Painful temporomandibular disorders, sleep bruxism, and anxiety symptoms in adolescents: a cross-sectional study

Abstract

To analyze the association between painful temporomandibular disorders (TMD), sleep bruxism, and anxiety symptoms in adolescents. A cross-sectional study was conducted with 497 adolescents aged 14-19 years. Data were collected on sociodemographic characteristics, painful temporomandibular disorders, sleep bruxism, and anxiety symptoms. Associations between categorical variables were assessed using Pearson's chi-square test, and binary logistic regression was performed to evaluate factors associated with painful temporomandibular disorders, with a significance level of 5%. The prevalence of painful TMD was 29.6%, anxiety symptoms were present in 78.9% of the sample, and clinically defined sleep bruxism was identified in 4.4% of the participants. In the adjusted model, adolescents with anxiety symptoms were 2.7 times more likely to have painful TMD (95% CI 1.5-4.8), and those with sleep bruxism were 6.5 times more likely to have painful TMD (95% CI 2.5-17.2). The highest estimated probability of painful TMD (74.7%) was observed among adolescents presenting both anxiety symptoms and sleep bruxism. Painful temporomandibular disorders were significantly associated with anxiety symptoms and sleep bruxism in adolescents, whereas no significant associations were observed with the sociodemographic factors examined. These findings highlight the importance of early identification of the co-occurrence of painful temporomandibular disorders, sleep bruxism, and anxiety symptoms in adolescents, supporting preventive strategies and multidisciplinary care aimed at reducing chronic pain and its psychosocial impact.