Association Between Waking-State Oral Behaviors and Health, Anxiety, and Distress in Adolescents

Objectives: Stress and anxiety are common emotional states experienced by individuals in their daily lives. Adolescents are highly susceptible to these psychological factors that contribute to various behavioral manifestations, including oral parafunctional behaviors, which occur during wakefulness. This study aimed to explore the relationship of waking-state oral activities with general health, distress, and anxiety in adolescents and to determine the psychological predictors for high wake-state parafunction.
Methods: A cross-sectional study was performed. The investigation was approved by the ethics committee of Universidad CES. One hundred adolescents 12-15 years old from private and public schools in Medellín, Colombia were enrolled. Subjects with known systemic diseases, altered neurological conditions, and/or respiratory or sleep disturbances were excluded. The frequency of oral behaviors was appraised with the oral behavior checklist (OBC). Instruments from the DC/TMD Axis II were used to assess the general health (PHQ-A), symptoms of anxiety (GAD-7), and distress (PSS-C). Data were analyzed with the Spearman correlation test and ordinal-multiple-variable regression analyses.
Results: Twenty adolescents did not complete the instruments, thus data from 80 participants (mean age 13.4 ± 1.6 years) were analyzed. Of those, 63.6% had low parafunction (score 1–24 in the OBC) (LP) and 36.4% high parafunction (score 25–84 in the OBC) (HP). While general health did not vary substantially, adolescents with waking-state HP exhibited significantly greater distress and anxiety than adolescents with LP. Correlations between OBC and distress and anxiety were moderate to high when significant (r= 0.51-0.72/0.81-0.93). Increase-to-increase frequency of distress (ordinal OR = 3.55) and anxiety (ordinal OR = 2.32) were found to be significant predictors of wake-state HP.
Conclusions: Distress and anxiety were risk factors for waking-state HP, increasing its odds by about 2.32 times.