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

Bruxism associated with short sleep duration in children with autism spectrum disorder: The Japan Environment and Children's Study

Bruxism, the involuntary activity of masticatory muscles, is common among individuals with autism spectrum disorders (ASD). Although bruxism is bidirectionally associated with sleep issues, whether an infant's sleep duration contributes to the development of bruxism remains unknown. In this study, a dataset (n = 83,720) obtained from the Japan Environment and Children's Study, a nationwide birth cohort study, was subjected to multiple imputations using logistic regression analysis with adjustments for several maternal and child-related variables. The aim of this study was to assess whether shorter sleep duration in the neonatal period additively affected the high prevalence of parent-reported bruxism (PRB) among children with ASD. The prevalences of ASD and PRB in the participants were 1.2% and 7.2%, respectively, and the odds ratio of the increased risk of PRB prevalence in individuals with ASD (95% confidence interval) was 1.59 (1.31-1.94) after covariate adjustments. Importantly, shorter sleep duration in the neonatal period (at one month of age) was significantly associated with an increased risk of PRB prevalence in individuals with ASD. The increased occurrence of bruxism, known to be highly prevalent among children with ASD, is associated with shorter sleep duration, particularly in the neonatal stage. Based on our results, a better understanding of the development of bruxism in individuals with ASD would provide valuable information for the prevention of oral diseases.

Sleep Bruxism in Children—What Can Be Learned from Anamnestic Information

Sleep bruxism (SB) is a masticatory muscle activity during sleep, and its clinical manifestation in young children is still unclear. The aim of the present study was to evaluate the role of anamnestic information in predicting possible SB in children aged 4–12 years. In a cross-sectional retrospective exploratory study, the dental files of 521 children were examined with regard to the following anamnestic information: gender, age, medical conditions associated with ear, nose, and throat (ENT), respiratory disorders, use of methylphenidate (Ritalin), oral habits, and bruxing during sleep. A child was defined as presenting possible SB when a positive report was received from parents regarding such behavior (SB positive, No. = 84). There were no age- and/or gender-wise differences between SB-positive children and children whose parents did not report SB behavior (SB negative). SB-positive children suffered more from ENT and respiratory disorders than children without SB. Additionally, the use of pacifiers/finger sucking, as well as snoring, were more common among SB-positive children as compared to their SB-negative counterparts (Chi-square). The variables which were found to significantly increase the odds of possible SB in children were mouth breathing, ENT problems, and use of a pacifier or finger sucking (forward stepwise logistic regression). Clinicians should look for clinical signs of possible SB in children whose anamnesis reveals one or more of these anamnestic signals.

Prospective association of short sleep duration in newborns with bruxism behavior in children: The Japan Environment and Children's Study (JECS)

BACKGROUND

Bruxism is defined as a repetitive masticatory muscle activity, characterized by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Although the bruxism etiology can be bidirectionally described with sleep disorders, there are few studies available to understand the association of sleep duration with bruxism behavior in early childhood.

METHODS

A dataset of children (n = 90,148) from the Japan Environment and Children's Study (JECS) - an ongoing nationwide, prospective birth cohort study - was used to investigate the prospective association of the infant's sleep duration with bruxism behavior, which were acquired using self-reported questionnaire. After multiple imputation of data, the association between sleep duration and bruxism behavior in early childhood was examined using a binomial logistic regression analysis. It was conducted with adjustments for several maternal (e.g., age at delivery and sleep duration) and child-related (e.g., sex and sleep position) variables.

RESULTS

The prevalence of bruxism behavior at the ages of two and four were 16.2% and 22.5%, respectively. Using the shortest sleep duration group's participants (≤13 h) as the reference, the odds ratio (95% confidence interval) for prevalence of bruxism behavior decreased with longer sleep duration at one month of age, but not at 36 months of age, after covariate adjustments. Furthermore, in comparison with the impacts between daytime and nighttime sleep, nighttime sleep with longer duration were dominantly associated with bruxism behavior.

CONCLUSION

The sleep duration in infant stage, especially during newborn stage was associated with the prevalence of bruxism behavior in children.

Relationship Analogy between Sleep Bruxism and Temporomandibular Disorders in Children: A Narrative Review

Sleep bruxism (SB) is a condition characterized by repetitive clenching or grinding teeth and/or by bracing or thrusting of the mandible during sleep. Although SB is not considered a disorder in children, SB can be a potential physical and psychological hazard or consequence, and this study examines whether SB is a risk factor for TMD as it is in adults. A narrative review on the topic of inferring the relationship between sleep bruxism and TMD in children was performed based on a search in the PubMed and Google Scholar databases for articles published between 1999 and 2022. A total of 76 articles were included in this review. SB is very common in children, may be related to psychological distress or sleep breathing disorder, with a prevalence of up to 49%, and mainly occurs in the non-rapid eye movement stage in the sleep structure. SB may be one cause of TMD. The prevalence of TMD in children is 16–33%. Compared to the female-dominant TMD prevalence in adults, the sex-differences in TMD prevalence in children are less pronounced. However, TMD-related pain is more prevalent in girls than in boys. Given the complex etiology of each of SB and TMD in children, it can be inferred that the explanation of the relationship between the two conditions is very challenging. Ultimately, their relationship should be understood in the individual biopsychosocial model in the process of special physical growth and mental development of children. Moreover, appropriate clinical guidelines for a definitive diagnosis of SB and TMD in children and more research with a high scientific evidence level, which is comprehensive, considering physical, psychological, genetic, and social cultural factors, are required.

Prevalence of Sleep Bruxism Reported by Parents/Caregivers in a Portuguese Pediatric Dentistry Service: A Retrospective Study

The definition of sleep bruxism (SB) has changed over the years, and although it is no longer defined as a disorder, it is considered a risk factor that can result in prejudicial systemic and stomatognathic issues. The prevalence of SB in children is variable among studies, and its decrease during adolescence is a controversial matter among authors. We aimed to determine SB prevalence and assess its trend with age in a sample of pediatric patients who frequented the Lisbon Pediatric Dentistry Service. We conducted a retrospective observational study based on information provided by patients’ parents/caregivers and without examination or polysomnography examination. Data were collected between August 2019 and December 2020 by five dentists. A total of 1900 patients were included, 50.6% and 49.4% of which were male and female, respectively. Of the total sample, 334 (17.6%, 95% confidence interval of 15.9–19.4%) had bruxism, corresponding to 18.9% and 16.2% of male and female patients, respectively (p = 0.121). SB was reported in 20.7% of patients 0–6 years old, in 19.4% of those 7–11 years old, and in 14.6% of those 12–17 years old. In conclusion, SB showed a slightly higher prevalence among male pediatric patients, but further studies are needed to rule out confounding factors.