Self-reported bruxism and phobic symptoms: a survey on 43 cases

Objectives: Prolonged experiences of stressful life events, pathological anxiety and/or aggressiveness are increasingly reported among psychological factors possibly involved in causing bruxism. Moreover, recent data have drown attention to a possible relationship between personality traits, tooth clenching and craniomandibular dysfunction in subjects with a long-standing bruxism behaviour. We examined whether anxiety, phobia or dental fears may differently affect self-reported bruxers or non-bruxers. Methods: We recruited 43 patients with usual tooth clenching (cases) and 89 subjects without parafunctional habits (controls), among consecutive dental patients attending an oral surgery unit for a planned treatment. Just before dental procedures, two self-administered psychological inventories were used in the waiting room: the STAI-Y1 questionnaire for anxiety state assessment and the Phobia Scale by Marks-Sheehan for phobic symptoms' evaluation. Other variables such as demographics, dental information from clinical records and proper schedule on dental fears were included in the analysis. Results: The STAI-Y1 total score resulted higher in bruxers compared to controls (ANOVA F 5.07; P= 0.03). Likewise, bruxers pointed out higher severity scores at the Phobia Scale compared to non-bruxers, although the two groups (cases and controls) did not show significant differences in their phobic avoidance behaviour, which resulted for both to be quite low. Conclusions: Evidence was found of higher levels of anxious and phobic symptoms in bruxers compared to controls. Our data suggest that the involuntary habit of tooth clenching is strictly connected with patients' ability to cope with moderate/intense state of anxiety mainly resulting from agoraphobia or social phobia concomitant with low levels of phobic avoidance.