Depression, pain, and site:

Objective: To assess the level of depression, severity of pain and pain in single/multiple sites in patients with different severity of bruxing behavior and Temporomandibular Disorders (TMDs). Methods: We evaluated 131 patients with bruxism and TMDs: 20 patients with mild bruxism, 42 patients with moderate bruxism, 45 patients with severe bruxism and 24 patients with extreme bruxism. We used the Beck Depression Inventory (BDI), clinical examination, a questionnaire of clinical epidemiological data, criteria for TMDs and bruxism, palpation of muscles and joints, the Visual Analogue Scale for pain, classification of the occlusion and biomechanical tests to assess for internal joint derangements. Results: The level of depression increased from the mild, to the moderate, severe and extreme bruxing behavior groups, but the difference was significant only from the mild to the extreme group (p<0.001). Pain levels increased from the mild and moderate to the severe and extreme subgroups, but were not statistically significant. Mean number of pain sites increased from the mild, to the moderate, severe and extreme subgroup and the difference was extremely significant (p<0.0001). Conclusion: Levels of depression, severity of pain and pain sites increased with severity of bruxing behavior. A higher number of pain sites with more severe bruxism indicates somatization in bruxers, but a further study using the same protocol and a psychological test for somatization would be indicated to further substantiate these findings.