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

Abstract

Renner AC, da Silva AAM, Rodriguez JDM, Simões VMF, Barbieri MA, Bettiol H, Thomaz EBAF, Saraiva MC. Are mental health problems and depression associated with bruxism in children? Community Dent Oral Epidemiol 2011. © 2011 John Wiley & Sons A/S Abstract – Objectives: Previous studies have found an association between bruxism and emotional and behavioral problems in children, but reported data are inconsistent. The objective of this study was to estimate the prevalence of bruxism, and of its components clenching and grinding, and its associations with mental problems and depression. Methods: Data from two Brazilian birth cohorts were analyzed: one from 869 children in Ribeirão Preto – RP (São Paulo), a more developed city, and the other from 805 children in São Luís – SL (Maranhão). Current bruxism – evaluated by means of a questionnaire applied to the parents/persons responsible for the children – was defined when the habit of tooth clenching during daytime and/or tooth grinding at night still persisted until the time of the assessment. Additionally, the lifetime prevalence of clenching during daytime only and grinding at night only was also evaluated. Mental health problems were investigated using the Strength and Difficulties Questionnaire (SDQ) and depression using the Children’s Depression Inventory (CDI). Analyses were carried out for each city: with the SDQ subscales (emotional symptoms, conduct problems, peer problems, attention/hyperactivity disorder), with the total score (sum of the subscales), and with the CDI. These analyses were performed considering different response variables: bruxism, clenching only, and grinding only. The risks were estimated using a Poisson regression model. Statistical inferences were based on 95% confidence intervals (95% CI). Results: There was a high prevalence of current bruxism: 28.7% in RP and 30.0% in SL. The prevalence of clenching was 20.3% in RP and 18.8% in SL, and grinding was found in 35.7% of the children in RP and 39.1% in SL. Multivariable analysis showed a significant association of bruxism with emotional symptoms and total SDQ score in both cities. When analyzed separately, teeth clenching was associated with emotional symptoms, peer problems, and total SDQ score; grinding was significantly associated with emotional symptoms and total SDQ score in RP and SL. Female sex appeared as a protective factor for bruxism, and for clenching and grinding in RP. Furthermore, maternal employment outside the home and white skin color of children were associated with increased prevalence of teeth clenching in SL. Conclusions: Mental health problems were associated with bruxism, with teeth clenching only and grinding at night only. No association was detected between depression and bruxism, neither clenching nor grinding. But it is necessary to be cautious regarding the inferences from some of our results.

Community based study of sleep bruxism during early childhood

“…However, among pre-school and first grade children, the higher frequencies of sleep-bruxism (e.g., more than four times a week) were congruent with values previously reported (e.g., [1,[8][9][10]). Notably, sleep-bruxism distinction and frequency is not equivalently described in all studies; thus, many epidemiological studies on sleep bruxism are not fully comparable.…”

“…The reported prevalence of sleepbruxism is highest during childhood, decreases across the life span and can resolve spontaneously [7]. The prevalence of childhood sleep-bruxism varies from 14% to 17% [1], 5-20% [8], 22% [9], 28-30% [10], and 38% [11]; however, prevalence rates may be underestimates since less common occurrences may not come to medical attention [12]. The reported prevalence of child sleep-bruxism ranges widely; large community-based samples of children could help clarify prevalence rates.…”

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

“…This may be attributed, at least partially, to differences in the questionnaires used. The authors observed great variation in the questions, for example: single-item or part of sleep behavior questionnaires 20,21 , frequency-time 22,23 or general question 24 , and some studies included in this systematic review had unspecified questions 25 . In this study, the GQ does not distinguish between wake-time and sleep bruxism, unlike the FTQ, which was more specific with respect to the moment of the events.…”

Malocclusion and deleterious oral habits among adolescents in a developing area in northeastern Brazil

“…There is evidence of an association between bruxism and tension, stress, and emotional disturbance, corroborating this idea. 22 Therefore, special attention should be paid to children with a habit of finger sucking during infancy to prevent a future occurrence of other DOH.…”