in structure in any of these groups, with coefficients of factor congruence ranging from .83 to .99. This longitudinally demonstrated invariance of personality structure is discussed in terms of the implications for the stability of personality organization throughout the adult years and for the use of personality tests in elderly groups.
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Emotional stress and brux-like activity of the masseter muscle in rats
Article
  • Feb 2002
The aim of this study was to further clarify the relationship between emotional stress and bruxism. In experiment 1, 60 male 9‐week‐old Wistar rats were divided into four groups: the emotionally stressed (ES), the emotionally non‐stressed (NS), the electrically foot‐shocked (FSd), and the non‐foot‐shocked (NSd). ES rats were confined in a communication box for one hour a day to observe the emotional responses of neighbouring FSd rats. On days 0, 1, 4, 8, and 12, the electromyographic activity of the ES and NS rats' left masseter muscles was recorded for one hour, three hours after confinement in the communication box. Brux‐like activity appeared in the masseter muscle of the ES group on days 1, 4, 8, and 12, but not in the NS group. In experiment 2, 36 male Wistar rats, 9 weeks old, were divided into three groups: emotionally stressed rats treated with an anti‐anxiety drug (DES), emotionally stressed rats treated with saline as a vehicle (VES), and 24 FSd rats. Stress and EMG procedures were the same as those in experiment 1. Brux‐like episodes decreased in DES rats from day 1 and significant differences were found on days 4 ( P < 0.01), 8 ( P < 0.05), and 12 ( P < 0.05), when compared with the VES group. These findings suggest that emotional stress induces brux‐like activity in the masseter muscle of rats, which was reduced with anti‐anxiety drugs.
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Characteristics of participants in the oral physiology component of the BLSA
Article
  • Jul 1981
This report describes a variety of demographic, socioeconomic and dental characteristics of 254 (145 male, 109 female) participants in a longitudinal study of oral physiology and aging. All individuals are part of the U.S. National Institute on Aging's Baltimore Longitudinal Study of Aging. Subjects are generally in middle to upper middle socioeconomic strata, well educated and in good health (about 75% not taking prescription medication). Most participants practice regular oral hygiene habits and receive regular and comprehensive dental care. Less than 4% of all subjects are edentulous and the average number of natural teeth present for all participants was about 23. Data are presented on DMFT scores, cervical caries (active an restored) scores and gingival and periodontal disease indices for male by age group (20-39, 40-59, 60-88 years) and for females by menopause status (pre-, post-).
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Personality traits in a group of patients with long-standing bruxing behavior
Article
  • Sep 1997
The personality pattern of 29 subjects, 10 men and 19 women, with a mean age of 37.7 years (range 23-68) was studied by means of a personality inventory (KSP) and compared with the personality traits of a 'normal population'. The bruxers had significantly higher scores in the somatic anxiety and muscular tension scales and lower scores in the socialization scale; that is, the bruxers were more anxiety-prone, had higher vulnerability for psychosomatic disorders and were less socialized. The frequent clenchers (once to twice a week) comprised a special subgroup within the material with higher values in the somatic anxiety, psychic anxiety and muscular tension scales. A strong correlation was found between high values in the muscular tension scale and headache; aching neck, back, throat or shoulders; tooth clenching; number of muscles tender at palpation and the clinical dysfunction index (Di). The results of this study indicate a possible aetiological relationship between personality, tooth clenching and craniomandibular dysfunction (CMD). However, the material was small and some precaution must be taken prior to generalization of the results. Studies on larger material are needed and especially more studies in sleep laboratories.
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Risk Factors for Sleep Bruxism in the General Population*
Article
  • Jan 2001
Sleep bruxism can have a significant effect on the patient's quality of life. It may also be associated with a number of disorders. However, little is known about the epidemiology of sleep bruxism and its risk factors in the general population. Cross-sectional telephone survey using the Sleep-EVAL knowledge based system. Representative samples of three general populations (United Kingdom, Germany, and Italy) consisting of 158 million inhabitants. Thirteen thousand fifty-seven subjects aged > or = 15 years (United Kingdom, 4,972 subjects; Germany, 4,115 subjects; and Italy, 3,970 subjects). None. Clinical questionnaire on bruxism (using the International Classification of Sleep Disorders [ICSD] minimal set of criteria) with an investigation of associated pathologies (ie, sleep, breathing disorders, and psychiatric and neurologic pathologies). Grinding of teeth during sleep occurring at least weekly was reported by 8.2% of the subjects, and significant consequences from teeth grinding during sleep (ie, muscular discomfort on awakening, disturbing tooth grinding, or necessity of dental work) were found in half of these subjects. Moreover, 4.4% of the population fulfilled the criteria of ICSD sleep bruxism diagnosis. Finally, subjects with obstructive sleep apnea syndrome (odds ratio [OR], 1.8), loud snorers (OR, 1.4), subjects with moderate daytime sleepiness (OR, 1.3), heavy alcohol drinkers (OR, 1.8), caffeine drinkers (OR, 1.4), smokers (OR, 1.3), subjects with a highly stressful life (OR, 1.3), and those with anxiety (OR, 1.3) are at higher risk of reporting sleep bruxism. Sleep bruxism is common in the general population and represents the third most frequent parasomnia. It has numerous consequences, which are not limited to dental or muscular problems. Among the associated risk factors, patients with anxiety and sleep-disordered breathing have a higher number of risk factors for sleep bruxism, and this must raise concerns about the future of these individuals. An educational effort to raise the awareness of dentists and physicians about this pathology is necessary.
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Emotional stress and brux-like activity of the masseter muscle in rats
Article
  • Mar 2002
The aim of this study was to further clarify the relationship between emotional stress and bruxism. In experiment 1, 60 male 9-week-old Wistar rats were divided into four groups: the emotionally stressed (ES), the emotionally non-stressed (NS), the electrically foot-shocked (FSd), and the non-foot-shocked (NSd). ES rats were confined in a communication box for one hour a day to observe the emotional responses of neighbouring FSd rats. On days 0, 1, 4, 8, and 12, the electromyographic activity of the ES and NS rats' left masseter muscles was recorded for one hour, three hours after confinement in the communication box. Brux-like activity appeared in the masseter muscle of the ES group on days 1, 4, 8, and 12, but not in the NS group. In experiment 2, 36 male Wistar rats, 9 weeks old, were divided into three groups: emotionally stressed rats treated with an anti-anxiety drug (DES), emotionally stressed rats treated with saline as a vehicle (VES), and 24 FSd rats. Stress and EMG procedures were the same as those in experiment 1. Brux-like episodes decreased in DES rats from day 1 and significant differences were found on days 4 (P < 0.01), 8 (P < 0.05), and 12 (P < 0.05), when compared with the VES group. These findings suggest that emotional stress induces brux-like activity in the masseter muscle of rats, which was reduced with anti-anxiety drugs.
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