Prevalence of suspected bruxism and its association with anxiety, depression, and stress among persons deprived of liberty in the Peruvian Amazon: a cross-sectional study

Suspected bruxism remains poorly documented in prison populations, particularly in Latin America, where the intersection between mental and oral health has been scarcely investigated. To determine the prevalence of suspected bruxism and examine its relationship with anxiety, depression, stress, and clinical oral health indicators among persons deprived of liberty in the Peruvian Amazon. A cross-sectional census included 201 eligible participants from three wards of the Huancas Penitentiary Establishment. Suspected bruxism was identified using the Clinical Self-Report Screening Test (McNeill, 1993; modified by Kindernecht, 1997), with a positive result defined as ≥2 affirmative responses across 25 items. Anxiety, depression, and stress were assessed using the DASS-21, and oral health using the DMFT index and Basic Erosive Wear Examination (BEWE). Bivariate analyses included Chi-square or Fisher's exact tests and Spearman correlations. Binary logistic regression was performed, with multicollinearity assessed using the Variance Inflation Factor (VIF) and model fit evaluated using the Hosmer-Lemeshow test and Nagelkerke R 2 . Suspected bruxism prevalence was 72.6% ( n  = 146; 95% CI: 66.1–78.3%), with the highest prevalence observed in the women's ward (80.5%). Severe anxiety showed a significant bivariate association with suspected bruxism (11.6% vs. 0.0%; p  = 0.028). Weak but statistically significant positive associations were observed between suspected bruxism and depression (rho=0.159; p  < 0.05) and stress (rho=0.179; p  < 0.05). No statistically significant independent associations were identified in the logistic regression (all p  > 0.05), in the context of moderate multicollinearity (maximum VIF=7.10) and sparse observations in some categories. Among participants with available DMFT data, 81.1% had a high caries index, while mean BEWE was 8.00 ± 6.57, with no significant difference according to suspected bruxism status ( p  = 0.40). A high prevalence of screening-defined suspected bruxism was observed among persons deprived of liberty in the Peruvian Amazon. Severe anxiety showed a significant bivariate association, while depression and stress showed weak positive associations with suspected bruxism. These findings highlight the potential value of considering psychological and oral health jointly in correctional healthcare and warrant further research using standardized bruxism-specific clinical or instrumental assessment.