Treatment Approaches for Bruxism in Children
Sleep problems are frequent among healthy school going children seen at general
pediatric practice. Sleep related problems were reported in 42.7% children that
included nocturnal enuresis (18.4%), sleep talking (14.6%), bruxism (11.6%)
nightmares (6.8%), night terrors (2.9%) snoring (5.8%) and sleepwalking (1.9%).
Bruxism is a destructive habit. It is defined as the nonproductive diurnal or
nocturnal clenching or grinding of the teeth.
Bruxism happens in about
15 percent of youngsters and in as many as 96 percent of grown-ups. The etiology
of bruxism is unclear. It has been linked with stress, occlusal disorders,
allergies and sleep positioning. In addition, type A personality behavior
combined with stress is more predictive of bruxism. Because of its nonspecific
pathology, bruxism may be difficult to diagnose.
Beside complaints from
sleep partners, clenching-grinding, sleep bruxism, myofacial pain,
craniomaxillofacial musculoskeletal pain, temporomandibular disorders,
oro-facial pain, fibromyalgia, and chronic fatigue spectrum disorders are
linked. The main clinical signs of bruxism comprise tooth wear, tooth mobility,
hypertrophy masticatory muscles, and tender joints. Other symptoms of bruxism
are multiple and diverse. They include temporomandibular joint pain and
dysfunction, head and neck pain, erosion, abrasion, loss of and damage to
supporting structures, headaches, oral infection, tooth sensitivity muscle pain
and spasm, disturbance of aesthetics, and interference and oral
Treatment for bruxism may be simple or complex, depending on
the nature of the disorder. Severe bruxism disorders are difficult to treat and
their prognoses also may be questionable. Children with bruxism are generally
managed with observation and reassurance. Most of the children's bruxism habit
will disappear naturally as they grow up. Adults may be managed with stress
reduction therapy, modification of sleep positioning, drug therapy, biofeedback
training, physical therapy and dental evaluation. Correction of the malocclusion
with orthodontic procedures, restorative procedures, or occlusal adjustment by
selective grinding will not control the bruxism habit.
prevention? Researchers have found only a weak correlation between different
types of morphologic malocclusion such as Class II and III molar relationship,
deep bite, overjet, and dental wear or grinding. Moreover, there is no
correlation between periodontal disease and bruxism in children. Because the
malocclusions' status in children does not increase the probability of bruxism,
early orthodontic treatment (braces) to prevent bruxism is not scientifically
Bruxism is a destructive habit that may result in severe
dental deterioration. Bruxism in childhood may be a persistent trait. The
occlusal trauma and tooth wear in childhood bruxism can be succeeded by
increased anterior tooth wear 20 years later. If your child has significant
tooth attrition, dental mobility or tooth fracture may happen. Therefore, it is
mandatory to take your child to your dentist for evaluation of bruxism.
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