<b>Bruxism Burden and Masticatory Performance in Orthodontic Patients</b>

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.