Patients with post-traumatic stress disorder (PTSD) may be more likely to develop temporomandibular disorder (TMD) and awake bruxism, according to a study recently published in the Journal of Dentistry.
When assessing symptom severity, awake bruxism severity may be correlated with the number of PTSD symptoms, the authors wrote.
"The results of our study suggest that screening for PTSD may be a worthwhile addition to pre-treatment assessments of patients presenting for treatment of orofacial pain and dysfunction," wrote the authors, led by Wendy Knibbe of the University of Amsterdam in the Netherlands (J Dent, March 1, 2025, 105656).
For this study, 701 patients with an average age of 46 completed self-report screening questionnaires between May 2023 and November 2024. The Trauma Screening Questionnaire assessed traumatic events, post-traumatic stress symptoms, and PTSD. Painful TMD was evaluated while awake and sleep bruxism were measured using the Oral Behaviors Checklist, they wrote.
Researchers analyzed descriptive characteristics, including PTSD prevalence, and conducted statistical analysis using univariate and multivariate logistic regression, as well as Spearman's and partial correlations.
Univariate analysis showed that PTSD was linked to painful TMD, awake bruxism, and sleep bruxism. Multivariate analysis confirmed significant associations between PTSD and both painful TMD and awake bruxism, the authors wrote.
Additionally, patients with subthreshold post-traumatic stress symptoms had higher odds of painful TMD and sleep bruxism compared to those with no traumatic event.
Furthermore, PTSD was most prevalent among patients with awake bruxism (14.7%). After adjusting for painful TMD and sleep bruxism severity, awake bruxism severity showed a weak but significant correlation with the number of post-traumatic stress symptoms (r = 0.171, p < 0.001), they wrote.
The study, however, had limitations. The results relied on self-reported screening measures, therefore future studies should confirm these findings using established diagnostic methods, the authors added.
"Increased knowledge about the role of post-traumatic stress in the aetiology of these orofacial conditions may enable tailoring treatment to these specific patient groups, and thus to increase the likelihood of treatment success," they concluded.
