Prevalence of painful temporomandibular disorders, awake bruxism and sleep bruxism among patients with severe post-traumatic stress disorder.

Background: Post-traumatic stress disorder (PTSD) is associated with painful temporomandibular disorder (TMD) and may be part of the aetiology of awake bruxism (AB) and sleep bruxism (SB). Investigating the associations between PTSD symptoms on the one hand, and painful TMD, AB and SB on the other, can help tailoring treatment to the needs of this patient group.

Objectives: The aim of this study was to investigate the associations between PTSD symptoms and painful TMD, AB and SB among patients with PTSD, focusing on prevalence, symptom severity and the influence of trauma history on the presence of painful TMD, AB and SB.

Methods: Individuals (N = 673) attending a specialised PTSD clinic were assessed (pre-treatment) for painful TMD (TMD pain screener), AB and SB (Oral Behaviours Checklist), PTSD symptoms (Clinician-Administered PTSD Scale) and type of traumatic events (Life Events Checklist).

Results: Painful TMD, AB and SB were more prevalent among patients with PTSD (28.4%, 48.3% and 40.1%, respectively) than in the general population (8.0%, 31.0% and 15.3%, respectively; all p's < .001). PTSD symptom severity was found to be significantly, but poorly, associated with the severity of painful TMD (r  = .126, p = .001), AB (r  = .155, p < .001) and SB (r  = .084, p = .029). Patients who had been exposed to sexual assault were more likely to report AB than patients who had not. Similarly, exposure to physical violence was associated with increased odds for SB.

Conclusion: Patients with severe PTSD are more likely to experience painful TMD, AB or SB, whereas type of traumatic event can be of influence. These findings can contribute to selecting appropriate treatment modalities when treating patients with painful TMD, AB and SB.