The Impact of Bruxism on Athletic Performance: a Systematic Review and Meta-analysis

Abstract

Bruxism, an involuntary clenching or grinding of teeth, is increasingly prevalent among athletes due to elevated stress, performance anxiety, and intense training. This systematic review analyzed 11 studies (2000–2023) on bruxism prevalence, underlying factors, and its impact on athletic performance. Data were extracted on prevalence, strength, endurance, coordination, reaction time, psychological stress, sleep quality, and injury risk. Random-effects models calculated pooled prevalence, standardized mean differences, and odds ratios. Bruxism prevalence among athletes ranged from 15 to 70%, with a pooled estimate of 38% (95% confidence interval: 25–52%), significantly higher than the general population’s 8–20%. Combat sports (58%) and weightlifting (50%) showed the highest rates. Athletes with bruxism exhibited reduced strength (standardized mean difference=− 0.48), endurance (standardized mean difference=− 0.41), coordination (standardized mean difference=− 0.45), slower reaction times (standardized mean difference=− 0.33), elevated anxiety (standardized mean difference=0.62), poorer sleep quality (standardized mean difference=− 0.56), and a 2.5-fold higher injury risk (odds ratio=2.5). Bruxism poses significant challenges for athletes, compromising oral health, sleep, and performance. Further research should clarify sport-specific risk factors and develop targeted management strategies to safeguard athletes’ health and competitive outcomes.

Keywords

bruxism - athletic performance - sport-specific risk factors

Publikationsverlauf

Eingereicht: 12. Dezember 2024

Angenommen nach Revision: 14. April 2025

Accepted Manuscript online:
15. April 2025

Artikel online veröffentlicht:
15. Mai 2025

• References

• 1 Pontes L, Prietsch S. Bruxismo do sono: estudo de base populacional em pessoas com 18 anos ou mais na cidade de Rio Grande, Rio Grande do SulSleep bruxism: population based study in people with 18 years or more in the city of Rio Grande, Brazil. Rev Bras Epidemiol 2019; 22: 190038
• 2 Góra A, Laskowski G, Węgrzyn P. et al. Diagnosis and management of bruxism. A literature review. Qual Sport 2024; 22: 54807
• 3 Saczuk K, Wilmont P, Pawlak Ł, Łukomska-Szymańska M. Bruxism: Aetiology and diagnostics. A literature review. Prosthodontics 2018; 68: 456-463
• 4 Wetselaar P, Vermaire E, Lobbezoo F, Schuller AA. The prevalence of awake bruxism and sleep bruxism in the Dutch adult population. J Oral Rehabil 2019; 46: 617-623
• 5 Winocur E, Uziel N, Lisha T, Goldsmith C, Eli I. Self-reported Bruxism - associations with perceived stress, motivation for control, dental anxiety and gagging. J Oral Rehabil 2011; 38: 3-11
• 6 Shetty S, Pitti V, Satish Babu CL, Surendra Kumar GP, Deepthi BC. Bruxism: A Literature Review. J Indian Prosthodont Soc 2010; 10: 141-148
• 7 Ashley P, Di Iorio A, Cole E, Tanday A, Needleman I. Oral health of elite athletes and association with performance: a systematic review. Br J Sports Med 2015; 49: 14-19
• 8 Clarke NG, Townsend GC. Distribution of nocturnal bruxing patterns in man. J Oral Rehabil 1984; 11: 529-534
• 9 Casett E, Réus JC, Stuginski-Barbosa J. et al. Validity of different tools to assess sleep bruxism: a meta-analysis. J Oral Rehabil 2017; 44: 722-734
• 10 Lobbezoo F, Ahlberg J, Glaros AG. et al. Bruxism defined and graded: an international consensus. J Oral Rehabil 2013; 40: 2-4
• 11 Kato T, Thie NM, Huynh N, Miyawaki S, Lavigne GJ. Topical review: sleep bruxism and the role of peripheral sensory influences. J Orofac Pain 2003; 17: 191-213
• 12 Vieira KRM, Folchini CM, Heyde MDVD, Stuginski-Barbosa J, Kowacs PA, Piovesan EJ. Wake-Up Headache Is Associated With Sleep Bruxism. Headache 2020; 60: 974-980
• 13 Oliveira JMD, Pauletto P, Massignan C. et al. Prevalence of awake Bruxism: A systematic review. J Dent 2023; 138: 104715
• 14 Pingitore G, Chrobak V, Petrie J. The social and psychologic factors of bruxism. J Prosthet Dent 1991; 65: 443-446
• 15 Gallagher J, Ashley P, Petrie A, Needleman I. Oral health and performance impacts in elite and professional athletes. Community Dent Oral Epidemiol 2018; 46: 563-568
• 16 Manfredini D, Lobbezoo F. Role of psychosocial factors in the etiology of bruxism. J Orofac Pain 2009; 23: 153-166
• 17 Nishigawa K, Bando E, Nakano M. Quantitative study of bite force during sleep associated bruxism. J Oral Rehabil 2001; 28: 485-491
• 18 Miranda JS, Santos JFR, Aquino JA. et al. Risks of resistance training for the bruxism: a cross-sectional study. Rev Eletrônica Acervo Saúde 2022; 15: e10882
• 19 The PRISMA Group. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6: 1000097
• 20 Sterne JAC, Savović J, Page MJ. et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: 4898
• 21 Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-560
• 22 Cohen J. Statistical Power Analysis for the Behavioral Sciences. Routledge; 2013
• 23 Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994; 50: 1088-1101
• 24 Rosenthal R. The file drawer problem and tolerance for null results. Psychol Bull 1979; 86: 638-641
• 25 Stachyra E, Dolina A. Prevalence and risk factors for bruxism among climbers. J Educ Health Sport 2019; 9: 400-405
• 26 Queiroz RLS, Castro RK, Caponi LQ. et al. ORAL HEALTH CONDITIONS AND SELF-REPORTED PRESENCE OF PAIN IN ROWERS: AN EPIDEMIOLOGY STUDY. Rev Bras Esporte 2021; 27: 549-552
• 27 Babiuc I, Minescu L, Tănase G. et al. CLINICAL STUDY ON THE INCIDENCE OF BRUXISM THROUGHOUT ROMANIAN HIGH-PERFORMANCE ATHLETES. Acta Medica Transilvanica 2019; 24: 103-106
• 28 Ribeiro MC, Regalo SC, Pepato AO. et al Bite force, electromyography, and mandible mobility during the 6-month period after surgical treatment for isolated fractures of the zygomatico-orbital complex. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 111 1-7–7
• 29 Huang SH, Liu P, Mokasdar A, Hou L. Additive manufacturing and its societal impact: a literature review. Int J Adv Manuf Technol 2013; 67: 1191-1203
• 30 Soileau KM, Le A, Bresky I. Effects of oral health problems in athletic performance. Int J Prev Clin Dent Res 2024; 11: 10-15
• 31 Huang D-H, Chou S-W, Chen Y-L, Chiou WK. Frowning and jaw clenching muscle activity reflects the perception of effort during incremental workload cycling. J Sports Sci Med 2014; 13: 921-928
• 32 Allen C, Garner DP. The effects of jaw clenching and mouthpiece use on bat swing velocity in Division II athletes. J Sports Sci 2024; 42: 763-768
• 33 Needleman I, Ashley P, Petrie A. et al. Oral health and impact on performance of athletes participating in the London 2012 Olympic Games: a cross-sectional study. Br J Sports Med 2013; 47: 1054-1058
• 34 de la Parte A, Monticelli F, Toro-Román V, Pradas F. Differences in Oral Health Status in Elite Athletes According to Sport Modalities. Sustainability 2021; 13: 7282