Association of sleep quality and psychological aspects with reports of bruxism and TMD in Brazilian dentists during the COVID-19 pandemic

Peixoto, Karen Oliveira; Resende, Camila Maria Bastos Machado de; Almeida, Erika Oliveira de; Almeida-Leite, Camila Megale; Conti, Paulo César Rodrigues; Barbosa, Gustavo Augusto Seabra; Barbosa, Juliana Stuginski

doi:10.1590/1678-7757-2020-1089

Karen Oliveira Peixoto Corresponding address: Karen Oliveira Peixoto, Universidade Federal do Rio Grande do Norte - Departamento de Odontologia - Rua Salgado Filho - Lagoa Nova - 59056-000 - Natal/RN - Brasil. phone: +55 (84) 3215-4100 e-mail: karenoliveirap@hotmail.com

Universidade Federal do Rio Grande do Norte (UFRN), Departamento de Odontologia, Natal, RN, Brasil.

https://orcid.org/0000-0002-7658-2305

Camila Maria Bastos Machado de Resende

Universidade Federal do Rio Grande do Norte (UFRN), Departamento de Odontologia, Natal, RN, Brasil.

Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Departamento de Morfologia, Belo Horizonte, MG, Brasil.

https://orcid.org/0000-0002-6221-2733

Erika Oliveira de Almeida

Universidade Federal do Rio Grande do Norte (UFRN), Departamento de Odontologia, Natal, RN, Brasil.

Camila Megale Almeida-Leite

Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Departamento de Morfologia, Belo Horizonte, MG, Brasil.

https://orcid.org/0000-0003-2694-8521

Paulo César Rodrigues Conti

Universidade de São Paulo, Bauru Orofacial Pain Group, Bauru, SP, Brasil.

Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil

Gustavo Augusto Seabra Barbosa

Universidade Federal do Rio Grande do Norte (UFRN), Departamento de Odontologia, Natal, RN, Brasil.

Juliana Stuginski Barbosa

Universidade de São Paulo, Bauru Orofacial Pain Group, Bauru, SP, Brasil.

https://orcid.org/0000-0002-7805-5672

Corresponding address: Karen Oliveira Peixoto, Universidade Federal do Rio Grande do Norte - Departamento de Odontologia - Rua Salgado Filho - Lagoa Nova - 59056-000 - Natal/RN - Brasil. phone: +55 (84) 3215-4100 e-mail: karenoliveirap@hotmail.com

Conflicts of interest

There are no conflicts of interest.

Authors’ contributions

Peixoto, Karen Oliveira: Conceptualization (Equal); Data curation (Equal); Formal analysis (Equal); Investigation (Equal); Methodology (Equal); Writing-original draft (Equal); Writing-review & editing (Equal). Resende, Camila Bastos Machado: Conceptualization (Equal); Data curation (Equal); Formal analysis (Equal); Investigation (Equal); Methodology (Equal); Writing-original draft (Equal); Writing-review & editing (Equal). Almeida, Erika Oliveira de: Supervision (Equal); Validation (Equal); Visualization (Equal); Writing-original draft (Equal); Writing-review & editing (Equal). Almeida-Leite, Camila Megale: Supervision (Equal); Validation (Equal); Visualization (Equal); Writing-review & editing (Equal). Conti, Paulo César Rodrigues: Supervision (Equal); Validation (Equal); Visualization (Equal); Writing-review & editing (Equal). Seabra Barbosa, Gustavo: Supervision (Equal); Validation (Equal); Visualization (Equal); Writing-original draft (Equal); Writing-review & editing (Equal). Stuginski Barbosa, Juliana: Formal analysis (Equal); Supervision (Equal); Validation (Equal); Visualization (Equal); Writing-original draft (Equal); Writing-review & editing (Equal).

Gender	G1 (n=206)	G2 (n=400)	G3 (n=32)	Total (n=638)	p^* * Pearson's chi-square test. G1: quarantined. G2: outpatient care/practice. G3: frontline in hospitals.
Male	20.9% (n=43)	28.5% (n=114)	18.8% (n=6)	25.5% (n=163)	0.72
Female	79.1% (n=163)	71.5% (n=286)	81.3% (n=26)	74.5% (n=475)
Marital Status	G1 (n=206)	G2 (n=398)	G3 (n=32)	Total (n=636)	p
Married/Common-law	60.2% (n=124)	61.6% (n=245)	62.5% (n=20)	61.2% (n=389)	0.49
Single	33.5% (n=69)	30.9% (n=123)	37.5% (n=12)	32.1% (n=204)
Divorced/Widow	6.3% (n=13)	7.6% (n=30)	0.0% (n=0)	6.8% (n=43)
Concerns about COVID-19	G1 (n=208)	G2 (n=400)	G3 (n=32)	Total (n=640)	p ^* * Pearson's chi-square test. G1: quarantined. G2: outpatient care/practice. G3: frontline in hospitals.
Not worried or little worried	4.3% (n=9)	9.3% (n=37)	9.4% (n=3)	7.7% (n=49)	0.89
Worried to extremely worried	95.7% (n=199)	90.8% (n=363)	90.6% (n=12)	92.3% (n=591)

Reporting Sleep Bruxism	G1 (n=208)	G2 (n=401)	G3 (n=32)	p^* * Pearson chi-square test with significance level <0.05; sleep bruxism (SB); awake bruxism (AB); temporomandibular disorder (TMD); quarantined (G1); outpatient care/practice (G2); frontline in hospitals (G3).
Without SB	39.4% (n=82)	42.4% (n=170)	53.1% (n=17)	0.33
Possible SB	60.6% (n=126)	57.6% (n=231)	46.9% (n=15)
Reporting Awake Bruxism	G1 (n=208)	G2 (n=401)	G3 (n=32)	p ^* * Pearson chi-square test with significance level <0.05; sleep bruxism (SB); awake bruxism (AB); temporomandibular disorder (TMD); quarantined (G1); outpatient care/practice (G2); frontline in hospitals (G3).
Without AB	47.1% (n=98)	46.1% (n=185)	40.6% (n=13)	0.79
Possible AB	52.9% (n=110)	53.9% (n=216)	59.4% (n=19)
TMD Pain Screening	G1 (n=208)	G2 (n=401)	G3 (n=32)	p ^* * Pearson chi-square test with significance level <0.05; sleep bruxism (SB); awake bruxism (AB); temporomandibular disorder (TMD); quarantined (G1); outpatient care/practice (G2); frontline in hospitals (G3).
Without symptoms of TMD	75.5% (n=157)	76.1% (n=305)	71.9% (n=23)	0.86
With symptoms of TMD	24.5% (n=51)	23.9% (n=96)	28.1% (n=9)
PSQI > 5	G1 (n=208)	G2 (n=401)	G3 (n=32)	p ^* * Pearson chi-square test with significance level <0.05; sleep bruxism (SB); awake bruxism (AB); temporomandibular disorder (TMD); quarantined (G1); outpatient care/practice (G2); frontline in hospitals (G3).
Good sleeper	7.7% (n=16)	6.0% (n=24)	6.3% (n=2)	0.72
Poor sleeper	92.3% (n=192)	94.0% (n=377)	93.8% (n=30)

DASS-21
Stress symptoms
Group	Average (SD)	CI 95%		Minimum	Maximum
		LL	L
G1 (n=208)	13.35 (7.77)	12.28	14.41	0	40
G2 (n=401)	12.07 (7.66)	11.32	12.82	0	40
G3 (n=32)	13.38 (7.86)	10.54	16.21	0	38
Total (n=641)	12.55 (7.72)	11.95	13.15	0	40
p^* * Oneway ANOVA $ Mann Whitney (groups in which there was a statistically significant difference among them).	0.127
Anxiety symptoms
Group	Average (SD)	CI 95%		Minimum	Maximum
		LL	UL
G1 (n=208)	6.39 (6.13)	5.56	7.23	0	32
G2 (n=401)	5.50 (5.94)	4.91	6.08	0	34
G3 (n=32)	5.56 (5.09)	3.72	7.40	0	18
Total (n=641)	5.79 (5.97)	5.33	6.25	0	34
p^* * Oneway ANOVA $ Mann Whitney (groups in which there was a statistically significant difference among them).	0.208
Depression symptoms
Group	Average (SD)	CI 95%		Minimum	Maximum
		LL	UL
G1 (n=208) $	8.07 (6.85)	7.13	9.00	0	34
G2 (n=401) $	6.62 (6.87)	5.94	7.29	0	42
G3 (n=32)	7.25 (7.01)	4.72	9.78	0	28
Total (n=641)	7.12 (6.89)	6.59	7.66	0	42
p^* * Oneway ANOVA $ Mann Whitney (groups in which there was a statistically significant difference among them).	0.048

MODEL	INDEPENDENT VARIABLES	p^ p: p-value. OR: Odds Ratio. CI: Confidence Interval.	OR	CI (95%)
Depression	Working status during the pandemic	0.010	0.630	0.443-0.897
Depression	Concern about the pandemic^* * Inversion of the variable categorization by model.	0.083	0.517	0.245-1.091
Stress	Working status during the pandemic	0,956	0.991	0.727-1.351
Stress	Concern about the pandemic^* * Inversion of the variable categorization by model.	0.014	0.360	0.159-0.816
Anxiety	Working status during the pandemic	0,321	0.838	0.591-0.626
Anxiety	Concern about the pandemic^* * Inversion of the variable categorization by model.	0.002	0.255	0.107-0.609
Sleep Quality	Working status during the pandemic	0.45	0.879	0.628-1.229
Sleep Quality	Concern about the pandemic^* * Inversion of the variable categorization by model.	<0.001	0.256	0.122-0.539

MODEL	INDEPENDENT VARIABLES (pandemic)	p	OR	CI (95%)
TMD Screening	Depression^* * protection factor.	<0.001	0.425	0.292-0.618
	Stress^* * protection factor.	<0.001	0.147	0.096-0.226
	Anxiety^* * protection factor.	<0.001	0.287	0.198-0.418
	Sleep Quality	<0.001	3.010	2.064-4.389
Possible Awake Bruxism	Depression^* * protection factor.	<0.001	0.434	0.30-0.617
	Stress^* * protection factor.	<0.001	0.350	0.244-0.503
	Anxiety^* * protection factor.	<0.001	0.318	0.224-0.453
	Sleep Quality	<0.001	1.68	1.230-2.312
Possible Sleep Bruxism	Depression	0.024	1.491	1.055-2.039
	Stress	0.001	1.777	1.248-2.531
	Anxiety^* * protection factor.	<0.001	0.496	0.351-0.701
	Sleep Quality	<0.001	1.793	1.301-1.165

[1] Corresponding address: Karen Oliveira Peixoto, Universidade Federal do Rio Grande do Norte - Departamento de Odontologia - Rua Salgado Filho - Lagoa Nova - 59056-000 - Natal/RN - Brasil. phone: +55 (84) 3215-4100 e-mail: karenoliveirap@hotmail.com

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Association of sleep quality and psychological aspects with reports of bruxism and TMD in Brazilian dentists during the COVID-19 pandemic

Abstract

Objective:

Methodology:

Results:

Conclusion: