Bruxism is a parafunctional activity characterized by clenching or grinding of the teeth during wakefulness or sleep. Increasing evidence suggests that bruxism is not only related to orofacial structures but may also be associated with broader musculoskeletal and psychosocial conditions. Emerging literature indicates that central sensitization, stress, and anxiety may contribute to both bruxism and chronic pain conditions. However, the potential relationship between bruxism and pelvic health outcomes has not been sufficiently investigated. Pelvic pain and sexual dysfunction, including erectile dysfunction, are multifactorial conditions that may involve neuromuscular, psychological, and autonomic mechanisms. Considering the shared mechanisms related to muscle hyperactivity, stress responses, and central pain modulation, bruxism may be associated with pelvic pain symptoms and sexual dysfunction in men. Additionally, anxiety is recognized as a common contributing factor in both bruxism and pelvic floor dysfunction. The aim of this cross-sectional study is to investigate the association between bruxism, pelvic pain, erectile dysfunction, and anxiety levels in young adult men. Participants will be assessed using validated self-report questionnaires to evaluate bruxism symptoms, pelvic pain complaints, erectile function, and anxiety levels. Understanding the potential relationship between these variables may contribute to a more comprehensive biopsychosocial understanding of male pelvic health and may help guide future multidisciplinary assessment and management strategies.
Bruxism has been linked with stress, anxiety, autonomic nervous system dysregulation, and central sensitization processes. These mechanisms may also play a role in the development and maintenance of chronic pain conditions beyond the orofacial region. Pelvic pain and sexual dysfunction in men, including erectile dysfunction, are complex conditions with multifactorial etiologies involving musculoskeletal, neurological, vascular, and psychosocial factors. Increasing evidence suggests that pelvic floor muscle overactivity, stress-related autonomic responses, and psychological distress may contribute to pelvic pain syndromes and sexual dysfunction. Anxiety, in particular, has been identified as an important factor influencing both pelvic floor muscle tension and erectile function. Given that bruxism is associated with muscle hyperactivity, stress responses, and psychological factors, it is plausible that individuals with bruxism may also experience symptoms related to pelvic floor dysfunction. However, the potential relationship between bruxism and male pelvic health outcomes, such as pelvic pain and erectile dysfunction, has not been sufficiently investigated in the literature. Understanding whether bruxism is associated with pelvic symptoms may provide insight into shared neuromuscular or biopsychosocial mechanisms. The primary aim of this cross-sectional study is to investigate the association between bruxism and pelvic pain in young adult men. Secondary aims include examining the relationship between bruxism and erectile dysfunction as well as anxiety levels. Participants will be young adult men recruited from the general population. Bruxism status will be assessed using validated self-report measures consistent with current international consensus definitions of probable bruxism. Pelvic pain symptoms, erectile function, and anxiety levels will be evaluated using validated questionnaires. Statistical analyses will be conducted to examine the relationships between bruxism and pelvic pain, erectile dysfunction, and anxiety. Correlation and group comparison analyses will be used to explore potential associations between these variables. The findings of this study may contribute to a broader understanding of the relationship between orofacial parafunctional activities and pelvic health outcomes. Identifying potential links between bruxism and pelvic floor-related symptoms may help support a multidisciplinary perspective in the assessment and management of men presenting with pelvic pain or sexual dysfunction.
Study Type
OBSERVATIONAL
Enrollment
100
20 mins questionnaire survey
Necmettin Erbakan University
Konya, Turkey (Türkiye)
Bruxism Assessment
Bruxism will be assessed using self-report questions addressing both awake bruxism and sleep bruxism behaviors. Participants will report the presence and frequency of teeth clenching or grinding during wakefulness or sleep within the past six months. Pain related to bruxism will be evaluated using a Visual Analog Scale (VAS) ranging from 0 to 10, where: 0 represents no pain 10 represents the worst imaginable pain Higher scores indicate greater pain intensity associated with bruxism.
Time frame: 6 months
Jaw Function Assessment
Jaw functional limitations will be assessed using the Jaw Functional Limitation Scale-20 (JFLS-20). This instrument evaluates functional limitations in three domains: Mastication Jaw mobility Verbal and emotional expression Each item is scored on a 0-10 numeric rating scale, where: 0 indicates no limitation 10 indicates severe limitation The total score is calculated as the mean of the items within each domain or across all items. Higher scores indicate greater functional limitation.
Time frame: 6 months
Chronic Prostatitis / Chronic Pelvic Pain Symptoms
Pelvic pain symptoms will be assessed using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). The NIH-CPSI includes 9 items across three domains: Pain (0-21) Urinary symptoms (0-10) Quality of life impact (0-12) The total score ranges from 0 to 43, with higher scores indicating more severe symptoms related to chronic prostatitis or chronic pelvic pain syndrome. The validated Turkish version of the NIH-CPSI will be used (Coşkun et al., 2021).
Time frame: 6 months
Impact of Pelvic Pain on Daily Life
The impact of pelvic pain on daily functioning and quality of life will be assessed using the Male Pelvic Pain Impact Questionnaire. This questionnaire evaluates how pelvic pain affects daily activities, social participation, and emotional well-being. Higher scores indicate greater negative impact of pelvic pain on daily life.
Time frame: 6 months
Sexual Function Assessment
Sexual function will be assessed using questions derived from the International Index of Erectile Function (IIEF) focusing on erectile function during the previous four weeks. The erectile function domain score ranges from 1 to 30, with interpretation as follows: 26-30: normal erectile function 22-25: mild erectile dysfunction 17-21: mild to moderate erectile dysfunction 11-16: moderate erectile dysfunction ≤10: severe erectile dysfunction Higher scores indicate better erectile function.
Time frame: 6 months
Anxiety Assessment
Anxiety will be evaluated using the State-Trait Anxiety Inventory (STAI), which includes two subscales: STAI-State (STAI-S): measures current anxiety level STAI-Trait (STAI-T): measures general anxiety tendency Each subscale consists of 20 items, scored on a 4-point Likert scale. Possible scores range from 20 to 80, where: 20-37: low anxiety 38-44: moderate anxiety 45-80: high anxiety Higher scores indicate higher levels of anxiety.
Time frame: 6 months
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