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

Abstract

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.

Systematic Review on the Link between Sleep Bruxism and Systemic Chronic Inflammation

“…The patients enrolled in the study suffered from temporomandibular disorders, not bruxism itself [33]. The manifestation of clenching in patients with temporomandibular disorders (TMD) can, however, be a reflection of bruxism [38]. Interleukin 6 (IL-6) and interleukin 8 (IL-8) levels increased in response to tooth clenching in both groups, while interleukin 7 (IL-7), interleukin 13 (IL-13) and tumor necrosis factor (TNF) rose only in patients with TMD-related myalgia.…”

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

“…Previous studies suggested a relationship between SB and TMD in children. SB can cause tooth wear, masticatory muscle pain, TMD pain, limited mouth opening, ear pain, and headaches [ 30 ]. Balasubramaniam et al [ 55 ] summarized the negative consequences possibly associated with SB, such as occlusal and incisal wear, tooth fracture, TMJ discomfort or pain, and even symptoms such as a reduction in salivary flow and/or xerostomia.…”

“…The SB grading systems, as suggested by the international consensus group, refer to a positive self-report of an adult subject or report of his/her sleeping partner regarding bruxing activity during sleep. Regretfully, young children’s self-report concerning SB is not reliable and diagnosis of SB in children is mostly based on reports of family members that describe the characteristic sounds of teeth grinding during sleep [ 30 ]. The use of a single question posed to parents/caregivers regarding the possible presence of SB via the existence of dental tightening or audible noises related to teeth grinding is an accepted way to determine SB in children [ 31 ].…”

Neuromuscular and occlusion analysis to evaluate the efficacy of three splints on patients with bruxism

“…Occlusal trauma and prolonged abnormal biting pressures will lead to crown or root fractures, accelerate periodontal breakdown, such as gingival atrophy, alveolar bone absorption, resulting in tooth mobility and displacement [16][17][18]. Severe dental attrition can lead to orofacial dysfunction, such as decreased vertical distance, temporomandibular joint disorders, disc perforation, orofacial muscular pain, and even restricted mouth opening [19][20][21][22].Therefore, for patients with bruxism, we need to take some measures to protect oral and maxillofacial system .…”