Etiology, Diagnosis and Treatment of Bruxism in Children: A Review of the Literature

Abstract

Bruxism, a parafunctional habit often linked to stress, anxiety, or medical conditions, causes various symptoms such as jaw pain, headaches, tooth wear and potentially temporomandibular joint disorders. While bruxism is prevalent in children, the literature remains unclear on its characteristics in this age group, prompting further review and investigation. The prevalence and onset of bruxism in children varies greatly between different studies and populations, with rates ranging from 6.5% to 88% and while most studies do not report a significant difference between boys and girls, some have found higher rates in one gender or the other. Bruxism has multiple causative factors including dental malocclusion, temporomandibular joint problems, emotional and psychological disorders, sleep disorders, nutritional deficiencies, medical problems, stress and heredity. However, the correlations between these factors and bruxism are multifactorial and sometimes contradictory. Bruxism diagnosis relies on patient history, clinical examination and diagnostic criteria, with polysomnography for nocturnal cases and BiteStrip® devices as alternatives, while diagnosing children presents challenges due to the lack of valid diagnostic means and the inadvisability of polysomnography. The recognition of stressors and application of psychological stress reduction methods have also been found to have a significant effect in reducing or eliminating the signs of bruxism in children. Treatment approaches for childhood bruxism vary and may include dental information, correction of malocclusion, occlusal splints, drugs and psychological methods. The use of hard occlusal splints has been found to prevent dental wear and reduce the frequency of bruxism in some studies, but further research is needed. The aim of this review is to summarize the characteristics of bruxism in childhood.