Iran J Pediatr Jun 2010; Vol 20 (No 2), Pp:174-180
Original Article
The Prevalence of Bruxism and Correlated Factors in Children Referred to Dental Schools of Tehran, Based on Parents' Report Bahman Seraj1,2, DDs, Ms; Mehdi Shahrabi1, DDs, Ms; Sara Ghadimi*1, DDs, Ms; Rahil Ahmadi3, DDs, Ms; Jaleh Nikfarjam1, DDs, Ms; Farid Zayeri4, PhD; Fatemeh Pour Taghi1, DDs and Hadi Zare1 1. Department of Pediatric Dentistry, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, IR Iran 2. Dental Research Center, Tehran University of Medical Sciences, Tehran, IR Iran 3. Department of Pediatric Dentistry, Faculty of Dentistry, Zahedan University of Medical Sciences. Zahedan, IR Iran 4. Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
Received: Mar 04, 2009; Final Revision: Oct 20, 2009; Accepted: Jan 24, 2010
Abstract Objective: Bruxism is defined as the habitual nonfunctional forceful contact between occlusal tooth surfaces. The aim of this study was to determine the prevalence of bruxism and correlated factors in children referred to dental schools of Tehran, based on parents' report. Methods: This cross‐sectional descriptive study was conducted on 600 4‐12 year‐old children with a mean age of 7.4±2.4 years, who were referred to four dental schools in Tehran. After collecting information with questionnaire filled out by parents, χ2, Fisher Test, Mann‐Whitney and t‐Test were used to analyze the data. Findings: The prevalence of bruxism was 26.2%. Bruxism begun in average at the age of 4.9±2 years. Also it occurred 2.6 times more in children who had a family history of bruxism (father‐ mother), compared to children who didn’t have such a history. 87% of children with bruxism had a history of distressing events in their life, and 13% of children with bruxism did not report any history of distressing events in their life. In this study most common oral habit was nail biting. In study of parasomnias, drooling was the most, and snoring the least reported sleep disorder. Bruxism in children with drooling was twice more than in other children. The prevalence of bruxism in children with temporomandibular disorder was 63.6% and in children without TMD was 24.7%. Conclusion: Based on parents' report, 26.2% of children showed bruxism and there was a significant relation between bruxism and mother’s job, family history, distressing event in life, parasomnias, especially drooling and sleep walking, TMD, hyperactivity, depression, acrophobia and lygophobia. Iranian Journal of Pediatrics, Volume 20 (Number 2), June 2010, Pages: 174180
Key Words: Bruxism; Temporomandibular Disorder; Psychological Factors; Parasomnia; Children
* Corresponding Author; Address: Department of Pediatric Dentistry, Faculty of Dentistry, Tehran University of Medical Sciences. Enghelab Ave, Tehran. Iran E-mail:
[email protected] © 2010 by Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, All rights reserved.
Iran J Pediatr; Vol 20 (No 2); Jun 2010
Introduction Bruxism is a non‐functional grinding or clenching of the teeth[1]. This habit can occur during the day and night and it can be conscious or non conscious[2]. The prevalence of bruxism has a wide range because of difficult diagnosis of this parafunctional habit and different methodologies. The etiology of bruxism is multifactorial and the studies concerning this matter couldn’t gain exact results[3]. However, the discussed causes of bruxism include: local and mechanical factors, systemic factors, neurologic factors, psychological factors and genetics factors[4]. The most common clinical sign of bruxism is abnormal wear of teeth which is caused by periodic clenching or condensation of teeth. Other side effects of bruxism are tooth hypermobility, recession and inflammation of the gums, pain and hypertrophy of maseteric muscles, degenerative changes of temporo‐ mandibular joint and headache[3,5]. Alert parents ask dentists and physicians about tooth grinding of their children as well as the side effects of it and also how to stop this habit. They often want to know the reason of this habit and its prevalence. Thus it is important for dentists and physicians to inform parents properly. The aim of this investigation was to determine the prevalence of the bruxism and its etiologic factors to make some helping recommendations to the parents. The awareness of parents about bruxism and its side effects make them keen to contribute in recall sessions; on the other hand, dentists and physicians will be able to recognize etiologic factors to eliminate them.
Subjects and Methods This cross‐sectional descriptive study was done on 600 4‐12 year old children, who were referred to four dental schools of Tehran in 2007‐2008. After acquiring the parents’ informed consent, a questioner was administrated to all participants. The questionnaire included two sections: The first
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part contained the information about the age, sequence of birth, medical history and also parents’ age, education, and job. The second part was questions related to the time of bruxism during the day or night, manifestation of distressing events in the family (such as parental divorce, birth of new baby, start going to school or death of child's loved one), family history of bruxism, temporomandibular joint disorder, parasomnias, oral habits (nail biting, pacifier sucking and lip or thumb sucking) and psychological disorders. Temporomandibular joint disorders were considered as jaw clicking, pain or tenderness in muscles and limitation in mouth opening. Items related to psychological disorders include Irritability, seclusion, sadness, neophobia, crying easily, gazing at one point, hyperactivity, obsession, depression, acrophobia or lygophobia and finally parasomnias’ items include drooling, sleep talking, sleep walking, mouth breathing and snoring. After collecting information with the questionnaire filled out by parents, the analysis of data to determine the prevalence of bruxism and the percentage of contributing factors in children with or without bruxism was done, and the results of these 2 groups were compared. χ2, Fisher Test, Mann‐Whitney and t‐Test were used to analyze the data. A level of P
