A global bibliometric analysis on the relationship between tinnitus and temporomandibular disorders

BACKGROUND AND OBJECTIVES

This global bibliometric review aimed to investigate trends in publications relating to tinnitus and TMD.

METHODS

A search was performed in eight databases (June/2022), by independent researchers with relevant keywords about tinnitus and TMD, without restriction of date or language. Original research or case report/series evaluating prevalence, association and risk related to tinnitus and TMD were included. Independent examiners selected studies by title and abstract and performed data extraction. Data about publication and researchers, study population, objective, study design and diagnostic criteria for tinnitus and TMD were exported to VintagePoint® for bibliometric analyses. Data about the direct association between tinnitus and TMD were extracted.

RESULTS

One hundred and seventeen articles from 25 countries were included, most observational (68.4%) and evaluating association (N = 60; 44.8%). Among the 60 studies of association, 22 (36.6%) presented results of a direct association between the presence/absence of tinnitus and the presence/absence of TMD. Brazil (19.5%) and the United States (12.7%) were the countries with the most publications, and Dentistry (48.6%) was the main publication area. A growth in publications in Dentistry was observed in the past 30 years and in the past 10 years in Medicine. Half of the studies included the elderly population (50.2%). The main diagnostic criterion for both tinnitus (37.8%) and TMD (28%) was general questionnaires and/or self-report.

CONCLUSION

There is a growing trend in publications relating to tinnitus and TMD, especially in Dentistry, with a predominance of observational and association studies in the elderly population using questionnaires and/or self-report. More research with robust diagnostic methods and other study designs should be encouraged in the future.

Association Between Attention-Deficit/Hyperactivity Disorder Symptoms and Sleep, Bruxism and Dental Trauma in Pediatric Population: A Preliminary Study

Purpose: To evaluate the association between attention-deficit/hyperactivity disorder (ADHD) symptoms reported by parents and the variables sleep problems, possible sleep bruxism, possible awake bruxism and dental trauma (DT), and its mode of occurrence in children and adolescents.<br/> Methods: A cross-sectional study was conducted with the parents of 144 four- to 16-year-old subjects through a questionnaire on demographics, subjects' sleep, self-reported bruxism and DT mode of occurrence. The Swanson, Nolan and Pelham scale IV was used to assess ADHD signs and subtypes. Bivariate and multivariate analysis were performed (P <0.05).<br/> Results: The subjects' mean age was 7.9 years (±2.8 years) and 50.7 percent were boys. DT was reported in 80 percent of those with the hyperactive/impulsive subtype (ADHD-HI) and 72.7 percent of those with the combined subtype (ADHD-C). DT was caused solely by falls in the ADHD-C and inattention subtypes (ADHD-I). ADHD-C was associated with somniloquy (prevalence ratio [PR]=1.075; P =0.010). ADHD-HI was associated with bad sleep quality (PR=1.194; P =0.005), possible sleep bruxism (PR=1.088, 95% confidence interval=1.006 to 1.176; P =0.034), possible awake bruxism (PR=1.146; P =0.024) and sleep duration (PR=0.88; P =0.02).<br/> Conclusion: ADHD-C and -HI subtypes were associated with sleep characteristics. Possible sleep and awake bruxism were associated with symptoms of ADHD-HI. Despite no significant association, DT was present in most ADHD subjects, mostly due to falls.

Association between the severity of possible sleep bruxism and possible awake bruxism and attrition tooth wear facets in children and adolescents

OBJECTIVE

To evaluate the association between the severity of possible sleep bruxism (PSB) and possible awake bruxism (PAB) and attrition tooth wear facets (ATWF) in children/adolescents.

METHODS

Four hundred-thirty-four children/adolescents enrolled in schools in Lavras, Brazil, participated in this cross-sectional study. Caregivers answered a questionnaire about their childrens' PSB. Children/adolescents answered a questionnaire about the occurrence of PAB.

RESULTS

ATWF among individuals without PSB and PAB was lower than those with moderate/severe PSB (p = 0.038) and moderate/severe PAB (p = 0.003). ATWF in anterior teeth was lower among individuals without PSB compared to those with mild (p = 0.015) and moderate/severe PSB (p = 0.032). ATWF in posterior teeth was lower among individuals without PAB compared to those with mild (p = 0.046) and moderate/severe PAB (p = 0.017).

CONCLUSION

The number of attrition tooth wear facets is proportional to the severity of PSB and PAB.

Prevalence of Bruxism in Brazilian Children: A Systematic Review and Meta-Analysis

Purpose: The prevalence of bruxism in children varies considerably. The purpose of this study was to synthesize evidence of the prevalence of bruxism in Brazilian children and consider how proportions differ between genders, assessment approaches, and geographical regions. Methods: A search was conducted using five databases and in gray literature. Two independent investigators selected the studies and extracted data. The risk of bias was assessed via the Joanna Briggs Institute tool for studies on prevalence. The certainty of the evidence was evaluated using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Twenty-two cross-sectional studies were included after a two-step selection. Overall, 13,076 children from all regions of the country were assessed. The risk of bias ranged from high to low. Data were pooled in a random-effect model and resulted in an overall prevalence of sleep and awake bruxism of 25.8 percent (95 percent confidence interval [95% CI] equals 22.2 to 29.4; I2 equals 96 percent; prediction interval equals 0.07 to 0.44) and 20.1 percent (95% CI equals 18.0 to 22.3; I2 equals 30 percent; prediction interval equals 0.18 to 0.22), respectively. Subgroup and sensibility analysis showed distribution similarity between genders (P=0.96), assessment approaches (P=0.88), and geographical regions (P=0.44). Conclusions: "Possible" and "probable" sleep bruxism affects one in four Brazilian children, and there is evidence with a low level of certainty that its prevalence does not vary between genders, assessment approaches, or geographical regions. The distribution of bruxism is still an unknown subject and presumably occurs because of individual rather than regional or collective factors.

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.

Factors associated with awake bruxism according to perceptions of parents/guardians and self-reports of children

BACKGROUND

Bruxism is a repetitive activity of the masticatory muscles that has been associated with orofacial disorders and psychosocial factors AIM: The aim of this study was to investigate associations between possible awake bruxism (PAB) and family functioning, bullying, and dental caries in children 8-10 years of age.

DESIGN

A school-based study was conducted with 739 pairs of parents/guardians and children. The parents/guardians answered the Family Adaptability and Cohesion Evaluation Scales for the establishment of family functioning. Information on bullying due to dental conditions was collected from the children. Dental caries in the children was evaluated using International Caries Detection and Assessment System criteria. A directed acyclic graph was used to define the theoretical model and select control factors. Descriptive analysis was performed, followed by multivariate logistic regression for complex samples.

RESULTS

Considering the parental reports, fewer years of mother's schooling, a low family income, very flexible family adaptability, and cavitated dental caries were associated with PAB. The female sex, bullying, and orofacial dysfunction were associated with self-reported PAB.

CONCLUSIONS

Therefore, the factors associated with PAB differ according to the reports of parents/guardians or self-reports of children. Healthcare providers should consider both reports for a more effective intervention addressing PAB.

Validation of the Brazilian Version of the RMS Tactile Scale (B-RMS-TS)

This study aimed to validate the Brazilian version of the RMS Tactile Scale (B-RMS-TS) in children and adolescents with visual impairment. Ten visually impaired children and adolescents between 10 and 17 years old of an Educational Center for Visually Impaired People answered the verbalized Dental Anxiety Scale (DAS), and the DAS in Braille to evaluate their dental anxiety levels. B-RMS-TS construct validity was assessed by convergent and discriminant validity. Convergent validity was tested in two ways: Pearson's correlation between the B-RMS-TS and the overall anxiety question; Pearson's correlation between B-RMS-TS and verbalized DAS and DAS in Braille. B-RMS-TS reliability was measured by internal consistency (Cronbach's alfa and McDonald's omega) and test-retest reliability (ICC). B-RMS-TS was moderately correlated to the overall anxiety question (r=0.493;p=0.147). B-RMS-TS showed excellent correlation with verbalized DAS (r=0.971;p<0.001) and DAS in Braille (r=0.934;p<0.011). B-RMS-TS was able to discriminate dental anxiety levels between male and female (p=0.008). The B-RMS-TS demonstrated excellent reliability (Cronbach's alpha=0.661, McDonald's omega=0.700 and ICC=0.987; 95%CI=0.817-0.999). B-RMS-TS is valid and reliable to measure dental anxiety levels in Brazilian children and adolescents with visual impairment.

Utility of Smartphone-based real-time report (Ecological Momentary Assessment) in the assessment and monitoring of awake bruxism: A multiple-week interval study in a Portuguese population of university students

PURPOSE

The Ecological Momentary Assessment (EMA) concept was the basis for developing a smartphone application for the on-time report of awake bruxism (AB) activities. This study aims to monitor AB report over time in a population of healthy young adults.

METHODS

A population of young adults recruited among dental students in good general health was recruited. All answered to a questionnaire, including the Oral Behavior Checklist (OBC-1). They were then monitored with a smartphone application for AB report during seven consecutive days and completed three further observation periods (EMA-1, 2 and 3) at one-month intervals. After the third period (EMA-3), participants answered again the OBC questionnaire (OBC-2). Changes over time were described, and Pearson Correlation test was performed to assess the correlation between EMA and OBC items reports. A significance level of p = .01 was set.

RESULTS

Thirty-one University students completed the study protocol. Answers to the OBC showed an increase in the prevalence of self-reported bracing and teeth clenching from the first to second report (38.7%-54.8% and 77.4%-90.3%, respectively). A slight increase in the 'relaxed' condition (62.5%-69.0%) was observed with EMA-based smartphone application over time. No correlation between OBC items and EMA was detected between OBC-1 and EMA-1. A moderate positive correlation in bracing report (+0.509, p = .01) and weak positive correlation in teeth contact report (+0.380, p = .05) were found between OBC-2 and EMA-3.

CONCLUSION

Using a smartphone-based approach to AB report may be helpful to monitor AB over time and increase an individual's awareness to recognise actions such as bracing and teeth contact concerning the single-time report.

Circadian preference and its relationship with possible sleep and awake bruxism in adults assisted by the public health system

Modern lifestyle and social demands induce changes in sleep routines that may not meet individual circadian preferences (chronotype). Such changes may be associated with the development of unhealthy lifestyles and the emergence of diseases relevant to public health services, such as obesity, hypertension, and diabetes mellitus, as well as sleep bruxism (SB) and awake bruxism (AB). The present study aimed to assess the relationship between the evening, morning or intermediate chronotypes with the report of possible SB and AB in adult individuals assisted by the Family Health Strategy (FHS). The selection of participants was performed through probabilistic cluster analysis. The sample size (n = 384) was calculated to include a representative sample of the 52,628 adults registered in the FHS of a countryside city located in the Southeast Region of Brazil. The Morningness-Eveningness Questionnaire (MEQ) was used to determine the chronotype, and Questionnaire-Based Self-Reported Bruxism was used for identifying possible SB and AB. The following clinical and social-behavioral variables were also evaluated: age, sex, BMI, income, physical activity, schooling, alcohol consumption and smoking, chronic diseases and depression. Two logistic regression models were used: one for SB and one for AB. Possible SB was associated with female sex, lack of physical activity and income above 2 minimum wages. Regarding chronotype, a 19% reduction in the chance of possible SB was observed in morning individuals compared to evening individuals (p = .017). Possible AB was associated with younger individuals, smoking and depression. In conclusion, compared with the evening circadian preference, the morning circadian preference was associated with greater protection against possible SB in an adult population assisted by the FHS.

Prevalence of clinical signs and symptoms of the masticatory system and their associations in children with sleep bruxism: A systematic review and meta-analysis

Sleep bruxism (SB) is a behavior of central origin that is related to different factors. This systematic review aimed to determine the prevalence of clinical signs and symptoms of the masticatory system and their association in children with SB. A structured search in ten databases were taken. Two authors independently selected studies, extracted the data, study quality assessment and graded the evidence. A meta-analysis of proportion and association was performed under random-effect model, confidence interval of 95% and p < 0.05 for pulled values. Were included 22 studies, and their overall quality was poor. The more common clinical signs and symptoms of the masticatory system in children with SB were primary canine wear (P:84.13, 95% CI:78.13-89.32; p = 0.248; I² 25.05), dental wear (P:73.76, 95% CI:38.73-96.91; p < 0.001; I² 97.62) and headache (P:52.85, 95% CI:38.92-66.56; p < 0.001; I² 93.65). The prevalence of SB in children was 31.16% (P:31.16, 95% CI:22.18-40.92; p < 0.001; I² 98.56). There was no significant risk of dental wear and headache in children with SB. There is low to very low certainty of the evidence. The more prevalent clinical signs and symptoms of the masticatory system presented in children with SB were primary canine wear, dental wear and headache. Further studies of high quality are still needed to elucidate these important questions.

Patient-centered assessments: how can they be used in dental clinical trials?

Recently, there has been greater interest in adopting a more holistic approach to healthcare. However, this trend should not limit itself merely to the notion that a human being lies behind the mouth being treated. Rather, it should embrace the understanding that this human can actively participate in and contribute to the treatment process. Patient Report Outcome Measures (PROMs) and Patient Report Experience Measures (PREMs) provide means for measuring data from the patient's perspective, and enable health-related feelings and functions to be evaluated. Accordingly, this critical review aims to provide definitions, rationales and applications of patient-centered approaches in dental clinical research. Some patient-centered constructs are especially relevant to dental clinical trials, such as oral health-related quality of life, pain/discomfort, aesthetics and satisfaction concerning treatment and services. The selection and application of patient-reported measures can vary according to condition (generic, disease-specific or treatment-specific) and to the specific population evaluated (age and cognitive impairment). These measures can help weigh risks and benefits, as well as assess the cost effectiveness of treatments, thus influencing treatment recommendations and health policies. The incorporation of these measures into a professional's daily life not only represents an improvement in professional performance, but also addresses a humanitarian concern.

Is there association between dental malocclusion and bruxism? A systematic review and meta-analysis

OBJECTIVES

Given that current literature largely dissociates dental malocclusion and bruxism, the objective of this study was to gather, through a systematic review, scientific evidence to support their relationship.

METHODOLOGY

This study was performed according to the PECO strategy (where P = general population; E = dental malocclusion; C = no dental malocclusion; and O = bruxism). Literature searches were conducted without language or date restrictions in the following databases: PubMed, Scopus, the Web of Science, the Cochrane Library, LILACS/BBO via VHL and the grey literature. The search strategy included Medical Subject Headings/DECs, synonyms and free terms relevant to each database, with no age restrictions applied. Once the relevant data were extracted from the articles, the Fowkes and Fulton guidelines were followed to assess the quality and risk of bias. For quantitative analysis, dental malocclusions were divided into groups according to their type in order to perform odds ratio (OR) meta-analyses with 95% confidence intervals (CI) using the Review Manager software program (Cochrane, London, UK). The level of certainty of evidence was demonstrated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

RESULTS

After 1,502 studies found, 10 studies were included for qualitative analysis and nine for quantitative synthesis. Four studies presented high methodological quality. Five meta-analyses suggested a non-association between bruxism and Angle class I (OR: 1.05, 95% CI: 0.41-2.69; P = .92; I²  = 84%), Angle class II (OR: 1.49, 95% CI: 0.77-2.87; P = .23; I²  = 71%) or Angle class III (OR: 0.77, 95% CI: 0.31-1.93; P = .58; I²  = 0%). Bruxism was associated with children who did not present with a posterior crossbite (OR: 0.70, 95% CI: 0.51-0.96; P = .03; I²  = 27%) and present crowding (OR: 1.53, 95% CI: 1.03-2.26; P = .03; I²  = 0%). The GRADE analysis presented a very low quality of evidence.

CONCLUSION

Individuals who present with bruxism have a greater chance of crowding. However, bruxism is not associated with the presence of any of the other malocclusions evaluated.

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.

Oral lesions of higher clinical frequency in children – literature review

Abstract Objective: The objective of this article is to present to the dental professionals, through a literature review, the main oral lesions that are part of the odontopediatric stomatology, in order to improve the knowledge and attention to the health of the pediatric patients. Methods: The searches were carried out in the following bibliographic databases - PubMed, Web of Science, LILACS and Bireme. Data synthesis: This article deals with the description of the most frequent oral lesions in Pediatric Dentistry, ranging from characteristic changes in the newborn to pathological, non-pathological, congenital, fluid retained, ulcerative and those related to the main infectious diseases of childhood, with clinical manifestations in the oral cavity. Conclusion: It is very important, for General Practitioner and Pediatric Dentistry to,recognize oral lesions in children, to make a correct and early diagnosis of them, in order to improve the knowledge, attention to the health and quality of life of the pediatric patients. RESUMO Objetivo: apresentar aos profissionais da Odontologia, por meio de uma revisão da literatura, as principais lesões bucais que fazem parte da Odontopediatria, a fim de melhorar o conhecimento e a atenção à saúde dos pacientes pediátricos. Métodos: As buscas foram realizadas nas seguintes bases de dados bibliográficas - PubMed, Web of Science, LILACS e Bireme. Síntese dos dados: Este artigo trata da descrição das lesões bucais mais frequentes na Odontopediatria, desde mudanças características no recém-nascido até patológicas, não patológicas, congênitas, lesões com retenção de líquido, ulcerativas e aquelas relacionadas às principais doenças infecciosas da infância, com manifestações clínicas na cavidade bucal. Conclusão: É muito importante, para o clínico geral e para o odontopediatra, reconhecer as diversas lesões que podem acometer a cavidade bucal das crianças, propiciando um diagnóstico correto e precoce das mesmas, a fim de melhorar o conhecimento, atenção à saúde e qualidade de vida dos pacientes pediátricos. .

Use of distraction techniques for the management of anxiety and fear in paediatric dental practice: A systematic review of randomized controlled trials

OBJECTIVE

To determine whether distraction techniques (DT) reduce children's/adolescent's anxiety and fear during dental treatment.

METHODS

Randomized controlled trials (RCTs) in which any type of DT were used to manage dental anxiety and dental fear in children/adolescents were included. A systematic search of PubMed, Web of Science, Scopus, Cochrane Library, Lilacs, and Google Scholar was conducted. Two independent reviewers selected studies, extracted data, assessed methodological quality of studies using the Cochrane Collaboration's Risk of Bias tool (CCRBT), and approached certainty of evidence using GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Data were analysed descriptively.

RESULTS

Twenty studies covering several types of DT (audio, audiovisual, instruments camouflage, biofeedback, dental operating microscope, toys) were included. Qualitative analysis showed with very low certainty of evidence that DT effectively reduced dental anxiety and fear depending on the distraction type, instrument used to measure dental anxiety and dental fear, and dental procedure. CCRBT evaluation identified many methodological issues in included studies.

CONCLUSION

There is a very low certainty of evidence that DT can be effective in managing children's/adolescents' dental fear and anxiety during dental treatment. The heterogeneity of methodologies and findings in the studies, however, suggests more robust, and well-executed RCTs are needed.

The reassuring role of music associated with the personality traits of children during dental care: a randomized clinical trial

AIM

The objective of this study was to analyze the reassuring role of music associated with the personality traits of children during dental care.

METHOD

The study involved a randomized crossover clinical trial with 34 children, aged from 4 to 6 years, who exhibited two carious lesions on the occlusal surfaces of the molars. The children were divided into two groups: (G1) first tooth restoration intervention session with music, second session without music; and (G2) first tooth restoration intervention session without music, second session with music. The first consultation was to perform a clinical examination, and the second and third to perform modified Atraumatic Restorative Treatment (mART). Symphony No. 40 by Mozart was played via headphones. Pulse rate (PR) was measured using a pulse oximeter. The Brazilian version of the Eysenck Personality Questionnaire-Junior (EPQ-J) was used to measure the children's personality. For statistical analysis, descriptive, Chi-square, and Wilcoxon tests were carried out.

RESULTS

The G1 group exhibited a lower PR at the time of the intervention during the second consultation compared to the third consultation (p = 0.012). The G2 group exhibited a lower PR at the time of the intervention during the third consultation compared to the first consultation (p = 0.002). The majority of the children with a low level of extraversion presented with higher PR (p = 0.005).

CONCLUSION

Music could reduce the PR among children during dental intervention. Children with low extraversion showed a tendency towards a higher PR without music during dental care.

Study of Associated Factors With Probable Sleep Bruxism Among Adolescents

STUDY OBJECTIVES

To evaluate the prevalence of probable sleep bruxism (SB) and its association with sleep features, orthodontic fixed appliance wearing, and extraoral and intraoral clinical signs and symptoms in a population of adolescents.

METHODS

Two hundred thirty-nine 12-year-old adolescents enrolled in private and public schools in Brumadinho, southeast Brazil, and their parents were invited to participate. They answered a questionnaire containing information regarding adolescents' sleep features and history of SB. Extraoral and intraoral examination was performed to identify some clinical signs (ie, absence of lip competence, presence of mouth breathing, clicks in the temporomandibular joint [TMJ], tooth wear) and symptoms (ie, pain in the masseter muscle upon palpation), and ongoing orthodontic treatment with fixed appliances. Parental report and clinical examination were used to determine probable SB. Descriptive statistics and logistic regression were performed to identify association of probable SB with independent variables.

RESULTS

Of 239 adolescents initially selected, 231 (96.6%) participated in the study. Prevalence of probable SB was 16.9%. Adolescents who snored during sleep (odds ratio [OR] = 3.14; 95% confidence interval [CI] = 1.47-6.70), adolescents who did not have clicks in the TMJ (OR = 3.37; 95% CI = 1.11-10.15), and those who wore orthodontic appliances (OR = 2.72; 95% CI = 1.04-7.14) were more likely to be in the group with probable SB.

CONCLUSIONS

Snoring, absence of clicks in the TMJ, and fixed appliance wearing were associated with probable SB among adolescents. This study adds to the ongoing research on SB in adolescents and its associated factors.

COMMENTARY

A commentary on this article appears in this issue on page 1281.

Current Evidence About Relationships Among Prosthodontic Planning and Temporomandibular Disorders and/or Bruxism

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION

Prosthodontic planning in patients with temporomandibular disorders and/or bruxism: A systematic review. Manfredini D, Poggio CE. J Prosthet Dent. 2017;117(5):606-13.

SOURCE OF FUNDING

Information not available.

TYPE OF STUDY/DESIGN

Review.

Preterm Birth, Pacifier use and Breastfeeding: is there a Relationship?

Abstract The immaturity of born to preterm infants may predispose to sucking difficulties. This research aimed to evaluate if pacifier use is associated with preterm birth and influenced in type of infant feeding. This comparative cross-sectional study was conducted in Belo Horizonte, Brazil and evaluated 250 children aged 3 to 5 years. As a sample, two groups were established: the normal term children group (n=125) was selected at a day-care centre and the group of preterm children (125) was identified at a public university hospital with a preterm care project from birth to seven years of age. To collect data, a pre-tested questionnaire regarding information on gestational age, infant development, infant feeding and non-nutritive sucking habits was used for both groups. Bivariate and multivariate Poisson regression was used for the statistical analysis. Pacifier use was more prevalent in the preterm group (PR=1.20, 95% CI=1.02-1.42) who used the bottle (PR=1.38, 95% CI=1.15-1.64) and were breastfed for less than six months (PR=1.19, 95% CI=1.01-1.41). The majority of breastfed infants were of normal term birth (PR=1.14, 95% CI=1.04-1.20) and had monthly family income greater than USD 450.28 (RP= 1.10, 95% CI=1.01-1.20). In this study, pacifier use was more prevalent among preterm infants and associated with less than six months of breastfeeding and used of bottle. Monthly family income was associated with a prevalence of breastfeeding.

Evidence-Based Support for Sleep Bruxism Treatment Other Than Oral Appliances Remains Insufficient

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION

Management of sleep bruxism in adults: A qualitative systematic literature review. Manfredini D, Ahlberg J, Winocur E, Lobbezoo F. J Oral Rehab 2015;42:862-74.

SOURCE OF FUNDING

The authors declare that they did not receive any financial support for this article TYPE OF STUDY/DESIGN: Systematic review.

Relationship of self-reported sleep bruxism and awake bruxism with chronotype profiles in Italian dental students

OBJECTIVES

A cross-sectional study was performed to assess the association between possible sleep bruxism (SB) and awake bruxism (AB) with sleep characteristics and chronotype (i.e. circadian cycle preference).

METHODS

One-hundred-nineteen young adults filled out a self-reported questionnaire to assess SB and AB, a questionnaire about daily life aspects, as well as the Morningness-Eveningness Questionnaire (MEQ) to profile chronotype.

RESULTS

The frequency of self-reported SB and AB was 25.2% and 37.0%, respectively. Both SB and AB were significantly more frequent in females than males. Most participants had an intermediate chronotype profile (n = 85; 71.4%). Neither SB (p = 0.556) nor AB (p = 0.334) were associated with chronotype. Nightmares were more prevalent among individuals with possible SB (38.3%). Difficulty concentrating in daily activities was more frequently reported among individuals with AB (51.9%).

CONCLUSION

There was no association between possible SB and AB or the chronotype profiles among Italian dental students.

Association of possible sleep bruxism in children with different chronotype profiles and sleep characteristics

Sleep bruxism (SB) in children has been associated with several sleep characteristics, which may alter their sleep pattern. This change affects the internal biological clock and consequently the chronotype profile. The aim of this study was to evaluate the existence of an association between possible SB in children with specific chronotype profiles and sleep characteristics. The study included 207 parents/guardians of children aged between 3 and 12 years who were waiting for their children's dental treatment at the Pediatric Dentistry Clinic of the Federal University of Rio de Janeiro, Brazil. A questionnaire on the socio-demographic characteristics of parents and children as well as on the features of the children's sleep was applied. In addition, the CIRENS scale (Circadian Energy Scale) was completed by the parents to identify the children's chronotype. A chi-squared test was used to determine the association between possible SB, the chronotype, and sleep characteristics. A multiple logistic regression model was implemented to observe the influence of chronotype, age, and other independent variables on the possible SB. The logistic regression model demonstrated that nocturnal agitation (p = 0.009; OR = 3.42) and nightmares (p = 0.045; OR = 3.24) were associated with possible SB in children. Although no significant association (p = 0 .089) between the chronotype profile and possible SB was observed in the 3 to 5 years age group, a proportional difference was observed between the chronotype categories in this age group-12.5% of children with SB had a morning type, while 26.4% had an intermediate type and 47.8% an evening type compared to those without possible SB. Nocturnal agitation and nightmares were associated with possible SB. In addition, young children with an evening chronotype had a tendency toward possible SB.

Influence of negative dental experiences in childhood on the development of dental fear in adulthood: a case-control study

The aim of this study was to evaluate the factors associated with high dental fear among Brazilian university students, especially the effect of a negative dental experience in childhood. This paired case-control study was conducted at the Universidade Federal de Minas Gerais in Brazil. Dental, psychology and mathematics students were divided into cases (high fear) and controls (low fear), defined by cluster analysis, according to the items of the Dental Fear Survey (DFS). Cases (n = 65) and controls (n = 260) participants were paired (1:4) by gender, undergraduate course and social vulnerability. The students self-reported the DFS and a questionnaire about oral health. Descriptive analysis, bivariate and multivariate conditional logistic regression were used as statistical tests with a significance level of 5%. The multivariate model showed that students who reported negative dental experiences in childhood (OR = 2·97; 95% CI: 1·44-6·14), toothache in the last 12 months (OR = 11·31; 95% CI: 4·79-26·68), discomfort during dental treatment (OR = 5·36; 95% CI: 2·53-11·36) and poor self-evaluation of oral health (OR = 3·82; 95% CI: 1·61-8·11) were more likely to have high dental fear. Negative dental experiences in childhood influence dental fear in adulthood. Oral health education should be addressed among university students to reduce dental fear.

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.

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

BACKGROUND

Bruxism is a repetitive jaw-muscle activity characterized by the clenching or grinding of teeth and/or the bracing or thrusting of the mandible.

OBJECTIVE

This study assessed parents/guardians' knowledge of nocturnal bruxism in children/adolescents.

METHOD

A cross-sectional study using a validated questionnaire was carried out on 134 Brazilian guardians. Data were analyzed descriptively and through the chi-square test to assess the association if guardians reported bruxism and the causes and consequences of nocturnal bruxism.

RESULTS

Mothers (68.7%) were the main contributors; 23.1% said their child had bruxism. Although most participants (73.9%) had no opinion, some believe bruxism is linked to emotional stress (13.4%), mysticism/religiosity (3.7%), health (3.7%) or dental problems (3.0%), and presence of parasites (2.2%). Among the parents/guardians of children without bruxism, 81.9% were unaware of some possible cause versus 18.1% of those with bruxism (p=0.011). There was no association between children with bruxism and the type of sleep (p=0.191) or sleep duration (p=0.377). The majority (90.3%) of guardians whose children have bruxism believe the condition affects their health (p=0.006).

CONCLUSION

Guardians have a widespread ignorance about the causes and consequences of sleep bruxism.

Verbal school bullying and life satisfaction among Brazilian adolescents: profiles of the aggressor and the victim

BACKGROUND

Bullying is a common occurrence in adolescence that may damage the physical and emotional health.

OBJECTIVE

The purpose of the present cross-sectional study was to analyze the profile of the adolescent aggressor only, aggressor/victim, victim only, and those not involved in verbal school bullying, and to associate their profiles with life satisfaction and familial characteristics evaluated through socioeconomic status.

SUBJECTS AND METHODS

A cross-sectional study was carried out with 366 Brazilian adolescents between 13 and 15years. Verbal school bullying was identified using the Brazilian National School-Based Adolescent Health Survey (PeNSE) questionnaire. The life satisfaction of the adolescents was assessed using the Multidimensional Life Satisfaction Scale for Adolescents (MLSSA). Statistical analyses involved the chi-square test, Fisher's exact test and the Poisson regression with robust variance.

RESULTS

Sixty-six adolescents (18%) were aggressors, 5.5% were victims, 2.7% were both aggressor and victim, and 73.8% were not involved in verbal school bullying. Most aggressors were male (PR=1.97, 95% CI: 1.23-3.14) and were satisfied with their family life (PR=2.13, 95% CI: 1.18-3.8). Victims of verbal school bullying exhibited a low prevalence of non-violence (PR=0.24, 95% CI: 0.09-0.64). Those who were both aggressors and victims were associated with factors of family support (PR=0.25, 95% CI: 0.07-0.89) and self-efficacy (PR=6.29, 95% CI: 1.54-25.6). Most of the adolescents who were not involved in verbal school bullying were female (PR=1.32, 95% CI: 1.16-1.51).

CONCLUSIONS

Boys tend to be aggressors and girls tend not to get involved in verbal school bullying. Family satisfaction, self-esteem, self-efficacy, and levels of violence are important factors that can influence the profile of adolescents in relation to verbal school bullying.

Sleep Bruxism, Awake Bruxism and Sleep Quality among Brazilian Dental Students: A Cross-Sectional Study

The aim of the study was to evaluate the association of sleep bruxism, awake bruxism and sleep quality among dental students of the Federal University of Minas Gerais, Belo Horizonte, Brazil. A cross-sectional study was performed including 183 Brazilian dental students aged from 17 to 46 years old. The complete course curriculum consists of 9 semesters. Students enrolled in the first semester, the middle semester and the final semester of the course participated in the survey. The PSQI-BR (the Brazilian version of the Pittsburgh Sleep Questionnaire Index) was used for data collection. The PSQI-BR was distributed during lecture classes. Sleep bruxism and awake bruxism diagnosis was based on self-reported data. Descriptive analysis, Kruskal-Wallis, Mann-Whitney and Poisson regression with robust estimator were the statistical tests used. Sleep bruxism prevalence was 21.5% and awake bruxism prevalence was 36.5%. Sleep duration components were associated with sleep bruxism (PR=1.540; 95% CI: 1.00-2.37) and awake bruxism (PR=1.344; 95% CI: 1,008-1,790). There was an association between awake bruxism and habitual sleep efficiency component (PR=1.323; 95% CI: 1.03-1.70). Sleep disturbance component and awake bruxism were associated (PR=1.533; 95% CI: 1.03-2.27). Poor sleep quality was an important factor among dental students, who reported sleep bruxism as well as among those who presented awake bruxism

Predictive factors for child behaviour in the dental environment

AIM

This was to evaluate the potential factors that influence behaviour in the paediatric dentistry environment of children aged 48 to 68 months who have never before been to a dentist.

STUDY DESIGN

Cross sectional.

METHODS

Child behaviour was evaluated using the Frankl scale during both clinical examination procedures and prophylaxis. All mothers of the 118 children investigated underwent a test to assess their anxiety (Manifest Anxiety Scale-MAS) and responded to a questionnaire on the medical history of the child as well as socioeconomic factors. The children were given a test to assess their anxiety (Venham Picture Test-VPT).

STATISTICS

The statistical tests adopted were the Chi-squared test and both simple and multiple unconditional logistic regression.

RESULTS

Children with high anxiety, those had previously experienced toothache and those had behaved uncooperatively during prior medical experiences, had a greater probability of behaving uncooperatively during their first dental consultation.

CONCLUSIONS

Dental professionals can identify the presence of predictive factors for child behaviour prior to the first clinical examination by including relevant questions in the dental and medical history, thereby facilitating a more positive initial contact between paediatric dentists and their patients.

Impact of wearing fixed orthodontic appliances on oral health-related quality of life among Brazilian children

OBJECTIVE

To assess the impact of wearing a fixed orthodontic appliance on oral health-related quality of life (OHRQoL) among Brazilian children.

DESIGN

Cross-sectional study.

SETTING

The Department of Paediatric Dentistry and Orthodontics at Federal University of Minas Gerais, Belo Horizonte, Brazil.

PARTICIPANTS

Sample of 579 children aged 11-14 years. The children were divided into two groups: wearing (n = 160)and not wearing (n = 419)a fixed orthodontic appliance.

METHODS

A clinical examination was performed by a single examiner to determine whether or not a fixed orthodontic appliance was worn,the presence of a malocclusion using the Dental Aesthetic Index (DAI)and cavitated carious lesions. The impact of wearing a fixed orthodontic appliance on OHRQoL was measured using the short form of the Brazilian version of the Child Perceptions Questionnaire (CPQ(11-14)). Data analysis involved descriptive statistics, Mann-Whitney test and univariate/multiple logistic regression.

RESULTS

The total CPQ(11-14) score revealed a more frequent impact among children who wore a fixed orthodontic appliance than those who did not (P = 0·002).Similar findings were observed for the FL (P = 0·005),EWB (P = 0·006) and SWB (P = 0·003) subscales.There was no statistically significant difference between the two groups regarding the score on the OS subscale (P = 0·124).While females were 1·76 times more likely to have a worse OHRQoL than males, the use of a fixed orthodontic appliance was also significantly associated with a greater chance (OR = 1·60; CI = 1·11-2·33)of impacting OHRQoL when both variables were inserted together in the regression model.

CONCLUSION

Children wearing a fixed orthodontic appliance had significantly worse OHRQoL compared with a control group with no malocclusion and not wearing a fixed appliance.

Signs, symptoms, parafunctions and associated factors of parent-reported sleep bruxism in children: a case-control study

Bruxism is the non-functional clenching or grinding of the teeth that may occur during sleep or less commonly in daytime. The aim of this study was to investigate the association between clinical signs and symptoms, parafunctions and associated factors of sleep bruxism in children. A population-based case-control study was carried out involving 120 children, 8 years of age, with sleep bruxism and 240 children without sleep bruxism. The sample was randomly selected from public and private schools in the city of Belo Horizonte, MG, Brazil. Groups were matched by gender and social class. The Social Vulnerability Index (SVI) drawn up by the city of Belo Horizonte was employed for social classification. Data collection instruments included clinical forms and pre-tested questionnaires. The diagnosis of sleep bruxism was supported by the American Association of Sleep Medicine (AASM) criteria. The McNemar test, binary and multivariate logistic regression models were used for statistical analysis. The risk factors associated with sleep bruxism included: primary canine wear (OR=2.3 IC 95% 1.2-4.3), biting of objects like pencils or pens (OR=2.0 IC 95% 1.2-3.3) and wake-time bruxism (tooth clenching) (OR=2.3 IC 95% 1.2-4.3). Children that present the parafunctions of object biting and wake-time bruxism were more susceptible to sleep bruxism.