Bruxism
Basics
DESCRIPTION
- Bruxism is defined as habitual nonfunctional forceful contact of teeth, which is involuntary. These movements can include excessive grinding, clenching, or rubbing of teeth.
- Other nonfunctional (or “parafunctional”) oral habits include movements not involved with normal chewing, swallowing, or speaking, such as chewing pencils, nails, cheek, or lip.
- Sleep bruxism should be distinguished from daytime awake bruxism. Sleep bruxism has been classified as a sleep-related movement disorder.
- Awake bruxism is rare with little or no audible sound during clenching, compared to the loud grinding sound commonly occurring in sleep bruxism.
EPIDEMIOLOGY
- Age/onset
- In children, prevalence in the literature is highly variable with a range of 4–40%. Prevalence decreases with increasing age.
- May occur throughout life but frequently tends to peak in early childhood, then decreases with age
- Sleep bruxism progressively diminishes around 9 to 10 years of age.
- Infants have been known to grind their teeth during the eruption of primary teeth.
- May be temporarily or intermittently present, which makes diagnosis difficult
- Gender
- Recent systematic review of literature reported no gender differences in prevalence.
- Previous studies suggested girls may be more affected than boys.
- Some studies support higher incidence in children with developmental disabilities, Down syndrome, sleep disorders, and autism.
RISK-FACTORS
GENETICS
- No genetic mechanism has been explained.
- Based on self-reports, 20–50% of children with sleep bruxism have an immediate family member who experienced bruxism as a child.
ETIOLOGY
- The exact cause is not known. It is likely to be a multifactorial process including oral motor activities, regulation of sleep–wake cycle, autonomic, catecholaminergic, hereditary, and psychosocial influences.
- Awake bruxism is more commonly associated with psychosocial factors and psychopathologic symptoms.
- Dental factors (current evidence suggests that they play a small role, only ~10% of cases)
- Occlusal interferences, including malocclusions, in which teeth do not interdigitate smoothly
- High dental restorations (e.g., fillings or crowns)
- Intraoral irritation (e.g., sharp tooth cusp)
- Teething
- Psychological factors
- Nervous tension (related to stress, anger, and aggression)
- Personality disorders
- Posttraumatic stress disorder
- Common systemic factors
- Moving between levels of sleep
- Sleep-disordered breathing
- Snoring and obstructive sleep apnea
- Tonsil/adenoid hypertrophy
- Mouth breathing
- Neurodevelopmental disorders (e.g., cerebral palsy)
- Brain injury
- ADHD
- Other possible factors
- Asthma
- Allergies
- Nasal obstruction
- Exposure to secondhand smoke
- Medications (amphetamines, barbiturates, antidepressants—particularly serotonin reuptake inhibitors)
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Citation
Cabana, Michael D., editor. "Bruxism." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. Medicine Central, im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14091/all/Bruxism.
Bruxism. In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14091/all/Bruxism. Accessed December 3, 2024.
Bruxism. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14091/all/Bruxism
Bruxism [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2024 December 03]. Available from: https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14091/all/Bruxism.
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