AWAKE BRUXISM PREVALENCE ACROSS POPULATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Objectives: Bruxism significantly affects oral health, with consequences such as tooth wear and restoration failures. Additionally, it is linked to various risk factors and co-occurring disorders. Unlike sleep bruxism, awake bruxism (AB) is more strongly associated with psychosocial factors. This review aimed to evaluate the prevalence of AB in the general population and specific subpopulations. Methods: The review followed PRISMA guidelines and was registered in PROSPERO (CRD42023398868). A literature search in PubMed, Scopus, and Web of Science until April 8, 2025 identified studies that fulfilled the inclusion criteria of reporting AB prevalence in adult populations. Risk of bias was assessed with Joanna Briggs Institute Prevalence Critical Appraisal Tool and a random-effects meta-analysis determined prevalence in various subpopulations. Results: The search yielded 8,818 records, with 5,408 abstracts screened after duplicate removal. Of these, 4,473 were excluded. Full-text assessment led to the exclusion of 843 articles that did not meet inclusion criteria. A hand search identified 5 additional studies. Ultimately, 94 studies involving 49,163 individuals were included, with 66 studies (39,823 individuals) analyzed in the meta-analysis. In the general population, self-reported "possible" AB had a mean prevalence of 25.9% (95% CI 22.2-29.9), and clinically based "probable" AB 16.0% (95% CI 10.0-24.5). Prevalence was significantly higher in specific subpopulations, such as individuals with temporomandibular disorders (50.0%, 95% CI 41.1-58.9) and systemic conditions (40.1%, 95% CI 31.4-49.5). Risk of bias was mainly related to assessment of AB. Conclusions: The variability between subpopulations highlights the importance of considering patient-specific factors and a targeted clinical approach in AB management.