Document Type : Original Article


1 Professor, Department of Oral Medicine, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran

2 Dentist, Private Practice, Kerman, Iran

3 Resident, Department of General Surgery, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran



BACKGROUND AND AIM: The habit of grinding teeth together is called grinding and the scientific term is “bruxism”. Bruxism usually occurs in deep sleep or when the person is under stress. This motivates the authors to investigate the relationship between stress and anxiety with the rate of free informed bruxism in the present work.
METHODS: This research was a cross-sectional study and the population under analysis was adults over 18 years of age who referred to dental clinics of Kerman, Iran, and also people who accompanied them (simple census). The ethical approval code was IR.KMU.REC.1399.321. The investigations included questioning the patients about the history of bruxism and clenching. The information was analyzed by chi-square test, using SPSS software with 0.05 confidence level.
RESULTS: The prevalence of self-reported bruxism was 23.2% and 15.1% among women and men, respectively. The percentage of clenching alone was 27.3%, and it was 23.5% and 25.6% in women and men, respectively. The prevalence of bruxism and clenching together was 9.8 %. In patients suffering from bruxism, the prevalence of temporomandibular signs was 24.6%, the feeling of fatigue, stiffness, or pain after awakening was 23.5%, temporomandibular joint (TMJ) sound was 6.9%, and limitation in mouth opening was 8.8%. In patients suffering from clenching, TMJ sound was 5.8%, oral pain was 8.8%, and limitation in mouth opening was 10.5%. Between 365 respondents, people who were aware of their bruxism significantly reported more anxiety.
CONCLUSION: Based on the present findings, self-reported bruxism, anxiety, and stress may be associated with each other.


Main Subjects

  1. Wassell R, Naru A, Steele J, Nohl F. Applied occlusion. London, UK: Quintessence; 2008. p. 26–30.
  2. Manfredini D, Winocur E, Guarda-Nardini L, Paesani D, Lobbezoo F. Epidemiology of bruxism in adults: A systematic review of the literature. J Orofac Pain 2013; 27(2): 99-110.
  3. Shetty S, Pitti V, Satish Babu CL, Surendra Kumar GP, Deepthi BC. Bruxism: A literature review. J Indian Prosthodont Soc 2010; 10(3): 141-8.
  4. Lobbezoo F, van der Zaag J, van Selms MK, Hamburger HL, Naeije M. Principles for the management of bruxism. J Oral Rehabil 2008; 35(7): 509-23.
  5. Lobbezoo F, van der Zaag J, Naeije M. Bruxism: its multiple causes and its effects on dental implants - an updated review. J Oral Rehabil 2006; 33(4): 293-300.
  6. Persaud R, Garas G, Silva S, Stamatoglou C, Chatrath P, Patel K. An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions. JRSM Short Rep 2013; 4(2): 10.
  7. Scully C. Oral and maxillofacial medicine: The basis of diagnosis and treatment. Edinburgh, UK: Churchill Livingstone; 2008. p. 291-2, 343, 353, 359, 382.
  8. Lobbezoo F, Naeije M. Bruxism is mainly regulated centrally, not peripherally. J Oral Rehabil 2001; 28(12): 1085-91.
  9. Manfredini D, Lobbezoo F. Role of psychosocial factors in the etiology of bruxism. J Orofac Pain 2009; 23(2): 153-66.

10. Pettengill CA. Interaction of dental erosion and bruxism: The amplification of tooth wear. J Calif Dent Assoc 2011; 39(4): 251-6.

11. Huynh N, Kato T, Rompre PH, Okura K, Saber M, Lanfranchi PA, et al. Sleep bruxism is associated to micro-arousals and an increase in cardiac sympathetic activity. J Sleep Res 2006; 15(3): 339-46.

12. Ahlberg K, Jahkola A, Savolainen A, Kononen M, Partinen M, Hublin C, et al. Associations of reported bruxism with insomnia and insufficient sleep symptoms among media personnel with or without irregular shift work. Head Face Med 2008; 4: 4.

13. Ahlberg J, Rantala M, Savolainen A, Suvinen T, Nissinen M, Sarna S, et al. Reported bruxism and stress experience. Community Dent Oral Epidemiol 2002; 30(6): 405-8.

14. Ahlberg K, Ahlberg J, Kononen M, Partinen M, Lindholm H, Savolainen A. Reported bruxism and stress experience in media personnel with or without irregular shift work. Acta Odontol Scand 2003; 61(5): 315-8.

15. Elo AL, Leppanen A, Jahkola A. Validity of a single-item measure of stress symptoms. Scand J Work Environ Health 2003; 29(6): 444-51.

16. Sjoholm TT, Piha SJ, Lehtinen I. Cardiovascular autonomic control is disturbed in nocturnal teethgrinders. Clin Physiol 1995; 15(4): 349-54.

17. de la Hoz-Aizpurua JL, Diaz-Alonso E, LaTouche-Arbizu R, Mesa-Jimenez J. Sleep bruxism. Conceptual review and update. Med Oral Patol Oral Cir Bucal 2011; 16(2): e231-e238.

18. Ahlberg J, Lobbezoo F, Ahlberg K, Manfredini D, Hublin C, Sinisalo J, et al. Self-reported bruxism mirrors anxiety and stress in adults. Med Oral Patol Oral Cir Bucal 2013; 18(1): e7-11.

19. Akhavan Abiri F, Shairi MR. Validity and reliability of Symptom Checklist-90-Revised (SCL-90-R) and Brief Symptom Inventory-53 (BSI-53). Clinical Psychology and Personality 2020; 17(2): 169-95. [In Persian].

20. Cohen S, Doyle WJ, Skoner DP. Psychological stress, cytokine production, and severity of upper respiratory illness. Psychosom Med 1999; 61(2): 175-80.

21. Winocur E, Uziel N, Lisha T, Goldsmith C, Eli I. Self-reported bruxism - associations with perceived stress, motivation for control, dental anxiety and gagging. J Oral Rehabil 2011; 38(1): 3-11.

22. Liddell A, Locker D. Gender and age differences in attitudes to dental pain and dental control. Community Dent Oral Epidemiol 1997; 25(4): 314-8.

23. Ciancaglini R, Gherlone EF, Radaelli G. The relationship of bruxism with craniofacial pain and symptoms from the masticatory system in the adult population. J Oral Rehabil 2001; 28(9): 842-8.

24. Carlsson GE, Egermark I, Magnusson T. Predictors of bruxism, other oral parafunctions, and tooth wear over a 20-year follow-up period. J Orofac Pain 2003; 17(1): 50-7.

25. Glaros AG, Tabacchi KN, Glass EG. Effect of parafunctional clenching on TMD pain. J Orofac Pain 1998; 12(2): 145-52.

26. Choi YS, Choung PH, Moon HS, Kim SG. Temporomandibular disorders in 19-year-old Korean men. J Oral Maxillofac Surg 2002; 60(7): 797-803.

27. Chen YQ, Cheng HJ, Yu CH, Gao Y, Shen YQ. Epidemic investigation on 3 to 6 years children's bruxism in Shanghai. Shanghai Kou Qiang Yi Xue 2004; 13(5): 382-4. [In Chinese].

28. Demir A, Uysal T, Guray E, Basciftci FA. The relationship between bruxism and occlusal factors among seven- to 19-year-old Turkish children. Angle Orthod 2004; 74(5): 672-6.

29. Shirani AM, Maleki L. Relation of oral parafunction habits and signs and symptoms of temporomandibular disorders. J Isfahan Dent Sch 2007; 2(4): 35-40. [In Persian].

30. Blasberg B, Greenberg MS. Temporomandibular disorders. In: Greenberg MS, Glick M, Ship JA, editor. Burket's oral medicine. 11th ed. Hamilton, ON: BC Decker Inc; 2015. p. 223-55.

31. Pullinger AG, Seligman DA, Gornbein JA. A multiple logistic regression analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features. J Dent Res 1993; 72(6): 968-79.

32. Gavish A, Halachmi M, Winocur E, Gazit E. Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescent girls. J Oral Rehabil 2000; 27(1): 22-32.

33. Barbosa TS, Miyakoda LS, Pocztaruk RL, Rocha CP, Gaviao MB. Temporomandibular disorders and bruxism in childhood and adolescence: Review of the literature. Int J Pediatr Otorhinolaryngol 2008; 72(3): 299-314.

34. Carvalho AL, Cury AA, Garcia RC. Prevalence of bruxism and emotional stress and the association between them in Brazilian police officers. Braz Oral Res 2008; 22(1): 31-5.

35. Lurie O, Zadik Y, Einy S, Tarrasch R, Raviv G, Goldstein L. Bruxism in military pilots and non-pilots: Tooth wear and psychological stress. Aviat Space Environ Med 2007; 78(2): 137-9.

36. Lavigne GJ, Khoury S, Abe S, Yamaguchi T, Raphael K. Bruxism physiology and pathology: An overview for clinicians. J Oral Rehabil 2008; 35(7): 476-94.

37. Restrepo CC, Vasquez LM, Alvarez M, Valencia I. Personality traits and temporomandibular disorders in a group of children with bruxing behaviour. J Oral Rehabil 2008; 35(8): 585-93.

38. Rompre PH, Daigle-Landry D, Guitard F, Montplaisir JY, Lavigne GJ. Identification of a sleep bruxism subgroup with a higher risk of pain. J Dent Res 2007; 86(9): 837-42.

39. Manfredini D, Fabbri A, Peretta R, Guarda-Nardini L, Lobbezoo F. Influence of psychological symptoms on home-recorded sleep-time masticatory muscle activity in healthy subjects. J Oral Rehabil 2011; 38(12): 902-11.

40. Ohayon MM, Li KK, Guilleminault C. Risk factors for sleep bruxism in the general population. Chest 2001; 119(1): 53-61.