Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil.
Departamento e Instituto de Psiquiatria (LIM-23), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
Clin Oral Investig. 2024 Feb 16;28(2):152. doi: 10.1007/s00784-024-05534-4.
The present study aimed to investigate the association between self-reported awake/sleep bruxism, and orofacial pain with post-traumatic stress disorder (PTSD).
A case-control study with a convenience sample was designed. Participants were recruited from a university-based Trauma Ambulatory. The diagnosis of PTSD was established through a clinical interview and the Structured Clinical Interview (SCID-I/P). Thirty-eight PTSD patients and 38 controls completed the Research Diagnostic Criteria for Temporomandibular Disorders Axis-II to categorize awake/sleep bruxism and orofacial pain. Following this, we performed a short clinical examination of the temporomandibular joint and extraoral muscles.
Adjusted logistic regression analysis showed that awake bruxism was associated with PTSD (OR = 3.38, 95% CI = 1.01-11.27, p = 0.047). Sleep bruxism was not associated with any covariate included in the model. In a Poisson regression model, PTSD (IRR = 3.01, 95% CI = 1.38-6.55, p = 0.005) and the muscle pain/discomfort (IRR = 5.12, 95% CI = 2.80-9.36, p < 0.001) were significant predictors for current orofacial pain.
PTSD was associated with self-reported awake bruxism and low-intensity orofacial pain. These conditions were frequent outcomes in patients previously exposed to traumatic events.
We suggest including a two-question screening for bruxism in psychiatry/psychology interviews to improve under-identification and to prevent harmful consequences at the orofacial level.
本研究旨在探讨自我报告的觉醒/睡眠磨牙症和口颌面疼痛与创伤后应激障碍（PTSD）之间的关系。
设计了一项基于病例对照的便利样本研究。参与者从大学创伤门诊招募。通过临床访谈和结构临床访谈（SCID-I/P）确定 PTSD 的诊断。38 名 PTSD 患者和 38 名对照完成了颞下颌关节紊乱症研究诊断标准轴 II，以分类觉醒/睡眠磨牙症和口颌面疼痛。之后，我们对颞下颌关节和咀嚼肌进行了简短的临床检查。
调整后的逻辑回归分析显示，觉醒性磨牙症与 PTSD 相关（OR=3.38，95%CI=1.01-11.27，p=0.047）。睡眠磨牙症与模型中包含的任何协变量均无关。在泊松回归模型中，PTSD（IRR=3.01，95%CI=1.38-6.55，p=0.005）和肌肉疼痛/不适（IRR=5.12，95%CI=2.80-9.36，p<0.001）是当前口颌面疼痛的显著预测因素。
PTSD 与自我报告的觉醒性磨牙症和低强度口颌面疼痛相关。这些情况是创伤后患者常见的后果。
我们建议在精神病学/心理学访谈中纳入关于磨牙症的两问题筛查，以提高识别不足，并预防口颌面层面的有害后果。
