Game over: Unraveling the prevalence and associations between bruxism, TMD and psychosocial factors in the Esports arena

Background: The professionalization of electronic sports (Esports) and streaming has introduced new challenges to players' physical and mental health, including chronic stress, sleep disruption and pain-related dysfunction. These factors are linked to bruxism and temporomandibular disorders (TMD), yet their prevalence and psychosomatic correlations within this community remain unknown. This study aimed to investigate the occurrence of bruxism and TMD among Esports players and streamers as well as their associations with psychosomatic and gaming-related variables. Methods: This cross-sectional study included 97 Esports players and streamers that completed validated self-report instruments screening for TMD (TMD pain-screener), bruxism, sociodemographic data, oral behaviors, sleep quality, perceived stress, anxiety, somatic symptoms, pain vigilance, and gaming/streaming habits. In addition to standard statistical tests, orthogonal partial least squares-discriminant analysis (OPLS-DA) were applied to identify group differences and multivariate associations. Results: Nearly half of the participants screened positive for TMD (49.5 %) and 78.4 % reported self-reported bruxism. Increased daily gaming hours correlated significantly with higher perceived stress and oral parafunctions. Multivariate analyses further showed that anxiety, somatic symptoms, poor sleep and perceived stress were key factors distinguishing participants with TMD from those without, and those with combined sleep and awake bruxism from those with only awake bruxism. Conclusion: TMD and bruxism are highly prevalent among Esports players and streamers, with greater daily gaming exposure linked to psychosomatic stress and oral parafunctions. Digital athletes with combined sleep and awake bruxism and/or TMD, experience greater psychosocial distress, indicating a subgroup that needs closer attention through early screening and targeted preventive strategies.