Abstract
Background: Bruxism is a multifactorial biopsychosocial condition involving repetitive jaw muscle activity, influenced by psychological stress, anxiety, and maladaptive coping strategies. Methods: In this cross-sectional observational study, 111 health sciences students (mean age 22.29 ± 3.10 years; 66.6% women) underwent standardized DC/TMD clinical evaluation and completed the GAD-7, COPE Inventory, and a 105-item Stroop Test. Results: Bruxism prevalence was 63.96% (71/111). Students with bruxism had higher GAD-7 scores (10.63 ± 5.78 vs. 5.80 ± 3.66; mean difference 4.83, 95% CI 2.88-6.78; p < 0.001, g = 0.94), with clinically relevant anxiety nearly three times more frequent (55.4% vs. 19.6%; RR = 2.83, 95% CI 1.68-4.76). Stroop interference times were slower in the bruxism group (42.19 ± 16.87 s vs. 34.57 ± 16.25 s; mean difference 7.63 s, 95% CI 0.90-14.35; p = 0.027, g = 0.46), though accuracy was similar. COPE results showed a shift toward emotion-focused and avoidance strategies with increasing muscle pain. Conclusions: Bruxism is strongly linked to elevated anxiety, maladaptive coping strategies, and reduced inhibitory control speed. Integrating psychological screening tools such as GAD-7 and COPE into dental and medical practice could enable early identification and referral, supporting comprehensive management that combines dental treatment with psychological interventions to prevent chronic pain and long-term complications.