Sleep Bruxism Could Play a Role in TMD Diagnoses

Dentistry Today


Temporomandibular disorders (TMD) and sleep bruxism (SB) are destructive to the masticatory system, though the link is unclear, prompting researchers at the UTHealth School of Dentistry (UTSD) at Houston to assess the relationship between them via groups of patients with TMD only and with TMD and SB.

The researchers conducted a retrospective chart review via axiUm, UTSD’s electronic health system, to look at patients with a chief complaint of jaw pain referred to and seen at UT Dentists, the school’s faculty group practice, between November 1, 2015, and April 1, 2018.

The review looked at patients with completed International Network for Orofacial Pain and Related Disorders Methodology history questionnaires and Diagnostic Criteria for Temporomandibular Disorder clinical examinations. In total, 52 patients, including 12 with TMD only and 40 with TMD and SB, met the study’s criteria.

The researchers investigated descriptions and measurements of patient symptoms. They also conducted a statistical analysis using chi squared, also known as an X2 test, which compares two variables in a contingency table to see if they are related. They used Fisher’s exact test as well, a statistical assessment used to determine if there are nonrandom associations between two categorical variables.

The results showed that patients who had TMD with SB reported a significantly higher number and/or frequency of oral behaviors such as clenching and grinding during sleep and waking hours as well as oral habits such as prolonged chewing gum, compared with patients who had TMD only. Patients who had TMD with SB also exhibited significantly more signs and symptoms of headache attributed to TMD compared with patients who had TMD only.

The researchers concluded that their results provided clinical evidence that clinicians need to diagnose and treat patients with TMD and SB. Clinicians also should consider SB while making the diagnosis in patients with temporal headaches attributed to TMD, the researchers said.

The study, “When Should Sleep Bruxism Be Considered in the Diagnosis of Temporomandibular Disorders?” was published by Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology.  

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