Predictors of Bruxism, Other Oral Parafunctions, and Tooth Wear over a 20-Year Follow-up Period

Aims: To analyze predictors of bruxism, other oral parafunctions, and tooth wear in a group of subjects who had been examined 20 years earlier. Methods: Originally, 402 randomly selected 7-, 11-, and 15-year-old subjects were examined clinically and by means of a questionnaire. Twenty years after the first examination, 94% of the original group could be traced, and 320 (85%) completed and returned the questionnaire. Of the oldest group, 100 (81%) also underwent a clinical examination focusing on occlusal factors and function and dysfunction of the masticatory system. For analyses of predictors of some oral parafunctions and tooth wear registered at the 20-year follow-up, logistic regression was used with record-ings at the first examination as independent variables. Results: Subjective reports in childhood of bruxism (defined as tooth clenching during daytime and/or tooth grinding at night), clench-ing only, grinding at night only, nail biting, and/or other parafunc-tions were predictors of the same oral parafunctions 20 years later. There were different predictors of the 2 components of bruxism, daytime tooth clenching and tooth grinding at night. Postnormal occlusion (Angle Class II malocclusion) and tooth wear in child-hood predicted increased tooth wear in adulthood. Subjects with nonworking-side interference had less anterior tooth wear than those without such interference. Conclusion: Oral parafunctions in childhood may be a persistent trait in many subjects. Postnormal occlusion and tooth wear in childhood predicted increased anterior tooth wear 20 years later, whereas nonworking-side interference reduced the risk for such wear in 35-year-old subjects.

dental occlusion; longitudinal study; nail biting; tooth clenching; tooth grinding

1. Rugh JD, Ohrbach R. Occlusal parafunction. In: Mohl ND, Zarb GA, Carlsson GE, Rugh JD (eds). A Textbook of Occlusion. Chicago: Quintessence, 1988:249–261.

2. Carlsson GE, Magnusson T. Management of Temporomandibular Disorders in the General Dental Practice. Chicago: Quintessence, 1999.

3. Molina OF, dos Santos J Jr, Nelson SJ, Nowlin T. Profile of TMD and bruxer compared to TMD and nonbruxer patients regarding chief complaint, previous consultations, modes of therapy, and chronicity. Cranio 2000;18:205–219.

4. DeBoever JA, Carlsson GE. Etiology and differential diagnosis. In: Zarb GA, Carlsson GE, Sessle BJ, Mohl ND (eds). Temporomandibular Joint and Masticatory Muscle Disorders. Copenhagen: Munksgaard, 1994:171–187.

5. Lund JP, Sessle BJ. Neurophysiological mechanisms. In: Zarb GA, Carlsson GE, Sessle BJ, Mohl ND (eds). Temporomandibular Joint and Masticatory Muscle Disorders. Copenhagen: Munksgaard, 1994:188–207.

6. Rugh JD, Dahlström L. Behavioral and psychological mechanisms. In: Zarb GA, Carlsson GE, Sessle BJ, Mohl ND (eds). Temporomandibular Joint and Masticatory Muscle Disorders. Copenhagen: Munksgaard, 1994:208–218.

7. Lobbezoo F, Lavigne GJ. Do bruxism and temporo-mandibular disorders have a cause-and-effect relationship?Review. J Orofac Pain 1997;11:15–23.

8. Widmalm SE, Christiansen RL, Gunn SM. Oral parafunctions as temporomandibular disorder risk factors in children. Cranio 1995;13:242–246.

9. Alamoudi N. Correlation between oral parafunction and temporomandibular disorders and emotional status among Saudi children. J Clin Pediatr Dent 2001;26:71–80.

10. Sari S, Sonmez H. Investigation of the relationship between oral parafunctions and temporomandibular joint dysfunction in Turkish children with mixed and perma-nent dentition. J Oral Rehabil 2002;29:108–112.

11. Winocur E, Gavish A, Finkelshtein T, Halachmi M, Gazit E. Oral habits among adolescent girls and their association with symptoms of temporomandibular disorders. J Oral Rehabil 2001;28:624–629.

12. Ciancaglini R, Gherlone EF, Radaelli G. The relationship of bruxism with craniofacial pain and symptoms from the masticatory system in the adult population. J Oral Rehabil 2001;28:842–848.

13. Egermark I, Carlsson GE, Magnusson T. A 20-year longitudinal study of subjective symptoms of temporomandibular disorders from childhood to adulthood. Acta Odontol Scand 2001;59:40–48.

14. Celic R, Jerolimov V, Panduric J. A study of the influence of occlusal factors and parafunctional habits on the prevalence of signs and symptoms of TMD. Int J Prosthodont 2002;15:43–48.

15. Israel HA, Diamond B, Saed-Nejad F, Ratcliffe A. The relationship between parafunctional masticatory activity and arthroscopically diagnosed temporomandibular joint pathology. J Oral Maxillofac Surg 1999;57:1034–1039.

16. Yamada K, Hanada K, Fukui T, et al. Condylar bony change and self-reported parafunctional habits in prospective orthognathic surgery patients with temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:265–271.

17. Greene C. The etiology of temporomandibular disorders: Implications for treatment. J Orofac Pain 2001;15:93–105.

18. Lobbezoo F, Naeije M. Bruxism is mainly regulated centrally, not peripherally. J Oral Rehabil 2001;28:1085–1091.

19. Hublin C, Kaprio J, Partinen M, Koskenvuo M. Sleep bruxism based on self-report in a nationwide twin cohort. J Sleep Res 1998;7:61–67.

20. Michalowicz BS, Pihlstrom BL, Hodges JS, Bouchard TJ Jr. No heritability of temporomandibular joint signs and symptoms. J Dent Res 2000;79:1573–1578.

21. Sjöholm T, Lehtinen I I, Helenius H. Masseter muscle activity in diagnosed sleep bruxists compared with non-symptomatic controls. J Sleep Res 1995;4:48–55.

22. Lavigne GJ, Rompre PH, Montplaisir JY. Sleep bruxism: Validity of clinical research diagnostic criteria in a controlled polysomnographic study. J Dent Res 1996;75: 546–552.

23. Bader GG, Kampe T, Tagdae T, Karlsson S, Blomqvist M. Descriptive physiological data on a sleep bruxism population. Sleep 1997;20:982–990.

24. Bader G, Kampe T, Tagdae T. Body movement during sleep in subjects with long-standing bruxing behavior. Int J Prosthodont 2000;13:327–333.

25. Kato T, Rompre P, Montplaisir JY, Sessle BJ, Lavigne GJ. Sleep bruxism: An oromotor activity secondary to microarousal. J Dent Res 2001;80:1940–1944.

26. Nyström M, Könönen M, Alaluusua S, Evälahti M, Vartiovaara J. Development of horizontal tooth wear in maxillary anterior teeth from five to 18 years of age. J Dent Res 1990;69:1165–1170.

27. Kieser JA, Groeneveld HT. Relationship between juvenile bruxing and craniomandibular dysfunction. J Oral Rehabil 1998;25:662–665.

28. Carlsson GE, Johansson A, Lundqvist S. Occlusal wear. A follow-up study of 18 subjects with extensively worn dentitions. Acta Odontol Scand 1985;43:83–90.

29. Ekfeldt A. Incisal and occlusal tooth wear and wear of some prosthodontic materials. An epidemiological and clinical study. Swed Dent J Suppl 1989;65:1–62.

30. Johansson A. A crosscultural study of occlusal tooth wear. Swed Dent J Suppl 1992;86:1–59.

31. Bartlett D, Phillips K, Smith B. A difference in perspective– North American and European interpretations of tooth wear. Int J Prosthodont 1999;12:401–408.

32. Hattab FN, Yassin OM. Etiology and diagnosis of tooth wear: A literature review and presentation of selected cases. Int J Prosthodont 2000;13:101–107.

33. Magnusson T, Egermark I, Carlsson GE. A longitudinal epidemiologic study of signs and symptoms of temporo-mandibular disorders from 15 to 35 years of age. J Orofac Pain 2000;14:310–319.

34. Carlsson GE, Egermark I, Magnusson T. Predictors of signs and symptoms of temporomandibular disorders. A 20- year follow-up study from childhood to adulthood. Acta Odontol Scand 2002;60:180–185.

35. Magnusson T, Egermark-Eriksson I , Carlsson GE. Five-year longitudinal study of signs and symptoms of mandibular dysfunction in adolescents. Cranio 1986;4: 339–344.

36. Magnusson T, Carlsson GE, Egermark I. Changes in subjective symptoms of craniomandibular disorders in children and adolescents during a 10-year period. J Orofac Pain 1993;7:76–82.

37. Magnusson T, Carlsson GE, Egermark I. Changes in clinical signs of craniomandibular disorders from the age of 15 to 25 years. J Orofac Pain 1994;8:207–215.

38. Egermark-Eriksson I. Mandibular dysfunction in children and in individuals with dual bite [dissertation]. Swed Dent J Suppl 1982;10:1–45.

39. Carlsson G, Egermark-Eriksson I, Magnusson T. Intra-and inter-observer variation in functional examination of the masticatory system. Swed Dent J 1980;4:187–194.

40. Helkimo M. Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state. Swed Dent J 1974;67: 101–121.

41. Good P. Permutation tests. A Practical Guide to Resampling Methods for Testing Hypotheses. New York: Springer, 2000:36–37.

42. Marbach JJ, Raphael KG, Dohrenwend BP, Lennen MC. The validity of tooth grinding measures: Etiology of pain dysfunction syndrome revisited. J Am Dent Assoc 1990; 120:327–333.

43. Wedel A, Carlsson GE. Analysis of functional disturbances of the masticatory system. J Craniomandibular Pract 1984;2:350–357.

44. Westling L, Carlsson GE, Helkimo M. Background factors in craniomandibular disorders with special reference to general joint hypermobility, parafunction, and trauma. J Craniomandib Disord 1990;4:89–98.

45. De Boever JA, Carlsson GE, Klineberg IJ. Need for occlusal therapy and prosthodontic treatment in the management of temporomandibular disorders. Part I. Occlusal interferences and occlusal adjustment. J Oral Rehabil 2000;27:367–379.

46. Henrikson T, Ekberg EC, Nilner M. Symptoms and signs of temporomandibular disorders in girls with normal occlusion and class II malocclusion. Acta Odontol Scand 1997;55:229–235.

47. Egermark-Eriksson I, Carlsson GE, Ingervall B. Function and dysfunction of the masticatory system in individuals with dual bite. Eur J Orthod 1979;1:107–117.

48. Marklund S, Wanman A. A century of controversy regarding the benefit or detriment of occlusal contacts on the mediotrusive side. Review. J Oral Rehabil 2000;27: 553–562.

49. Minagi S, Watanabe H, Sato T, Tsuru H. The relationship between balancing-side occlusal contact patterns and tem-poromandibular joint sounds in humans: Proposition of the concept of balancing-side protection. J Craniomandib Disord 1990;4:251–257.