Are mental health problems and depression associated with bruxism in children?

Association between possible bruxism, sleep quality, depression, anxiety and stress by gender. A cross-sectional study in a Spanish sample

OBJECTIVE

To explore the associations between possible bruxism, sleep quality, depression, anxiety and stress, with a specific focus on gender differences.

MATERIAL AND METHODS

An online questionnaire was administered to 400 Spanish-speaking participants, without cognitive impairments. The survey included the possible bruxism self-perception test of Lobbezoo et al., the Pittsburgh Sleep Quality Index, and the Depression, Anxiety, and Stress Scale-21 (DASS-21). Participants were recruited using a "snowball" sampling technique over a five-month period in 2024. The Chi-square test and the Fisher-Freeman-Halton exact test were used for statistical analysis. The significance level was set at 0.05.

RESULTS

Possible bruxists made up 25.4 % of women (n = 67) and 14.7 % of men (n = 20), with a statistically significant difference (P = 0.019). Depression was present in 30.0 % of participants (33.0 % of women and 24.3 % of men; P = 0.072), anxiety in 30.7 % (36.0 % of women and 20.6 % of men; P = 0.002), and stress in 29.0 % (33.3 % of women and 20.6 % of men; P = 0.008). No significant association was found between possible bruxism and emotional disorders in men, whereas a strong association was observed in women (P < 0.001). Similarly, no statistically significant relationship was found between possible bruxism and sleep quality in either gender. However, poor sleep quality was more common among women than men (54.6 % vs 43.7 %; P = 0.040).

CONCLUSIONS

Poor sleep quality, anxiety, stress and depression and possible bruxism are more frequent among women. While no association between possible bruxism and emotional disorders was found in men, a significant relationship was observed in women. Furthermore, although no direct association between possible bruxism and sleep quality was detected, sleep quality was significantly associated with emotional disorders in both genders.

CLINICAL RELEVANCE

These findings suggest that emotional disorders may contribute to the development of possible bruxism in women but not in men. Therefore, women with emotional disorders should be closely monitored, as they are particularly susceptible to possible bruxism and poor sleep quality. Dentists play a crucial role in diagnosing possible bruxism and identifying patients who may benefit from psychological support.

Probable sleep and awake bruxism in adolescents: A path analysis

BACKGROUND

Bruxism has a multifactorial etiology, including the influence of sleep characteristics and chronotypes.

AIM

To identify the pathways that influence the occurrence of probable sleep bruxism (PSB) and probable awake bruxism (PAB) in adolescents.

DESIGN

A total of 403 adolescents, aged 12-19 years, participated in the study. Parents/caregivers filled out a questionnaire about sociodemographic issues and the adolescent's health conditions, and the adolescents about sleep characteristics, occurrence of bruxism (based on previous study and the International Consensus of Bruxism), and chronotype (Circadian Energy Scale). Clinical examinations were performed. Statistical analysis included descriptive analysis and path analysis.

RESULTS

PSB and PAB are related to each other, with moderate and positive correlation (β = .390). Poor sleep quality and higher household income had a direct effect on both PSB (β = -.138; β = .123, respectively) and PAB (β = -.155; β = .116, respectively). Chronotype had a direct effect on PSB, in such a way that adolescents with a morningness chronotype tend to have PSB (β = -.102). Adolescents that drool on the pillow (β = .184) and/or have agitated sleep (β = .104) tend to have PSB.

CONCLUSION

Poor sleep quality, household income, morningness chronotype profile, drooling on the pillow, and agitated sleep influence the paths taken by PSB. PAB was influenced by the quality of sleep and family income.

Global Prevalence of Sleep Bruxism and Awake Bruxism in Pediatric and Adult Populations: A Systematic Review and Meta-Analysis

Background/Objectives: The purpose of this systematic review was to assess the global prevalence of sleep bruxism and awake bruxism in pediatric and adult populations. Methods: This systematic review was conducted by analyzing studies published from 2003 to 2023. The following keyword combination was utilized: prevalence, epidemiology, population, and bruxism. The PubMed database was analyzed, supplemented by manual searches using the Google search. Additionally, the snowballing procedure method was applied. A double assessment of the quality of publications was carried out to preserve the highest possible quality of evidence (e.g., Joanna Briggs Institute critical appraisal checklist). Analyses were conducted using the R statistical language. Results: The global bruxism (sleep and awake) prevalence is 22.22%. The global sleep bruxism prevalence is 21% and awake prevalence is 23%. The occurrence of sleep bruxism, based on polysomnography, was estimated at 43%. The highest prevalence of sleep bruxism was observed in North America at 31%, followed by South America at 23%, Europe at 21%, and Asia at 19%. The prevalence of awake bruxism was highest in South America at 30%, followed by Asia at 25% and Europe at 18%. Conclusions: One in four individuals may experience awake bruxism. Bruxism is a significant factor among women. It was observed that age is a significant factor for the occurrence of sleep bruxism in women. Among the limitations of the study is the lack of analysis of the prevalence of bruxism in Africa and Australia due to not collecting an adequate sample for analysis. The study was registered in the Open Science Framework (10.17605/OSF.IO/ZE786).

Sleep Bruxism in Children: A Narrative Review

Sleep bruxism, characterized by involuntary grinding or clenching of the teeth and/or by bracing or thrusting of the mandible during sleep, is common in children. Sleep bruxism occurs while the patient is asleep. As such, diagnosis can be difficult as the affected child is usually unaware of the tooth grinding sounds. This article aims to familiarize physicians with the diagnosis and management of sleep bruxism in children. A search was conducted in May 2023 in PubMed Clinical Queries using the key terms "Bruxism" OR "Teeth grinding" AND "sleep". The search strategy included all observational studies, clinical trials, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. According to the International classification of sleep disorders, the minimum criteria for the diagnosis of sleep bruxism are (1) the presence of frequent or regular (at least three nights per week for at least three months) tooth grinding sounds during sleep and (2) at least one or more of the following (a) abnormal tooth wear; (b) transient morning jaw muscle fatigue or pain; (c) temporary headache; or (d) jaw locking on awaking. According to the International Consensus on the assessment of bruxism, "possible" sleep bruxism can be diagnosed based on self-report or report from family members of tooth-grinding sounds during sleep; "probable" sleep bruxism based on self-report or report from family members of tooth-grinding sounds during sleep plus clinical findings suggestive of bruxism (e.g., abnormal tooth wear, hypertrophy and/or tenderness of masseter muscles, or tongue/lip indentation); and "definite" sleep bruxism based on the history and clinical findings and confirmation by polysomnography, preferably combined with video and audio recording. Although polysomnography is the gold standard for the diagnosis of sleep bruxism, because of the high cost, lengthy time involvement, and the need for high levels of technical competence, polysomnography is not available for use in most clinical settings. On the other hand, since sleep bruxism occurs while the patient is asleep, diagnosis can be difficult as the affected child is usually unaware of the tooth grinding sounds. In clinical practice, the diagnosis of sleep bruxism is often based on the history (e.g., reports of grinding noises during sleep) and clinical findings (e.g., tooth wear, hypertrophy and/or tenderness of masseter muscles). In childhood, sleep-bruxism is typically self-limited and does not require specific treatment. Causative or triggering factors should be eliminated if possible. The importance of sleep hygiene cannot be over-emphasized. Bedtime should be relaxed and enjoyable. Mental stimulation and physical activity should be limited before going to bed. For adults with frequent and severe sleep bruxism who do not respond to the above measures, oral devices can be considered to protect teeth from further damage during bruxism episodes. As the orofacial structures are still developing in the pediatric age group, the benefits and risks of using oral devices should be taken into consideration. Pharmacotherapy is not a favorable option and is rarely used in children. Current evidence on the effective interventions for the management of sleep bruxism in children is inconclusive. There is insufficient evidence to make recommendations for specific treatment at this time.

Unveiling the Unspoken: Exploring Oral Manifestations of Psychological Disorders

Psychological variables also interact closely with several tissues and systems leading to several diseases. The oral cavity is also linked to potential physical manifestations of psychological origin. Oral symptoms such as facial pain, oral dysaesthesia, extreme palatal erosion, or self-inflicted harm are perhaps the first or sole signs of mental health issues. It is crucial to remember that oral symptoms are frequently complex. Different people may respond differently to psychological variables and varied oral health. It is essential for dentists and medical professionals to recognize and resolve these vital problems. In this review, we have summarized the changes to oral mucosa and hard tissues and other pain disorders associated with psychological factors. Oral manifestations of a few known psychological disorders are also enumerated. This review emphasizes the role of the dentist in identifying the underlying psychological factors with oral changes. In conclusion, continuous dental care should be insisted on for patients with known mental illness to improve their quality of life. Oral health should be taken into account as part of the heightened emphasis on the overall physical well-being of those suffering from severe mental illnesses.

Evaluation of oral health-related quality of life in patients with temporomandibular disorders

OBJECTIVE

To evaluate oral health-related quality of life (OHRQoL) in patients with temporomandibular disorders (TMDs).

METHODS

Subjects included 56 patients diagnosed with TMD. Control subjects consisted of 30 individuals without temporomandibular joint symptoms. OHRQoL was evaluated using the Japanese version of the Oral Health Impact Profile (OHIP-J54) before and 4 months after treatment.

RESULTS

Total score and all subscale scores of the OHIP-J54 in patients before treatment were significantly higher than those of the control subjects and were significantly improved after treatment, except for social disability. Gender and NRS pain scores had statistically significant effects on OHRQoL, which was low in females and patients with severe pain.

CONCLUSION

OHIP-J54 appeared to be useful for understanding psychological and social problems as a screening tool and for assessing the extent of changes in the well-being of patients with TMD.

Are lower urinary tract conditions more common in children with sleep bruxism?

INTRODUCTION

Sleep bruxism is a parasomnia caused by rhythmic and non-rhythmic activity of the masticatory muscles during sleep. Prevalence of sleep bruxism is reported up to 40.6% in the literature. Sleep bruxism is a multifactorial issue and associated with multiple dental complications, sleep-related disorders, and psychosocial problems. We aimed to investigate if children with sleep bruxism suffer more from lower urinary tract conditions.

MATERIALS AND METHODS

Prospectively 128 children were included in this study. Sixty-four children constituted in the bruxism group and 64 children constituted in the control group. Children who admitted to the pediatric dentistry clinic with bruxism symptoms were recruited in the bruxism group. Control group constituted of consecutive 64 children who admitted to the pediatric dentistry clinic for routine dental examination. Parents were asked to fill out a questionnaire including Dysfunctional Voiding and Incontinence Scoring System (DVISS) form. Children's demographic data, presence of urinary frequency, presence of urgency, behaviour of voiding postponement, presence of daytime urinary incontinence, presence of enuresis nocturna, presence of fecal incontinence, presence of constipation, status of circumcision, and presence of bruxism related symptoms were recorded. Children with a DVISS score above 8 were considered to have functional voiding disorder. All children underwent a dental examination.

RESULTS

The mean age of children was 73.3 ± 26.9 months. For all children (n = 128), the girl to boy ratio was 40:88. Mean DVISS score was 2.5 ± 3.8 and the mean QOL score was 0.1 ± 0.4 for all children. Eight (6.3%) children were found to have functional voiding disorder based on the DVISS score. There was no statistically significant difference for any lower urinary tract condition between the bruxism group and the control group (Table). Children with bruxism significantly had more tooth wear and masseter muscle hypertrophy (<0.001 and < 0.05).

DISCUSSION

Sleep bruxism has been linked to a number of health issues including dental, systemic and psychosocial problems. Tooth wears, fatigue/pain in chewing muscles, gum recession, facial pain, masseter muscle hypertrophy and temporomandibular joint damage are the main complications of bruxism. Moreover, bruxism has been associated with systemic diseases and sypmtoms like asthma, respiratory illnesses, enuresis nocturna, anxiety, and stress.

CONCLUSIONS

Children with sleep bruxism suffer more from tooth wear, masseter muscle hypertrophy, and regional pain over the jaw. Additionally morning fatigue, relationship issues, and respiratory illnesses are more common in bruxist children. Lower urinary tract conditions are not more frequent in children with sleep bruxism.

Association between possible awake bruxism and bullying among 8- to 11-year-old children/adolescents

BACKGROUND

Bruxism is characterized by tooth grinding and/or clenching.

AIM

To evaluate the association between possible awake bruxism (PAB) and bullying among individuals aged 8-11 years.

DESIGN

A representative cross-sectional study was conducted with 434 eight- to eleven-year-old children/adolescents. Parents/caregivers answered a questionnaire to provide data on sociodemographic characteristics. Children/adolescents answered a questionnaire about the occurrence of PAB. The Olweus Bully/Victim Questionnaire was used. The Poisson regression analysis was performed.

RESULTS

Of the 434 children/adolescents, 209 (48.2%) were boys and 225 (51.8%) were girls. The mean age of the children/adolescents was 9.14 years (±1.00). Children/adolescents who were victims of bullying (PR = 1.52, 95% CI = 1.14-2.04, P = .005) and bullies-victims (PR = 2.08, 95% CI = 1.36-3.17, P = .001) presented a higher frequency of PAB than those who were not involved in bullying.

CONCLUSION

Children/adolescents who were bullying victims and bullies-victims had a higher frequency of PAB.

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.

Social, emotional, and behavioral problems and parent-reported sleep bruxism in schoolchildren

BACKGROUND

A number of theories associate emotional factors with the triggering of sleep bruxism (SB). Few studies have used validated instruments to assess psychological characteristics and SB in children. In this study, the authors aimed to assess the prevalence of parent-reported SB in children and its association with social, emotional, and behavioral problems.

METHODS

The authors conducted a cross-sectional study with a school-based sample at 20 public schools in Brazil. Parents or caregivers provided information related to tooth-grinding sounds during sleep and about children's social, emotional, and behavioral problems by using the Strength and Difficulties Questionnaire. Analyses were carried out considering each subscale of the Strength and Difficulties Questionnaire and the total score. The authors estimated prevalence ratios by using a Poisson regression model. Statistical inferences were based on 95% confidence intervals.

RESULTS

A total of 556 children aged 8 years were included. Prevalence of SB was 30.83%. Results of an adjusted analysis showed a significant association of SB with higher scores on total difficulties (overall score) (P < .001) and emotional symptoms (P < .001) and peer relationship problems (P = .010) subscales.

CONCLUSIONS

Parental reports of emotional and behavioral problems were associated with a higher prevalence of SB in schoolchildren.

PRACTICAL IMPLICATIONS

This study's results contribute to those of previous investigations about the association between psychological characteristics and SB. Interdisciplinary research involving dentistry and psychology may improve the understanding of bruxism.

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

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.

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.

Prevalence of probable sleep bruxism and associated factors in Brazilian schoolchildren

AIM

To determine the prevalence of probable sleep bruxism (PSB) and associated factors among schoolchildren.

DESIGN

This cross-sectional study was carried out with a representative sample of 440 schoolchildren. The children were submitted to a clinical oral examination for the evaluation of tooth wear and/or muscle discomfort. Parents/caregivers filled out a questionnaire with information related to characteristic sounds of sleep bruxism, sociodemographic factors, and the presence of harmful oral habits of children. The stress of the mothers was measured through the Lipp's Stress Symptoms Inventory for Adults (LSSI) instrument. The child's stress was measured through the Child Stress Scale (CSS). Data analysis included descriptive analysis and hierarchical Poisson regression (95% CI, P < 0.05).

RESULTS

The prevalence of PSB was 40.0% (n = 176). The final Poisson regression model showed that PSB was significantly more prevalent in children with a history of nail biting (PR: 1.50; 95% CI: 1.19-1.90; P = 0.001) and biting objects (PR: 1.30; 95% CI: 1.03-1.63; P = 0.025) and less prevalent among girls (PR: 0.78; 95% CI: 0.63-0.98; P = 0.033).

CONCLUSIONS

The prevalence of PSB in schoolchildren was high. Schoolchildren with a history of nail biting and biting objects had a higher prevalence of PSB.

Prevalence and associated factors to sleep bruxism in adolescents from Teresina, Piauí

INTRODUCTION

Sleep bruxism (SB) is defined as a repetitive jaw muscle activity whose epidemiology in adolescents has been little studied. This cross-sectional study aimed to determine the prevalence of sleep bruxism and associated factors in adolescents.

METHODOLOGY

The sample consisted of 594 students aged 11 to 14 years old from Teresina, Piauí, Brazil. Self-administered questionnaire was answered by parents/caregivers and dental clinical examination was performed. Pearson's chi-squared test was used to assess the association between SB and independent variables. Poisson regression analysis with robust variance was applied, with results expressed in prevalence ratio (PR).

RESULTS

The prevalence of SB in adolescents was 22.2%. Multivariate analysis showed a higher prevalence of SB in male gender adolescents (PR = 1.41; 95%CI 1.04 - 1.89), presenting snoring (PR = 1.39; 95%CI 1.02 - 1.89) and difficulty falling asleep (PR = 1.92; 95%CI 1.38 - 2.66).

CONCLUSION

SB is a frequent condition in adolescents, and the factors associated with its prevalence were: male sex, snoring and difficulty falling asleep.

Effects of attention deficit hyperactivity disorder signs and socio-economic status on sleep bruxism and tooth wear among schoolchildren: structural equation modelling approach

BACKGROUND

The prevalence of both bruxism and attention deficit hyperactivity (ADHD) has increased in recent years.

AIM

This study evaluated the direct and indirect effects of signs of ADHD, reported by parents/caregivers and teachers, with sleep bruxism. In addition, this study explores the effects of socio-economic status (SES) on sleep bruxism.

DESIGN

This cross-sectional study was performed in Diamantina, Brazil, with 851 randomly selected schoolchildren aged 6-12 years. The schoolchildren were underwent an oral examination for the evaluation of bruxism. Moreover, parents/caregivers fill out a form for the assessment of sleep bruxism and sociodemographic factors. Parents/caregivers and teachers responded to the Swanson, Nolan and Pelham scale - version IV (SNAP-IV) for the assessment of ADHD signs. The structural equation modelling approach was used, and standardized coefficients to direct, indirect and total effects were calculated.

RESULTS

ADHD signs had a significant moderate (SC = -0.19, P < 0.01) effect on sleep bruxism. SES had a significant indirect effect on bruxism via sucking habits. Moreover, SES had a significant direct (SC = -0.16, P = 0.01) and total effect on tooth wear (SC = -0.17, P < 0.01).

CONCLUSION

This study concluded that signs of ADHD and SES have a complex direct and indirect effects on sleep bruxism among schoolchildren.

Diagnosis of sleep bruxism can assist in the detection of cases of verbal school bullying and measure the life satisfaction of adolescents

BACKGROUND

Adolescence is a period with changes and conflicts.

AIM

The aim of this study was to investigate the association between sleep bruxism, verbal bullying at school, and life satisfaction among Brazilian adolescents.

DESIGN

A cross-sectional study of 1344 Brazilian adolescents was performed. Possible sleep bruxism was identified using the consensus criteria based on the reports of parents. The parents and the adolescents answered validated questionnaires. The data were statistically analyzed using the chi-squared test, Mann-Whitney U-test, and Poisson regression with robust variance.

RESULTS

A total of 205 adolescents presented possible sleep bruxism (15.3%). This parafunction was more prevalent among adolescents who were victims of verbal bullying at school (PR: 6.31; 95% CI: 4.78-8.32), victim/perpetrators (PR: 5.27; 95% CI: 3.82-7.27), and who belonged to families from a higher socioeconomic status (RP: 1.51; 95% CI: 1.23-1.86). Possible sleep bruxism was also associated with higher scores in the domains of self (PR: 1.04; 95% CI: 1.00-1.08), school (PR: 1.05; 95% CI: 1.02-1.09) and self-efficacy (PR: 1.07; 95% CI: 1.03-1.12), and lower scores in the non-violence domain (PR: 0.96; 95% CI: 0.93-0.99).

CONCLUSIONS

Possible sleep bruxism can assist in the detection of adolescents involved in school bullying at school in the roles of victim and victim/perpetrator.

Agreement between two different approaches to assess parent-reported sleep bruxism in children

INTRODUCTION

Parents' report is the most used method for the study of sleep bruxism (SB) in children, especially in research with large samples. However, there is no consensus about the questions used to assess SB, what may difficult the comparisons between studies.

OBJECTIVE

The aim of this research was to evaluate the agreement between two different approaches to assess possible sleep bruxism (PSB) in children using parents' report.

METHODS

This cross-sectional study was conducted with 201 parents/caregivers. Prior to the questionnaire completion, all participants received a standard explanation of SB concept. Subsequently, the parents/caregivers answered a general question (GQ) and a frequency-time question (FTQ) about SB, and the answers were compared.

RESULTS

The majority of the participants were the children's mothers (73%) and the childrens mean age was 7.5 years (SD: 2.25). PSB frequency in children did not differ statistically through the two questions [GQ: 30.7% (CI95%: 24.2 - 37.1) and FTQ: 26.6% (CI95%: 20.4 - 32.8)], and an almost perfect agreement was observed between the answers (kp=0.812). Nevertheless, the FTQ showed a more coherent relation with the factors already recognized as associated with childhood bruxism than GQ.

CONCLUSIONS

Different approaches result in similar PSB frequency, however, they show different ability to identify PSB associated factors and suggest the need of questions including frequency and time in further studies.

Association between proxy-reported sleep bruxism and quality of life aspects in Colombian children of different social layers

OBJECTIVE

To describe and explore the association between proxy-reported sleep bruxism (SB) and quality of life (QoL) in a population of Colombian children belonging to different social layers.

METHODS

The parents of 1556, 6-13-year-old school children, were administered the Pediatric Inventory of Quality of Life (PedsQL4.0™) and an evaluation of their sociodemographic and socioeconomic conditions. Associations between such proxy-reported, viz., "possible" SB and QoL features were assessed by means of the linear-by-linear association test on the overall sample and for distinct socioeconomic groups.

RESULTS

No significant associations were shown between proxy-reported sleep bruxism and the total and domain PedsQL scores, with the exception of a weak correlation with the School Functioning Score. As for the specific QoL items, only two variables of the Emotional Functioning Scale of the PedsQL4.0 (i.e., "feeling afraid or scared" and "trouble sleeping") and a feature of the School Functioning Scale (i.e., "forgetting things") were weakly correlated with SB, with correlation coefficients ranging from 0.092 to 0.119. Considering the different socioeconomic groups, no associations were found in the low layer. In the medium socioeconomic group, a significant association was pointed out with one emotional functioning aspect, while in the high layer an association was found with two emotional features and three school functioning variables.

CONCLUSION

The results pointed out only a few associations between proxy-reported SB and the emotional and school functioning aspects of children's quality of life, both in the total sample as well as in children belonging to medium and high socioeconomic status, while no associations were found with physical health and social functioning domains.

CLINICAL RELEVANCE

This article gives information to help clinicians evaluating the QoL, sociodemographic, and socioeconomic characteristics in children with possible sleep bruxism.

Association of temporomandibular disorder with occupational visual display terminal use

Increased visual display terminal (VDT) use has raised the prevalence of VDT-related adverse conditions, such as dry eye disease, and musculoskeletal and psychopathological symptoms, in office workers, including temporomandibular disorder (TMD). Many factors contributing to TMD have been identified, such as parafunctional habit (bruxism and teeth clenching), trauma, mental disorders, lifestyle, poor health, and nutrition, as well as hormonal factors (i.e., estrogen). It is likely that various contributing factors overlap in TMD development in individuals who routinely use a VDT for work. However, the relationship between TMD and VDT use has not been fully elucidated. In this mini-review, findings of recent studies of TMD in relation to occupational VDT use in Japan are discussed, as well as characteristic features and prevention strategies.

Sleep complaints in the Brazilian population: Impact of socioeconomic factors

National surveys are relevant for the study of sleep epidemiology since they can provide specific data about sleep in large dimension with important implications for the health system. Thus, the aim of this study was to investigate the prevalence of sleep complaints among the Brazilian population using a randomized cluster sample according to region and socioeconomic class. For this, a 3-stage sampling technique was used to randomly select Brazilian subjects of both genders older than 16 years. A total of 2017 subjects, from 132 different cities, were selected to estimate prevalence in the Brazilian population with a sampling error of ±2%. Questions about sleep complaints were administered face-to-face by Instituto Datafolha interviewers on April 10 and 16, 2012. Data were expanded using a weighted variable. The results showed that 76% of the study population suffers from at least 1 sleep complaint, indicating that approximately 108 million Brazilians may be affected by sleep disorders. On average, each subject had 1.9 sleep problems with the most common complaints being light and insufficient sleep, snoring, moving a lot during sleep, and insomnia, which usually occurred more than 3 times per week. Low income was associated with higher number of sleep complaints only in Northeast and Southeast regions. In conclusion, this study showed a high prevalence of sleep complaints in a sample of the Brazilian population, suggesting that sleep disorders may be markedly frequent in the Brazilian population with a possible correlation with the socioeconomic situation of the interviewed subjects.

Prevalence of sleep bruxism in children: a systematic review of the literature

The aim of the present investigation was to perform a systematic review of the literature dealing with the issue of sleep bruxism prevalence in children at the general population level. Quality assessment of the reviewed papers was performed to identify flaws in the external and internal validity. Cut-off criteria for an acceptable external validity were established to select studies for the discussion of prevalence data. A total of 22 publications were included in the review, most of which had methodological problems limiting their external validity. Prevalence data extraction was performed only on eight papers that were consistent as for the sampling strategy and showed only minor external validity problems, but they had some common internal validity flaws related with the definition of sleep bruxism measures. All the selected papers based sleep bruxism diagnosis on proxy reports by the parents, and no epidemiological data were available from studies adopting other diagnostic strategies (e.g. polysomnography or electromyography). The reported prevalence was highly variable between the studies (3·5-40·6%), with a commonly described decrease with age and no gender differences. A very high variability in sleep bruxism prevalence in children was found, due to the different age groups under investigation and the different frequencies of self-reported sleep bruxism. This prevented from supporting any reliable estimates of the prevalence of sleep bruxism in children.

Community based study of sleep bruxism during early childhood

OBJECTIVES

The aims for this study were to determine the prevalence of sleep-bruxism among young children, explore child behavior problems that may be associated with sleep-bruxism, and identify relations among sleep-bruxism, health problems, and neurocognitive performance.

METHODS

The current study was a retrospective analysis of parent report surveys, and behavioral and neurocognitive assessments. Parents of 1953 preschool and 2888 first grade children indicated their child's frequency of bruxism during sleep. A subsample of preschool children (n=249) had additional behavioral, as well as neurocognitive assessments. Among the subsample, parents also reported on their child's health, and completed the Child Behavioral Checklist; children were administered the Differential Ability Scales, and Pre-Reading Abilities subtests of the Developmental Neuropsychological Assessment.

RESULTS

36.8% of preschoolers and 49.6% of first graders were reported to brux ⩾1time per week. Among the preschool subsample, bruxing was independently associated with increased internalizing behaviors (β=.17). Bruxism was also associated with increased health problems (β=.19), and increased health problems were associated with decreased neurocognitive performance (β=.22).

CONCLUSIONS

The prevalence of sleep-bruxism was high. A dynamic and potentially clinically relevant relation exists among sleep-bruxism, internalizing behaviors, health, and neurocognition. Pediatric sleep-bruxism may serve as a sentinel marker for possible adverse health conditions, and signal a need for early intervention. These results support the need for an interdisciplinary approach to pediatric sleep medicine, dentistry, and psychology.