Association of gender, oral habits, and poor sleep quality with possible sleep bruxism in schoolchildren

Abstract The aim of this study was to verify the oral habits, symptoms, and characteristics of some children aged 8 to 10 years that could be associated with possible sleep bruxism. A cross-sectional study was performed. Questionnaires were sent to parents to obtain information on sex, age, school shift, sleep quality, parents' perception of children's behavior, and children's oral habits (nail biting, object biting, and lip biting), and symptoms such as headache or earache. In addition, parents reported the frequency of sleep bruxism (no day to 7 days a week). Descriptive analysis and multinomial logistic regression were performed and the level of significance was set at 5%. A total of 1,554 parents of children aged 8 to 10 years participated in this study. Possible sleep bruxism was reported as mild for 65.7%, moderate for 25.3%, and severe for 9% of the children. In the adjusted multinomial logistic regression, boys were 79% more likely to have sleep bruxism (OR: 1.79; 95%CI 1.23-2.60) and were 2.06 more times at risk of being in the habit of lip biting (OR: 2.06; 95%CI 1.26-3.37). Children with possible severe sleep bruxism were 61% more likely to develop object biting (OR: 1.61; 95%CI 1.09-2.39), 52% more likely to have headaches (OR: 1.52; 95%CI 1.01-2.28), and 3.29 more times at risk of poor sleep quality (OR: 3.29; 95%CI 2.25-4.82). Based on the report, boys with lip and object biting habits, headaches, and poor sleep quality presented a higher chance of possible severe sleep bruxism.

Bruxismo do sono: estudo de base populacional em pessoas com 18 anos ou mais na cidade de Rio Grande, Rio Grande do Sul / Sleep bruxism: population based study in people with 18 years or more in the city of Rio Grande, Brazil

RESUMO: Objetivos: Avaliar a prevalência do bruxismo do sono, bem como seus principais sinais e sintomas, na cidade de Rio Grande, Rio Grande do Sul. Avaliar a associação do bruxismo do sono com sexo, idade, escolaridade e estresse psicológico. Método: O estudo foi do tipo transversal. Uma amostra representativa da população (1.280 pessoas residentes na zona urbana da cidade com idade maior ou igual a 18 anos de idade) foi entrevistada. A avaliação do bruxismo do sono foi realizada por meio de questionário baseado nos critérios diagnósticos da Classificação Internacional de Distúrbios do Sono. Resultados: A prevalência de bruxismo do sono encontrada na população foi de 8,1% (intervalo de confiança de 95% - IC95% - 6,6 - 9,5). Entre os sinais e sintomas da disfunção utilizados para o diagnóstico de bruxismo do sono, o desgaste dentário (70,3%) e a dor nos músculos mastigatórios (44,5%) foram os mais frequentemente relatados pelas pessoas que declararam ranger os dentes durante o sono. Não houve diferença significativa na prevalência de bruxismo do sono entre os sexos. A faixa etária com mais de 40 anos teve maior prevalência de bruxismo do sono. A disfunção foi associada a um maior nível de escolaridade (razão de prevalência - RP = 1,92; IC95% 1,35 - 2,72) e de estresse psicológico (RP = 1,76; IC95% 1,11 - 2,81). Conclusão: O bruxismo do sono tem uma importante prevalência na população em geral, causando diversos danos ao sistema estomatognático. O estresse psicológico é um fator de risco para essa disfunção.

ABSTRACT: Objective: To evaluate the prevalence of sleep bruxism, as well as its principal signs and symptoms, in the city of Rio Grande. Evaluate the association of sleep bruxism with gender, age, education and psychological stress. Method: The study was cross-sectional type. A representative sample of the population (1280 people residing in the urban area of the city aged greater than or equal to 18 years old) were interviewed. The evaluation of sleep bruxism was by mean of questionnaire based on diagnostic criteria of the International Classification of Sleep Disorders. Results: The prevalence of sleep bruxism found in the population was 8,1% (confidence interval of 95% - 95%CI - 6,6 - 9,5). Among the signs and symptoms of dysfunction used for the diagnosis of sleep bruxism, tooth wear (70,3%) and pain in masticatory muscles (44,5%) were the most frequently reported by people who report teeth grinding during sleep. There was no significant difference in the prevalence of sleep bruxism between sexes. People older than 40 had a higher prevalence of sleep bruxism. The dysfunction was associated with a higher level of education (prevalence ratio - PR = 1.92; 95%CI 1,35 - 2,72) and psychological stress (PR 1,76; 95%CI 1,11 - 2,81). Conclusion: There was a significant prevalence of sleep bruxism in the general population, causing various damages to the Stomatognathic system. The psychological stress is a risk factor for this dysfunction.

Trastornos temporomandibulares en la infancia: bruxismo de sueño y compromiso de atm en artritis idiopática juvenil / Temporomandibular disorders in childhood: sleep bruxism and temporomandibular joint involvement in juvenile idiopathic arthritis

Los trastornos temporomandibulares (TTM) corresponden a un grupo de condiciones musculoesqueletales y neruromusculares que involucran las articulaciones temporomandibulares (ATM), los músculos masticatorios y todos los tejidos asociados. La etiología de los TTM es considerada multifactorial, siendo el bruxismo de sueño (BS) uno de muchos factores asociados con TTM dolorosos. Tanto los TTM como el BS se presentan en adultos y niños y actualmente es sabido que la etiopatogenia de ambos no difiere de acuerdo a la edad. Las ATM son articulaciones sinoviales que pueden verse afectadas por diversos TTM o por condiciones sistémicas como la artritis idiopática juvenil (AIJ). La ATM está involucrada en un 40% de los pacientes con AIJ, siendo subestimada debido a que clínica-mente se manifiesta con poco dolor. En el presente artículo se revisarán los conceptos de TTM y BS en niños, así como también la manifestación de la AIJ en el territorio orofacial, entregando una aproximación de su etiopatogenia, identificación y manejo.

Temporomandibular disorders (TMD) encompass a group of musculoskeletal and neuromuscular conditions that involve the temporomandibular joints (TMJ), the masticatory muscles, and all associated tissues. TMD's etiology is considered to be mul-tifactorial, were sleep bruxism (SB) is one of many causes of painful TMD. TMD and SB can present in adults and children and the etiology does not differ regarding age.TMJ are synovial joints that can be affected by many TMD as well as systemic conditions such as juvenile idiopathic arthritis (JIA). TMJ are involved in 40% of patients with JIA, which is usually underestimated because of its painless presentation.This article will review the concepts of TMD and SB in children, as well as JIA presentation in the orofacial region.

Evaluation of the association of bruxism, psychosocial and sociodemographic factors in preschoolers

Abstract The aim of the present study was to evaluate factors associated with sleep bruxism in five-year-old preschool children. A preschool-based cross-sectional study was conducted with 761 pairs of children and their parents/caregivers. Sleep bruxism was diagnosed using a questionnaire administered to the parents/caregivers, who also answered questionnaires addressing sociodemographic data and parent's/caregiver's sense of coherence. Clinical oral evaluations of the children to determine dental caries, traumatic dental injuries, malocclusion and tooth wear were performed by two researchers who had undergone a training exercise (interexaminer Kappa: 0.70 to 0.91; intraexaminer Kappa: 0.81 to 1.00). Descriptive analysis and logistic regression for complex samples were carried out (α = 5%). The prevalence of sleep bruxism among the preschool children was 26.9%. The multivariate analysis revealed that bruxism was associated with poor sleep quality (OR = 2.93; 95 CI: 1.52-5.65) and tooth wear (OR = 2.34; 95%CI: 1.39-3.96). In the present study, sleep bruxism among preschool children was associated with tooth wear and poor sleep quality of the child. In contrast, psychosocial aspects (sense of coherence) were not associated with sleep bruxism.

Sleep bruxism and anxiety level in children

This study evaluated the association of level of anxiety in children with and without sleep bruxism (SB). The study was performed with 84 six- to eigth-years-old children, divided into two groups: with bruxism (BG) and without bruxism (CG). Following the criteria purposed by American Academy of Sleep Medicine (AASM) to determine SB, the presence of tooth wear has been verified through clinical examinations, and the parents have answered a questionnaire about their children’s behavior and habits. Additionally, the State-Trait Anxiety Inventory for Children (STAIC) was applied to parents of the selected patients. Data analysis revealed a statistical significant difference between the groups (Student’s t-test, p= 0.0136). Based on the results, anxiety assessment revealed that children with bruxism have reached higher levels in the STAIC scale than the non-bruxism group. Therefore, it indicates a direct relationship between the presence of anxiety disorder and the onset of bruxism in children.

Terapéutica alternativa asociada al bruxismo: revisión de literatura / Alternative therapy associated to bruxism: literature review

Discutir las principales y más eficaces actividades terapéuticas en el control del bruxismo nocturno. Para la identificación de los estudios, fue realizada una estrategia de búsqueda detallada y avanzada en los bancos de datos: PubMed y Medline. Fueron utilizados como PALABRAS CLAVE: bruxism, therapeutics y drug therapy. Los criterios de inclusión fueron: artículos clínicos, estudios controlados aleatorios, estudios in vitro, revisiones de literatura y revisiones sistemáticas con y sin meta-análisis de los últimos 10 años, que aborden el tema propuesto. Los criterios de exclusión fueron: artículos sin resumen, estudios en animales, artículos cuyo idioma no sea el inglés y artículos de revistas que no pertenecen al área odontológica. De un total de 83 artículos, después de un análisis según el criterio de inclusión y exclusión, fueron seleccionados 33 artículos. A pesar de la pequeña cantidad de estudios clínicos prospectivos con alto grado de confiabilidad y que la mayoría de los estudios que evaluaron la eficacia de tratamientos alternativos fueron reportes de casos clínicos aislados, la literatura muestra que la utilización de la toxina botulínica se mostró eficaz para el control del bruxismo nocturno. Por otro lado, aspectos importantes como el efecto transitorio, dosis segura y técnica de aplicación aún son poco estudiados, de esa manera más investigaciones son necesarias para que esas dudas sean esclarecidas...

The aim of this study was to review the literature in order to discuss the main and the most effective therapeutic activities to control the nocturnal bruxism. To identify the studies included in this review, it was conducted a detailed and advanced search strategy in the PubMed and Medline databases. It was used as KEY WORDS: bruxism, therapeutics and drug therapy. Inclusion criteria were: case reports, randomized controlled trials, in vitro studies, literature reviews and systematic reviews with or without meta-analysis of the past 10 years that addressed the theme. Exclusion criteria were: articles without abstract, animal studies, articles whose first language was not English and articles from journals that do not belong to the dentario field. From a total of 83 articles, after an analysis according to the inclusion and exclusion criteria, 33 articles were selected. Despite the fact that there is a small number of prospective clinical studies with high degree of reliability and most studies that evaluated the alternative treatments effectiveness are isolated case reports, the current literature shows that the use of botulinum toxin has been shown to be effective in the control of nocturnal bruxism. On the other hand, important aspects such as transitory effect, safe dosage and application technique are still little discussed, then, further studies are needed to have these doubts clarified...

Prevalence and predictive factors of sleep bruxism in children with and without cognitive impairment

Studies have found a higher prevalence of sleep bruxism (SB) in individuals with cognitive impairment. The aim of this study was to identify the prevalence and factors associated with the clinical manifestation of SB in children with and without cognitive impairment. The sample was made up of 180 individuals: Group 1 - without cognitive impairment; Group 2 - with Down syndrome; Group 3 - with cerebral palsy. Malocclusions were assessed based on the Dental Aesthetic Index (DAI); lip competence was assessed based on Ballard's description. The bio-psychosocial characteristics were assessed via a questionnaire and clinical exam. Statistical analysis involved the chi-square test (p < 0.05) and multivariate logistic regression. The prevalence of bruxism was 23 percent. There were no significant differences between the groups (p = 0.970). Individuals with sucking habits (OR [95 percent CI] = 4.44 [1.5 to 13.0]), posterior crossbite (OR [95 percent CI] = 3.04 [1.2 to 7.5]) and tooth wear facets (OR [95 percent CI] = 3.32 [1.2 to 8.7]) had a greater chance of exhibiting SB. Sucking habits, posterior crossbite and tooth wear facets were identified as being directly associated with the clinical manifestations of bruxism.

Bruxismo: etiologia e tratamento / Bruxism: etiology and treatment

O trabalho tem por objetivo revisar a literatura sobre a etiologia e formas de tratamento para o bruxismo. Pôde-se observar que, após a revisão, a etiologia é multifatorial e o tratamento ainda é discutível. O profissional, cirurgião-dentista, deve conhecer os sinais e sintomas desta parafunção para elaborar um diagnóstico e medidas terapêuticas corretas.

Bruxismo nocturno / Sleep bruxism

El bruxismo nocturno es una parafunción caracterizada por contracciones musculares repetidas de la mandíbula. Esto se transforma en una condición patológica cuando el paciente presenta daño dentario. La mayor actividad muscular fue encontrada en el estadio dos del sueño y durante el despertar. El bruxismo es un fenómeno controvertido, pero existe consenso sobre su etiología multifactorial

Bruxismo e apnéia do sono / Sleep bruxism and apnea

A associação entre distúbios do sono e dor é uma queixa comum em pacientes portadores de dores orofaciais. Dentre os distúrbios do sono, o bruxismo e a apnéa são comprometimentos importantes que devem ser identificados e tratados. O intuito deste trabalho é revisar a literatura pertinente, ressaltando a etiologia, o diagnóstico e as modalidades terapêuticas empregadas no tratamento desses pacientes

Factores asociados con bruxismo en niños y su prevalencia / Factors associated with bruxism in children and its prevalence

En la actualidad son muy frecuentes las consultas por bruxismo en la clínica odontopediátrica. Los factores vinculados con su etiología son múltiples, no endontrándose aún totalmente definidos, aunque se lo considera una parasomnia primaria no específica del sueño. POr ser una parafunción incociente, cuyos signos y síntomas no se observan en forma inmediata, el interrogatorio a padres y pacientes es el elemento más importante para el diagnóstico. El objetivo de este estudio es analizar la prevalencia de bruxismo en dentición primaria y mixta, y relacionarla con los factores más frecuentemente asociados. Material y métodos: se evaluaron 172 niños de ambos sexos de 5.61 + 0.48 años con dentición priamaria (DP) y 195 de 8.83 + 1-03 con dentición mixta (DM), pertenecientes a escuelas públicas de Gran Buenos Aires. Se utilizó un cuestionario domiciliario dirigido a los responsables del niño, donde se interrogó sexo, edad, rechinamiento, alteraciones del sueño, hábitos alimenticios, dolor de oídos y/o cabeza, respiración bucal y otros hábitos orales, parásitos y antecedentes familiares de bruxismo. Las opciones de respuesta fueron por sí o por no. Clínicamente se evaluó tipo de dentición, apertura máxima con y sin dolor, ruido y dolor articular, facetas de desgaste y alteraciones de la oclusión. Los datos fueron procesados en base de datos y analizados estadísticamente por Test t de Fisher. La prevalencia de bruxismo fue del 29 por ciento en dentición primaria y 17.94 por ciento en dentición mixta, vinculándose positivamente en ambas denticiones con otras alteraciones del sueño (DP p<0.0001, DM p=0.0015), respiración b ucal (DP p=0.0165, DM p=0.0018), dieta blanda (DP p<0.0001, DM p<0.0001) y dolor de oído y/o cabeza (DP p=0.0212, DM p=0.0321). Conclusiones: en esta población se observó mayor prevalencia de bruxismo en niños con dentición primaria, vinculándose en ambas denticiones con respiración bucal, otras alteraciones del sueño, dificultades en la alimentación y dolor de oídos y/o cabeza

Bruxismo y dolor crónico orofacial / Bruxism and chronic orofacial pain

En el estado actual del conocimiento sobre los factores y mecanismos del bruxismo se han ido abandonando las posiciones de la relación causal estrecha entre oclusión y bruxismo, pero sin descartarla como factor a tener en cuenta por ser parte del complejo proceso perceptivo periférico. Crece la evidencia experimental del papel clave que juegan los mecanismos centrales excitadores e inhibidores de la actividad muscular y cuando se ha vuelto crónico de muy poca posibilidad de solución; salvo el efectgo placebo o la remisión espontánea. El dolor crónico orofacial no guarda una relación causal demostrable con el bruxismo pero, sin embargo, puede coexistir o no. No obstante, como factor irritativo crónico sobre las estructuras profundas perceptivas es muy probable que contribuya a establecer circuitos centrales por la acción neuroendócrina y de neuropéptidos vinculados a la acción neuromuscular y al dolor por el efecto de hiperalgesia central resultante de la estimulación repetitiva (wind up). Por ello, es muy importante el diagnósitoc multifactorial temprano y la terapia biaxial que es interactiva. La llamada vinculación del stress emocional con el dolor es parte de un fenómeno más complejo con los que se llaman fenómenos vivenciales como los culturales; estilo de enfrentamiento; rasgos de personalidad; ansiedad; angustia, miedo y la vinculación de la depresión con el dolor que interactúan con los neuroendócrinos. Dado que el dolor crónico (como otras enfermedades crónicas) es una condición para la cual usualmente la cura no es posible, el objetivo de la mayor parte de los casos de dolor crónico es un programa de tratamiento rehabilitativo más que curativo, para evitar la discapacitación y/o el padecimiento. Estos aspectos deben tratarse con una buena relación interpersonal, una serie de tests y una entrevista estructurada que permita la terapia cognitiva