Behavioral and psychosocial correlates of awake bruxism behaviors in esports athletes: a cross-sectional study

Awake bruxism (AB) has been little explored in esports. This study estimated the frequency of self-reported AB behaviors, described behavioral features, and identified associated factors in esports practitioners. In this cross-sectional study, 447 esports players from São Paulo, Brazil, completed self-report questionnaires using items derived from the BruxScreen protocol and the Standardized Tool for the Assessment of Bruxism (STAB). AB behaviors were assessed using a frequency-based approach, and participants were stratified into low- and high-frequency groups. Overall, 35% met the criterion for frequent AB. Compared with low-frequency individuals, high-frequency participants more often reported clenching (46.7% vs. 9.1%) and daily mandibular pain (39.1% vs. 7.2%). Behavior frequency correlated with previous AB history (ρ = 0.49), psychological distress (ρ = 0.42), and gastroesophageal symptoms (ρ = 0.37) (all p < 0.001), while male sex showed an inverse correlation (ρ = - 0.27; p < 0.001). In multivariable regression, previous AB history (B = 0.75; 95% CI 0.55-0.95), psychological distress (B = 0.06; 95% CI 0.03-0.10), and gastroesophageal symptoms (B = 0.24; 95% CI 0.11-0.36) remained independently associated (p < 0.001). The model explained 36% of the variance. AB behaviors are common in esports and reflect a multifactorial phenomenon influenced by psychosocial and contextual factors, supporting the need for preventive and educational strategies in this population and clinical awareness.