Bruxism as a new risk factor of musculo-skeletal disorders?

Amélie K Mainjot; Julie Oudkerk; Sandrine Bekaert; Nadia Dardenne; Sylvie Streel; Vinciane Koenig; Charlotte Grenade; Anoushka Davarpanah; Anne-Françoise Donneau; Bénédicte Forthomme; Olivier Bruyère

doi:10.1016/j.jdent.2023.104555

Bruxism as a new risk factor of musculo-skeletal disorders?

J Dent. 2023 Aug:135:104555. doi: 10.1016/j.jdent.2023.104555. Epub 2023 May 30.

Affiliations

¹ Dental Biomaterials Research Unit (d-BRU), Institute of Dentistry, University of Liège (ULiège), Liège, Belgium; Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), Liège, Belgium. Electronic address: a.mainjot@chuliege.be.
² Dental Biomaterials Research Unit (d-BRU), Institute of Dentistry, University of Liège (ULiège), Liège, Belgium; Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), Liège, Belgium.
³ Biostatistics and Research Method Center, University of Liege, Liege Belgium.
⁴ Department of Public Health, University of Liège, Belgium.
⁵ Dental Biomaterials Research Unit (d-BRU), Institute of Dentistry, University of Liège (ULiège), Liège, Belgium.
⁶ Department of Physical Medicine and Sports Traumatology, Sports², FIFA Medical Centre of Excellence, University and University Hospital of Liège, Liège, Belgium; Department of Rehabilitation and Sports Sciences, University of Liège, Liège, Belgium.
⁷ WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium.

PMID: 37263410
DOI: 10.1016/j.jdent.2023.104555

Abstract

Objectives: Musculoskeletal disorders (MSDs), particularly neck and low back pain, constitute a major public health issue worldwide with a heavy morbidity and economic impact. However, the relationships between the stomatognathic system and MSDs are subjected to debate, data sorely lacking. The study objective was to investigate the association between bruxism (BR) and MSDs. Secondary objective includes the study of the association between tooth wear (TW) and MSDs.

Methods: This is a cross-sectional study on 425 participants frequenting a university dental clinic. The presence of MSDs was evaluated with the standardized Nordic questionnaire. The sleep and awake BR assessments were based on clinical examination and self-report. TW was measured with the BEWE index. Socio-demographic factors, medical history, life habits and stress were analyzed as potential confounding variables.

Results: 91% of patients reported at least one MSD during the preceding 12 months and 75.5% were diagnosed as bruxers. In multivariate analyses, BR was associated with a 5-fold increased risk of prevalent MSD (OR=5.88 (2.7-12.5), p<0.0001). Regarding TW, for a one-point increase in anterior BEWE score, the risk to present an MSD was increased by 53% (OR=1.53 (1.12-2.08), p = 0.0076). Moreover, BR was independently associated with neck, shoulder, upper back, low back, hip & thigh and knee MSDs. Anterior TW was independently associated with neck, low back and hip & thigh MSDs, and global TW with knee MSDs.

Conclusions: BR and TW were shown to be associated with MSDs. The cause-and-effect relationships between those factors needs to be analyzed to optimize prevention and therapeutic care.

Clinical significance: Results suggest that the body is a whole, a balanced muscular system, where every part constitutes a link of the chain. MSDs management and prevention may require a multidisciplinary team approach and future perspectives include defining the dentist's role in this context, particularly with respect to BR diagnostic and treatment.

Keywords: BEWE index; Back pain; Neck pain; Nordic questionnaire; Sleep bruxism; Tooth wear.

MeSH terms

Bruxism* / complications
Bruxism* / epidemiology
Cross-Sectional Studies
Humans
Musculoskeletal Diseases* / prevention & control
Occupational Diseases* / prevention & control
Prevalence
Risk Factors
Surveys and Questionnaires
Tooth Attrition*