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Ahlberg J, Savolainen A et al. Community Dent Oral Epidemiol 2004; 32: 307–311

Two main types of aetiology have been proposed to account for bruxism: peripheral morphological factors (such as occlusal discrepancies), and central factors (such as stress and dopaminergic system disorders). In 1999, 1339 employees of the Finnish Broadcasting Company completed a questionnaire on tobacco use, bruxism and symptoms of TMD. In 2000, 205 out of a random sample of 1/5 of the original group (response rate 76%) completed a follow-up questionnaire on the same topics, giving a report of perceptions over a 24 month period.

On the basis of their reports, subjects were categorized as low bruxism (n = 131) and high bruxism (74) individuals. Smokers constituted 24% and 43% of these respective groups. In a multivariate model including affective disturbance, sleep disturbance, somatic symptoms, gender, and age, 3 other variables achieved significance in explaining high levels of bruxism: pain symptoms, TMD painless symptoms and smoking. The authors conclude that successful management of TMD requires the inclusion of smoking cessation.