Bruxism is a condition characterized by the involuntary grinding, gnashing, or clenching of teeth, often occurring during sleep or, less commonly, while awake. In children, bruxism is a relatively common issue, with many experiencing it during certain stages of growth. While the exact causes are not always fully understood, factors such as stress, anxiety, misaligned teeth, pain (e.g., teething or earaches), or even genetics can contribute to the development of this condition.
Children typically exhibit bruxism during the early years, often around the time they are teething or when their baby teeth are being replaced by permanent ones. For most children, bruxism resolves as they grow older. However, in some cases, the condition can persist, leading to potential dental and physical complications.
Bruxism can have several effects, including worn-down tooth surfaces, jaw pain, headaches, and even disrupted sleep. It is important for parents to be aware of the signs of bruxism and seek appropriate care from a paediatric dentist or healthcare provider to manage the condition effectively and prevent long-term damage.
Understanding the causes, symptoms, and potential consequences of bruxism is crucial for early intervention and ensuring the well-being of children affected by this condition. The prevalence of sleep bruxism in children and adolescents ranges from 3.5% to 40.6%, depending on the diagnostic methods used, which include interviews, parent reports, clinical evaluations ( Manfredini et al., 2013). Children with sleep bruxism may experience poor sleep quality, often sleeping less than 8 hours per night ( Negra et al., 2013).
Causes of sleep Bruxism:
The etiology is multifactorial, involving complex processes that may not be directly linked to specific sleep patterns or tooth contact ( Lobbezoo et al., 2013). Behavioral issues, sleep disorders, excessive digital media use, and poor eating habits may be considered risk factors for bruxism in children and adolescents (Kuhn et al., 2018) Both direct and indirect light and sound stimuli may serve as predisposing factors for bruxism in children (Guo et al., 2018). The combination of poor eating habits, particularly excessive sugar intake, and excessive media use may contribute to the onset of sleep bruxism (Restrepo et al., 2021). A study found that sleep bruxism in children was associated with increased perceived psychological stress and elevated salivary cortisol levels (Castelo PM et al., 2012).
The causes of sleep bruxism in children are multifactorial and can include:
- Psychological Stress and Anxiety: Emotional stress, including anxiety and frustration, can contribute to bruxism. This may be linked to school pressures, family issues, or other emotional concerns. Psychiatrists and family therapists who identify separation anxiety in young children may advise parents to ensure their child receives regular dental check-ups to detect and monitor signs of sleep bruxism (Rostami et al., 2020)
- Sleep Disorders: Conditions such as sleep apnea, restless leg syndrome, or other sleep disturbances may increase the likelihood of bruxism. Research into sleep physiology is also important, as sleep disturbances, including alterations in breathing patterns during sleep, have been strongly associated with headaches, sleep apnea, hypopnea, and sleep bruxism (Firmani et al., 2015)
- Excessive Media Use: Excessive use of digital devices, especially before bedtime, can interfere with sleep quality and potentially trigger bruxism.
- Genetic Factors: A family history of bruxism may increase the likelihood of a child developing the condition (Wiscicki et al)
- Teeth Misalignment or Dental Issues: Structural problems with teeth or jaw alignment can sometimes lead to bruxism.
- Physical or Medical Conditions: Certain medical conditions, such as cerebral palsy or other neurological disorders, can be linked to bruxism in children.
Symptoms of sleep Bruxism:
- Abnormal tooth wear, enlargement of the masseter muscles due to voluntary forceful clenching, and discomfort, fatigue, or pain in the jaw muscles (including transient morning jaw muscle pain and headaches) ( Sateja et al., 2013).
- Earaches, especially in the morning.
- Reduced mouth opening, Sore jaw muscles
- Increased Tooth Sensitivity: Sensitivity to hot, cold, or pressure due to enamel wear.
Treatment of sleep Bruxism:
In many cases, treatment is not required. Many children tend to outgrow the condition without treatment. If Bruxism is severe, dental treatments, therapies and medicines can be used to stop or lessen grinding and clenching.
Dentist may suggest one of the following methods to stop Bruxism:
- Splints and mouth guards keep the top and bottom teeth separated while sleeping , which can stop the damage caused by clenching and grinding.
- If the Bruxism in an individual is due to anxiety and stress, tips from a medical health professional may help.
- Medicines: In general, medicines are not very effective for the treatment of Bruxism. Healthcare professional may suggest taking a muscle relaxant before bedtime in extreme cases.
CONCLUSION :
Sleep bruxism is a significant clinical concern in children, as tooth grinding can be severe and persistent over time. It leads to tooth wear, headaches, facial muscle pain, difficulty chewing, and restricted mouth opening. Combination of treatments such as behavioural therapy, dental interventions and physical therapies can effectively manage bruxism. Bruxism is a distinct condition that the medical community must recognize for proper identification and treatment. Primary care physicians should diagnose bruxism in children accurately, educate parents, prevent potential oral health issues, and identify any associated comorbidities. Additionally, comprehensive clinical guidelines for managing bruxism in children should be established.
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