Sleep bruxism in children, from evidence to the clinic. A systematic review

Evaluation of the relationship between bruxism and/or temporomandibular disorders and stress, anxiety, depression in adults: A systematic review and qualitative analysis

OBJECTIVE

The objective of this study was to map and systematically review the available evidence regarding the relationship between bruxism and/or temporomandibular disorders, psychological factors (stress, anxiety, depression) in adults.

MATERIAL AND METHOD

A systematic review has been conducted following the criteria described in Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020). A systematic search was performed in the Web of Science database with the last search updated as of November 2024. Observational studies in adults in which bruxism is assessed by questionnaires or clinical examination were included in the search. 10 of the 92 articles met the inclusion and exclusion requirements and were subject to a qualitative analysis.

RESULTS

There seems to be an association between bruxism, temporomandibular disorders and psychological factors. Clenching and grinding may be associated with overload of the chewing structures and give rise to symptoms typical of temporomandibular disorders, all under the probable influence of psychological factors.

CONCLUSIONS

Bruxism, associated with psychological factors, leads to the appearance of symptoms typical of temporomandibular disorders. More research is needed to understand how the factors interact.

CLINICAL SIGNIFICANCE

Clinicians should be aware of the psychological factors associated with bruxism and the relationship with temporomandibular disorders.

Parenting Styles of Divorced Parents and Their Influence on Their Children's Bruxism: A Cross-Sectional Study

Purpose

Parental divorce is one of the most common adverse events in childhood and can cause children emotional problems and influence their oral health. To explore differences in possible bruxism, state anxiety, coping and parenting styles between a group of divorced parents and a group of cohabiting parents.

Patients and Methods

A cross-sectional study was conducted, with data collected through self-report questionnaires filled in by 186 patients (8-16 years) and their parents. Children completed State Trait Anxiety Inventory (STAI), Self-Report Coping Measure (SRCM) and Parenting Style Scale. The Self-Reported Bruxism Questionnaire (SBQ) was completed by their parents.

Results

The results showed significant differences were seen between the group of divorced parents (n=93) and the control group (n=93), with higher levels of state anxiety and possible bruxism in the group of children of divorced parents. In addition, in terms of coping strategies, externalisation and problem-solving deficits stood out. In terms of parenting style, autonomy promotion was higher. Additionally, possible bruxism was influenced by coping strategies (seeking social support), attachment-based parenting style and communication, behavioural control and state anxiety. Finally, it was found that high anxiety may act as a moderating variable in the relationship between divorced parents and possible bruxism.

Conclusion

Children of divorced parents showed more possible bruxism, anxiety, coping and behavioural problems.

Wear behavior of CAD-CAM zirconia, ceramic, and 3D printed nano-hybrid resin crowns for the restoration of primary and permanent molars: An in vitro study

STATEMENT OF PROBLEM

Early childhood caries is one the world's most common problems in infants and treatment of posterior teeth with esthetic crowns in a low rate of wear on opposite dentition is a challenge for pediatric dentists.

PURPOSE

The purpose of this in vitro study was to evaluate the wear behavior of the tooth colored crown materials and the opposing teeth in using different esthetic crown materials in the mixed dentition period.

MATERIAL AND METHODS

The following tooth type and crown materials were considered in the experiment. Primary molars consist of first and second molars that were close to exfoliation or needed to be extracted because of orthodontic treatment and were caries free and with no restorations. Permanent teeth consisted of third molars that were caries free and with no restorations. Three different types of crown materials were used: nano-hybrid resin (VarseoSmile Crown plus; Bego GmbH), tetragonal zirconia polycrystalline stabilized with 3 mol% yttria (G-CERAM; Atlas Enta), and lithium disilicate glass-ceramic (IPS e.max CAD; Ivoclar AG). The wear test was performed in an artificial saliva environment (pH=6.7), based on the pin-on-plate technique, for a 2-mm stroke, under a compressive force of 30-N, at a frequency of 2-Hz and with 10 000, 20 000, and 30 000 cycles. A multi-way ANOVA statistical method was used (α=.05).

RESULTS

Wear of the opposing teeth by the glass-ceramic was greater than by the nano-hybrid resin or zirconia materials (P<.05). All 3 crown materials wore primary teeth more than permanent teeth (P<.05). Compared with nano-hybrid resin, zirconia led to more wear of the opposing tooth (P<.05). The wear behavior of the nano-hybrid resin was more predictable compared with the other 2 materials.

CONCLUSIONS

Zirconia and lithium disilicate-based glass-ceramic materials caused more wear on both primary and permanent teeth compared with nano-hybrid materials, yet exhibited less wear themselves when opposed by primary or permanent teeth.

Parental Sociodemographic Characteristics and Bruxism's Risk Factors Among Children: Saudi Arabian Evaluation

Objective

This study aimed to assess the association between sleep bruxism (SB) among children and parental sociodemographic characteristics and SB risk factors (eg, nose obstruction).

Methods

A cross-sectional survey was conducted with 250 parents of children under the age of 13 who visited pediatric dental clinics. Data were collected through a questionnaire completed by parents. Sociodemographic characteristics, the child's medical history, sleep patterns and parents' awareness of bruxism and its symptoms were investigated. Descriptive, bivariate and binary logistic regression analyses were performed.

Results

The response rate was 85.2% (55% females, 45% males) and 25.8% of the parents self-reported that their children had bruxism. The regression analysis revealed that parents reporting SB among their children were significantly more likely to have SB themselves (8.62 [3.68-20.16], p = 0.001). While children whose mothers had lower education level and were unaware of bruxism-related symptoms (such as teeth, jaw, or face pain) were less likely to be reported as having SB (0.35 [0.16-0.75], p = 0.007; 0.36 [0.14-0.97], p = 0.043, respectively). Parents who identified nose obstruction as a cause of bruxism also had children with a higher likelihood of having SB (5.49 [1.04-29.08], p = 0.045).

Conclusion

The findings highlighted that parental sociodemographic characteristic and SB risk factors associated signficantly with the prevalence of childhood SB.

Sleep bruxism (SB) may be not associated with obstructive sleep apnea (OSA): A comprehensive assessment employing a systematic review and meta-analysis

Associations between obstructive sleep apnea (OSA) and sleep bruxism (SB) are the subject of discussion but have not been confirmed definitively. Therefore, the objective of this meta-analysis was to examine the relationship between OSA and SB. This systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Embase and Web of Science were screened up to February 2024. The risk of bias was assessed with the Joanna Briggs Institute tool. 2260 records were identified, but only 14 studies were included. The odds of SB presence in OSA did not differ from the control group (OR: 1.23, 95 % CI: 0.47-3.20). The chance of SB compared to controls also did not differ in mild OSA (OR: 1.56, 95 % CI: 0.76-3.18), in moderate OSA (OR: 1.51, 95 % CI: 0.77-2.94) and in severe OSA (OR: 1.50, 95 % CI: 0.68-3.29). Additionally, the odds of SB were not increased in moderate OSA in comparison to mild OSA (OR: 1.14, 95 % CI: 0.63-2.94), in severe OSA compared to moderate OSA (OR: 1.31, 95 % CI: 0.61-2.79) or in severe OSA compared to mild OSA (OR = 1.42, 95 % CI: 0.69-2.93). The presence of SB in OSA did not differ between genders (OR: 2.14, 95 % CI: 0.65-7.05). The quality of the major studies included is low; therefore, the noted lack of correlation between OSA and SB may require further research. The relationship between OSA and SB seems to be multi-faceted. Presented results should not exempt clinicians from exact diagnosis of concomitant sleep conditions in OSA subjects.

Effects of different interventions on bruxism: an overview of systematic reviews

OBJECTIVE

This study aimed to evaluate, qualify, and summarize evidence presented in systematic reviews (SR) on treatments for bruxism.

METHODS

The overview was conducted using the PICO strategy: children, adolescents, and adults with bruxism (P) were submitted to different treatments (I) compared to other treatments, placebo, or no treatment (C) in order to evaluate incidence, prevalence, and number of episodes of bruxism (O). The search was carried out in six databases and gray literature up to July 2023. Data were extracted, and the ROBS tool was used, followed by a descriptive synthesis of the results.

RESULTS

A total of 31 SR were included. Sixteen showed a positive effect on episodes of bruxism (BE), while two had negative, one had neutral, and nine had inconclusive effects. Using the risk of bias in systematic reviews tool (ROBIS), risk of bias varied from low (n = 23) to high (n = 5) among the SR. Pharmacological treatment, oral rehabilitation, and other therapeutic approaches presented inconclusive or negative effects on BE, while oral appliances showed controversial effects. Biofeedback, physical therapy, laser therapy, and botulinum toxin showed positive effects on the reduction of BE.

CONCLUSION

Biofeedback, physical therapy, laser therapy, and botulinum toxin showed positive effects on the reduction of BE; there is still a lack of studies to support the safe and long-term use of these therapies.

REGISTRATION NUMBER

PROSPERO CRD42021273905.

Influence of psychiatric symptom profiles of parents on sleep bruxism intensity of their children

OBJECTIVE

The objective of this study was to evaluate the effects of parental anxiety, depression levels and psychiatric symptom profiles of parents on the occurrence of sleep bruxism in children.

MATERIAL & METHODS

This cross-sectional study was carried out with a sample of 94 children aged 6 to 12 years, divided into two groups: with sleep bruxism (bruxism group-BG) and without sleep bruxism (control group-CG). Beck Depression Inventory (BDI), Symptom Checklist (SCL-90-R), Symptom Checklist and Screen for Child Anxiety Related Emotional Disorders-Parent (SCARED-P) scale were used to assess anxiety and depression levels of parents. All questionnaires were filled out by parents of children. Intraoral and extraoral examinations were carried out of children in the clinic and sleep bruxism was determined. All stress conditions were investigated by logistic regression analysis. In the comparison of the qualitative data, chi-square and Fisher exact tests were used.

RESULTS

The data revealed that participants whose mothers had high anxiety and interpersonal sensitivity scores, and participants whose fathers had a medium level of obsessive-compulsive disorder were more likely to have an SB problem (p < 0.05). According to the results of BDI, the fathers' results between the BG and the CG were not statistically significant (p > 0.05). However, the mothers' results between the BG and the CG were statistically significant (p < 0.05) When all subscales of SCARED-P were evaluated, the separation anxiety disorder subscore was statistically significant in the bruxism group.

CONCLUSION

The psychological status of parents is a significant risk factor associated with SB development in school-age children.