Presença de stress, de possível bruxismo do sono e em vigília e de medo da Covid-19 em estudantes de Odontologia

Abstract

Introduction: Human beings seek to adapt to external changes that occur in their environment, looking for balance, with stress as the body’s response. The impact of stress on everyone’s life is different, and one of its manifestations is sleep bruxism and/or awake bruxism. The social isolation imposed by the COVID-19 pandemic has drastically changed the routine of dental students, becoming yet another source of stress. Objective: To investigate the prevalence of perceived stress, possible sleep bruxism and awake bruxism, and fear of COVID-19 in dental students; their possible associations with sociodemographic variables and to estimate the influence of perceived stress on sleep and awake bruxism during the COVID-19 pandemic. Methodology: Observational, cross-sectional, and descriptive-analytical research, carried out in seven dental schools (four public and three private) located in the state of Paraíba. The probabilistic sample consisted of 391 regularly enrolled students who attended classes, divided into three groups: initial (1st to 4th semesters); middle (5th to 7th semesters), and final (8th to 10th semesters). The inclusion of participants followed the snowball recruitment technique. Four different instruments were used for data collection: sociodemographic questionnaire, Perceived Stress Scale (PSS-10), questionnaire for diagnosing sleep and awake bruxism, and COVID-19 Fear Scale. Data collection took place remotely from April to June 2021 through the Google platform®, first via WhatsApp®. For situations in which collection was not successful, e-mail and/or the social network Instagram® were used. The Statistical Package for the Social Scienced (SPSS) version 23.0 and MedCalc version 19.4 programs were used for database creation and statistical analysis. Normality and homogeneity of continuous variables were tested using the Shapiro-Wilk and Levine tests, respectively. Participant’s age was expressed as median and interquartile ranges. The chi-square test was used to assess differences between groups with dependent and independent variables; Spearman’s correlation test was used to investigate possible correlation between perceived stress and awake bruxism, perceived stress and sleep bruxism, and awake bruxism and sleep bruxism. Multiple logistic regression was performed to discriminate the explanatory variables of perceived stress in dental students and for awake bruxism and sleep bruxism. Hosmer and Lemeshow and chi-square tests were used to verify the goodness of fit of the model. Results: A total of 391 dental students participated in this research, most of them women (69,8%), without a partner (69,8%), average age of 22 years, family income less than three minimum wages (60,9%). The practice of physical activity was high (63,2%). The prevalence of perceived stress was high at 27,9%; while the occurrence of awake bruxism and sleep bruxism was 49,4% and 39,6%, respectively, and 81,1% of low COVID-19 fear. Multiple logistic regression showed influence of fear of COVID-19 on perceived stress at the beginning (p<0,001 and OR=5,61) and end of the course (p=0,013 and OR=3,40), gender (p=0,006 and OR=5,71) and family income (p=0,032 and OR=0,32) at the middle of the course. There is a significant correlation between sleep bruxism and awake bruxism in all models (p<0,001 and OR=0,201). Conclusion: There was a high prevalence of perceived stress, as well as sleep and awake bruxism, and of low COVID-19 fear. There was an association between the use or psychotropic drugs, the fact of being female and the fear of COVID-19 with the student’s perceived stress. Perceived stress influenced awake bruxism. Keywords: bruxism; Covid-19; stress; psychological; students, dental.