Bruxism Burden and Masticatory Performance in Orthodontic Patients

Main Article Content

Saba Riaz
Nasiba Mumtaz
Aimen Javed
Rabia Majeed
Fiza Irtaza
Kashaf Asjad
Zoha Malik
Ayesha Mazhar

Abstract

Background: Bruxism is highly prevalent among orthodontic patients and may negatively affect masticatory efficiency, muscular function, and pain perception. Despite increasing recognition of parafunctional jaw activity during orthodontic treatment, the functional consequences of bruxism on chewing performance remain insufficiently investigated. Objective: To assess the association between bruxism risk and masticatory performance, and to examine the relationship of bruxism risk and chewing dysfunction with pain severity among orthodontic patients. Methods: This cross-sectional observational study included 115 orthodontic patients recruited through convenience sampling from dental hospitals and clinics in Lahore, Pakistan. Bruxism risk was assessed using the Bruxism Evaluation Questionnaire (BEQ), chewing performance was evaluated using the Chewing Function Questionnaire (CFQ), and pain severity was measured using the Visual Analogue Scale (VAS). Data were analyzed using IBM SPSS Statistics version 27.0.1. Descriptive statistics and Pearson’s chi-square tests were applied, with statistical significance established at p < 0.05. Results: High bruxism risk was identified in 88 participants (76.5%). Mild chewing difficulty was the most frequent chewing category (43.5%), while 27.0% demonstrated moderate chewing difficulty. Significant associations were observed between bruxism risk and chewing dysfunction, χ²(6) = 41.967, p < 0.001, bruxism risk and pain severity, χ²(2) = 26.023, p < 0.001, and chewing dysfunction and pain severity, χ²(6) = 41.967, p < 0.001. Among participants with high bruxism risk, 85.2% demonstrated some degree of chewing dysfunction, compared with 33.3% in the low-risk group. Moderate-to-severe pain was also substantially more frequent among high-risk participants. Conclusion: Bruxism risk was highly prevalent among orthodontic patients and was significantly associated with impaired masticatory performance and increased pain severity. These findings support routine bruxism screening and chewing function assessment during orthodontic treatment and emphasize the need for multidisciplinary strategies aimed at improving oral function and reducing pain-related burden. Keywords: Bruxism; masticatory performance; chewing function; orthodontic treatment; orofacial pain; parafunctional habits.

Article Details

Section

Articles

How to Cite

1.
Saba Riaz, Nasiba Mumtaz, Aimen Javed, Rabia Majeed, Fiza Irtaza, Kashaf Asjad, et al. Bruxism Burden and Masticatory Performance in Orthodontic Patients. JHWCR [Internet]. 2026 Mar. 21 [cited 2026 Jul. 4];4(6):1-8. Available from: https://jhwcr.com/index.php/jhwcr/article/view/1879

References

1. Araya Zavala S, Barrientos Reyes J, Pavez M. Bruxism and masticatory pattern: an understudied relationship. Jaw Funct Orthop Craniofac Growth. 2022;2(2):86-97.

2. Bortoletto CC, Kobayashi FY, Costa YM, Conti PCR. Evaluation of muscle activity and bite force in masticatory muscle after massage therapy or occlusal splint in sleep bruxism childhood. Res Soc Dev. 2021;10(3):e38810313468.

3. Chattrattrai T, Aarab G, Lobbezoo F. Network analysis of sleep bruxism in the EPISONO adult general population. J Sleep Res. 2024;33(2):e13957.

4. Gulzar M, Fida M, Shaikh A. Self-reported bruxism in patients undergoing orthodontic treatment: a cross-sectional study. BMC Oral Health. 2024;24(1):1577.

5. Hardy RS, Bonsor SJ. The efficacy of occlusal splints in the treatment of bruxism: a systematic review. J Dent. 2021;108:103621.

6. Heleiwa-Ferioli T, de la Cruz Vigo S. Association between bruxism and the use of aligners in orthodontics. J Clin Exp Dent. 2024;16(10):e1247-e1254.

7. Kilinc HE, Onan D, Ergun N. Investigation of masticatory muscle thickness and mechanosensitivity of cervical and masticatory muscles in myofascial temporomandibular disorder patients with bruxism: a cross-sectional study. Musculoskelet Sci Pract. 2024;70:102919.

8. Lan KW, Jiang SS, Wang CH, Chen YJ. Comparative study of surface electromyography of masticatory muscles in patients with different types of bruxism. World J Clin Cases. 2022;10(20):6876-6887.

9. Michelotti A, Rongo R, D’Antò V, Bucci R. Occlusion, orthodontics, and temporomandibular disorders: cutting edge of the current evidence. J World Fed Orthod. 2020;9(3 Suppl):S15-S18.

10. Nykänen L, Manfredini D, Lobbezoo F, Ahlberg J. Assessment of awake bruxism by a novel bruxism screener and ecological momentary assessment among patients with masticatory muscle myalgia and healthy controls. J Oral Rehabil. 2024;51(1):162-169.

11. Persic S, Palac A, Bunjevac T, Celebic A. Development of a new chewing function questionnaire (CFQ): factor analysis. Coll Antropol. 2012;36(4):1179-1186.

12. Riley P, Glenny AM, Worthington HV, Littlewood A, Clarkson JE, McCabe MG. Oral splints for patients with temporomandibular disorders or bruxism: a systematic review and economic evaluation. Health Technol Assess. 2020;24(7):1-224.

13. Smaglyuk L, Liakhovska A, Trofymenko M. EMG-characteristics of masticatory muscles in subjects with bruxism. Ukr Dent Almanac. 2022;(1):43-49.

14. Vlăduțu DE, Ionescu E, Perlea P, Tănase G, Burlibașa M. Ecological momentary assessment of masseter muscle activity in patients with bruxism. Int J Environ Res Public Health. 2022;20(1):581.

15. Wieckiewicz M, Martynowicz H, Smardz J, et al. Moving beyond bruxism episode index: discarding misuse of the number of sleep bruxism episodes as masticatory muscle pain biomarker. J Sleep Res. 2025;34(1):e14301.

16. Lobbezoo F, Ahlberg J, Raphael KG, et al. International consensus on the assessment of bruxism: report of a work in progress. J Oral Rehabil. 2018;45(11):837-844.

17. de Leeuw R, Klasser GD. Orofacial pain: guidelines for assessment, diagnosis, and management. 6th ed. Chicago: Quintessence Publishing; 2018.

18. Ohrbach R, Dworkin SF. The evolution of TMD diagnosis: past, present, future. J Dent Res. 2016;95(10):1093-1101.

19. Manfredini D, Winocur E, Guarda-Nardini L, Lobbezoo F. Epidemiology of bruxism in adults: a systematic review of the literature. J Orofac Pain. 2013;27(2):99-110.

20. Svensson P, Baad-Hansen L, Pigg M, et al. Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions. J Oral Rehabil. 2011;38(5):366-394.