Bruxism and its cofactors: psychoemotional, vegetative and motor aspects

Abstract

Introduction: Bruxism is a parafunctional activity, consisting of excessive teeth grinding and jaw clenching. It affects at least 15-20% of the general population, and it is estimated that 85-90% of people experience at least one episode of bruxism during their lifetime. Awake bruxism has a higher prevalence in women, in contrast to sleep bruxism, that is more prevalent in men. The objectives of our research are the following: analyzing the quantitative indices of awake bruxism under the influence of stress, nicotine, caffeine and alcohol; assessing the diagnostic possibilities for the fractal analysis of cardiac rhythm. Materials and methods: There were studied 19 patients with awake bruxism and 19 persons without bruxism. The influence of bruxism cofactors was quantified. There were analyzed the quantitative indices of bruxism, the EMG activity of the masseter muscle and the fractal analysis indices of the heart rate (sample entropy - SampEn, correlation dimension – D2). There were used the Polispectr- Ritm, Neuro-MVP diagnostic equipment and the Sleep Guard SG5 device (USA). Results: All the studied cofactors had a higher intensity in bruxers than in non-bruxers, with the highest statistical significant difference observed for emotional stress (p˂0,001) and alcohol consumption (p˂0,01). Bruxers are more likely to smoke more cigarettes than non-bruxers (p˂0,02). Caffeine consumption is two-fold higher for bruxers in comparison to non-bruxers (p˂0,03). The surface electromyography has shown changes under the influence of all cofactors, the highest Amax value was recorded under the influence of alcohol (p˂0,01). The lowest influence on the bioelectrical activity ofthe masseter muscle was observed for caffeine and nicotine. The most significant changes (p˂0,05) for SampEn index were observed under the influence of alcohol. For the D2 index, the influence of alcohol and stress are more significant (p˂0,001) in comparison to nicotine and caffeine (p˂0,05). Conclusion: In patients with awake bruxism, the intensity of factors increases in the following order: caffeine˂nicotine˂alcohol˂stress; the number of episodes, their total duration and the bioelectric activity of masseter muscle increases under the action of the cofactors in the following order: alcohol˂nicotine˂caffeine˂stress. Differentiated evaluation of the action of daily cofactors in patients with awake bruxism can be achieved based on the fractal analysis of the heart rate, which reflects the peculiarities of quantitative manifestation of awake bruxism episodes.