Knowledge of parents/guardians about nocturnal bruxism in children and adolescents

Attitude of Italian dental practitioners toward bruxism assessment and management: A survey-based study

INTRODUCTION

Bruxism is a spectrum of masticatory muscles activities. According to the recent evidence and international consensus, there is no indication to treat bruxism unless clinical consequences are present. The aim of the present study was to investigate the approach of Italian dentists to bruxism in their clinical practice.

METHODS

An anonymous online survey was developed, composed by 26 items grouped into five sections: (1) Characteristics of the respondent (Q1-Q6); (2) Bruxism frequencies (Q7-Q11); (3) Bruxism assessment (Q12-Q15); (4) Bruxism management (Q16-Q20); (5) Occlusal splints therapy (Q21-Q26).

RESULTS

A total of 384 practitioners, including specialists and non-specialists, participated in this survey. The majority of the respondents reported that 1-3 out of ten patients presented with bruxism. The diagnosis is mainly performed with non-instrumental methods, and facial pain and dental wear are the major clinical consequence associated with bruxism. Almost the entire sample of respondents report to offer occlusal splints to bruxism patients, and 41% refer to perform occlusal adjustments. Almost half of the respondents have never proposed any form of cognitive-behavioural therapy.

CONCLUSION

The results of the current survey highlighted several inconsistencies in Italian dentists' approaches to bruxism, suggesting the need for better education of practitioners and for the development of a standardized protocol to assess and manage bruxism in dental practices.

Sleep bruxism in children and adolescents-A scoping review

BACKGROUND AND OBJECTIVE

This review paper focuses on sleep bruxism (SB) in children and adolescents. It aims to assess the landscape of knowledge published in the last 20 years.

METHODS

A total of 144 relevant publications from 386 previously identified through Medline were included, of which 83 were on possible SB, 37 on probable SB, 20 on definite SB and 4 were non-applicable. The review places emphasis on the recent evidence on prevalence, pathophysiology, diagnosis and management of SB in children and adolescents, with special focus on probable and definitive SB.

RESULTS

The prevalence ranges from 5% to 50% depending on the age range and on the SB diagnosis (possible, probable or definitive). The pathophysiology is multifactorial, arousal associated and with behavioural problems and sleep disorders (obstructive sleep apnoea, snoring, nightmares) as risk factors, as well as respiratory conditions (allergies, oral breathing). Screening should include questionnaires and dental assessment. Instrumental recording is helpful to confirm diagnosis although more studies are needed to validate this approach in children. SB management includes controlling orofacial and dental consequences and assessing for any other comorbidity. Management options include occlusal splints, oral appliances (advancement mandibular), rapid maxillary expansion and some medications, although this last option is supported by limited evidences in children.

CONCLUSION

Suggestions of future topics in research are delivered to better understand comorbidities, diagnosis and management with improved outcomes compared to what is currently available.

Evaluation of the relationship between sleep bruxism and sleeping habits in school-aged children

OBJECTIVE

To evaluate the relationship between sleep habits and sleep bruxism (SB) in schoolaged children.

METHODS

Survey data were collected from the parents of 500 children (267 males and 233 females; age range 6-12 years). The American Academy of Sleep Medicine diagnostic criteria were used to evaluate SB. A Children's Sleep Habits Questionnaire was conducted to determine sleep habits. The chi-square test was used for statistical evaluation.

RESULTS

SB was observed in 160 children (32%). SB awareness was 5.4%. The presence of SB in other family members, mothers' education ≤8 years, and income below minimum wage were found as family risk factors. The presence of sleep disorders was 61.4% and observed to be statistically higher in those with SB.

CONCLUSION

SB is a prevalent disorder that might be associated with sleep disorders. The parents of children with SB had inadequate knowledge and awareness pertaining to SB.

Breathing problems, being an only child and having parents with possible sleep bruxism are associated with probable sleep bruxism in preschoolers: a population-based study

PURPOSE

To determine the prevalence of probable sleep bruxism (SB) in preschoolers and associated factors.

METHODS

A cross-sectional, population-based study was carried out with 862 dyads of parents/preschoolers aged 5 from Teresina, Brazil. Data collection was performed through a questionnaire answered by parents/guardians about socioeconomic, demographic, and health condition data. Each child was examined for diagnosis of probable SB based on the presence of dental wear associated or not with the report of teeth grinding by parents/guardians. The analysis of independent variables was stratified into four levels of determinants: demographic characteristics of the child (distal), characteristics of the family, environmental factors (intermediate), and health conditions (proximal). Descriptive analysis and bivariate and multivariate Poisson's regression were performed using a hierarchical approach (p < 0.05).

RESULTS

The prevalence of probable SB was 36%. In the final adjusted multivariate hierarchical model, a preschooler who was the only child (PR = 1.25; 95%CI = 1.02-1.51), with breathing problems (PR = 1.43; 95%CI = 1.19-1.73), and having parents/guardians with possible sleep bruxism (PR = 1.65; 95%CI = 1.32-2.07) had a higher prevalence of probable SB.

CONCLUSION

The prevalence of probable SB in preschoolers was high and associated with the condition of being an only child, the presence of breathing problems, and having parents/guardians with possible sleep bruxism.

Knowledge of parents/caregivers about the sleep bruxism of their children from all five Brazilian regions: A multicenter study

BACKGROUND

Sleep bruxism (SB) is a masticatory muscle activity that affects children. Parents' knowledge is important for its identification and report to dentists.

AIM

To investigate parents' knowledge about SB among their children.

DESIGN

A cross-sectional study included 1325 parents of children from dental clinics of seven institutions from all regions of Brazil. Parents answered questions about child's sleep, knowledge about SB and its occurrence among children and parents. SB definition given by parents was dichotomized as "correct"/"incorrect", based on the American Academy of Sleep Medicine definition. Descriptive, bivariate and multivariate analyses were performed (P < 0.05).

RESULTS

Most parents (57.3%) did not know what SB is and 88.9% would like to receive more information. SB prevalence among parents was 15.4% and 24.0% among children. Between parents who correctly defined SB, its prevalence increased to 27.5% among parents and 40.6% among children. Parents whose children had/have SB, who would like to receive more information about SB and were from the North, Central-West, Southeast, and South regions were more likely to define SB correctly (P > 0.05).

CONCLUSION

There is a lack of knowledge of parents about SB. SB among children, parents' interest in receiving more information and their location were factors associated to their knowledge.

Knowledge of parents/caregivers about bruxism in children treated at the pediatric dentistry clinic

Objective

To evaluate the knowledge on bruxism among parents/caregivers of children treated at the pediatric dentistry clinic.

Methods

A cross-sectional study was conducted with 103 parents/caregivers that filled out a questionnaire based on the criteria of the American Association of Sleep Medicine during the dental care offered to their children. The questionnaire addressed demographic issues of the child and caregiver, issues related to child's sleep characteristics (duration, quality and whether he/she sleeps alone) and questions about bruxism (knowledge of the parafunctional habit, bruxism in the caregiver and the child, search for treatment, causes and consequences of bruxism, and whether the caregivers wanted more information on the subject). Pearson's χ2 test and Fisher's exact test were performed (α = 5%).

Results

Sixty-seven percent reported knowing what bruxism is and 52.4% correctly described the parafunctional habit. Regarding the cause, 74.8% were unable to say and 16.5% associated the habit to an emotional factor. The prevalence of bruxism was 25.2% and 16.5% in the children and caregivers, respectively. Among the caregivers of children with bruxism, only 2.9% had sought some type of help. Child's sex, child's sleep and the search for help were significantly associated with bruxism (p = 0.034, 0.013 and < 0.001, respectively).

Conclusion

The knowledge among caregivers about bruxism is still insufficient, especially with regard to the etiology of the parafunctional habit. The lack of knowledge impedes caregivers from seeking help, and thus contributes to the worsening consequences of bruxism in adulthood.