Changes in self-reported sleep and awake bruxism in relation to the management of temporomandibular disorders (“care as usual”) in a specialty clinic population

Background. The treatment of temporomandibular disorders (TMD) often includes the management of sleep bruxism (SB) and awake bruxism (AB). However, few studies have investigated how SB and AB change after the initiation of the interventions aimed at reducing the activity of masticatory muscles in TMD patients. Objectives. The aim of the present study was to investigate changes in self-reported SB and/or AB with regard to baseline at 6 weeks after receiving TMD treatment, i.e., counseling alone or counseling combined with any other treatment, and to investigate the association between the type of TMD treatment and changes in self-reported SB and/or AB. Material and methods. A total of 68 TMD patients were included in this prospective study, and they all received counseling. Thirty-three of the 68 patients received additional treatment, e.g., physical therapy, psychological therapy and/or an oral appliance, beside counseling. The self-reported SB and AB frequency values were obtained from the Oral Behavior Checklist (OBC) questionnaire at baseline (t₀) and at week 6 after receiving treatment (t₁). The frequency of SB and AB was assessed as SB, AB-grinding, AB-clenching, AB-bracing, and AB-combined (i.e., the maximum frequency of all AB types combined). The Wilcoxon signed-rank test was used to compare the SB and AB frequency at t₀ and t₁ in patients who received counseling alone and those who received counseling combined with other treatment. The χ² test was used to investigate the association between the type of TMD treatment and changes in SB and/or AB. Results. The frequency of self-reported SB and all types of AB did not change in patients who received counseling only. In contrast, there was a significant increase in the frequency of AB-bracing and AB-combined between t₀ and t₁ in patients who received counseling combined with other treatment. Conclusions. No changes in the frequency of self-reported SB and all types of AB were found in patients who received counseling only. However, patients who received counseling combined with other treatment showed a significant increase in the frequency of AB-bracing and AB-combined as compared to baseline.