Standardised Tool for the Assessment of Bruxism.

OBJECTIVE: This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences. METHODS: The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications. RESULTS: The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self-reported information on bruxism status and possible consequences (subject-based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject-Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self-report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra- and Extra-Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep-related Conditions Assessment (B2), Concurrent Non-Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration. CONCLUSIONS: The instrument is now ready for on-field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields.

Prevalence of spontaneous oral dyskinesia in the elderly: a reappraisal.

The prevalence and status of spontaneous oral dyskinesia (SOD), clinically defined as the presence of oral stereotypies of no apparent cause, remain controversial in the elderly. The reported high prevalence of SOD in institutionalized demented cases, the apparent similarity between SOD and tardive dyskinesia (TD), and the role of aging in both conditions, are used as arguments to minimise the prevalence of TD and causal role of antipsychotics. We observed 1,018 (69.3% women) noninstitutionalized, frail elderly subjects attending day care centers to document the prevalence and phenomenology of SOD. A total of 38 subjects, including 29 women, were suspected of having SOD, for a prevalence rate of 3.7% (95% confidence interval, 2.6-4.9%), 4.1% for women and 2.9% for men. A survey covering medical and dental issues was filled out by 508 volunteers. Subjects with suspected SOD reported more frequent ill-fitting dental devices (P = 0.002; odds ratio [OR] = 3.5), oral pain (P = 0.01; OR = 3.0), and a lower rate of perception of good oral health (P = 0.04; OR = 0.4) compared to nondyskinetics. Individuals with suspected SOD typically presented with mild stereotyped masticatory or labial movements compared to the more complex phenomenology of probable TD cases. Thus, SOD is comparatively infrequent in the elderly. The relation between its distinct orodental health profile and stereotyped manifestations warrants further attention.