Prevalence of sleep bruxism in children: A systematic review

Survey using the following research databases: MEDLINE, Cochrane, EMBASE, PubMed, Lilacs and BBO, from January 2000 to February 2013, focusing on studies specifically assessing the prevalence of SB in children.

RESULTS:

After applying the inclusion criteria, four studies were retrieved. Among the selected articles, the prevalence rates of SB ranged from 5.9% to 49.6%, and these variations showed possible associations with the diagnostic criteria used for SB.

CONCLUSION:

There is a small number of studies with the primary objective of assessing SB in children. Additionally, there was a wide variation in the prevalence of SB in children. Thus, further, evidence-based studies with standardized and validated diagnostic criteria are necessary to assess the prevalence of SB in children more accurately.

Sleep bruxism; Bruxism; Prevalence; Child

Study	Sample size	Study location	Sample characteristics	SB diagnosis criteria
Fonseca et al,⁶ 2010	170 children attending municipal kindergartens	Study conducted in the rural area of Itanhandu, SP, Brazil	Mean age of 4.37 ± 1.69 years (51.76% girls)	Clinical examination according to the American Academy of Sleep Medicine associated with a questionnaire filled in by parents
Serra-Negra et al,⁷ 2010	652 children randomly selected from public and private schools	Study conducted in Belo Horizonte, MG, Brazil	Children aged between 7 and 10 years (52% girls)	Parents’s report based on a questionnaire according to the criteria of the American Academy of Sleep Disorders
Lam et al,⁸ 2011	6389 questionnaires filled in by patient’s parents	Study conducted in the districts of Shatin and Tai Po in Hong Kong, China	Mean age of 9.2 ± 1.8 years (50.6% boys)	Parents’ validated questionnaire (HK-CSQ)
Insana et al,⁹ 2013	1953 preschool children and 2888 first graders, and a sub-sample of preschool children (n = 249)	Study conducted in Jefferson County, Kentucky, USA	Preschool children (aged between 2.5 - 6.9 years); first graders (aged between 3 - 8.6 years); sub-sample of preschool children (aged between 2.87 - 6.11 years )	Parents’ questionnaire and additional behavioral and cognitive assessments in the sub-sample of 249 preschool children

Study	SB prevalence	Important findings	Study limitations	Study suggestions
Fonseca et al,⁶ 2010	15.29% (n = 26) were diagnosed as bruxists	Positive correlation was found between restless behavior and the presence of SB	Tooth wear may not reveal the actual level of SB. The study did not perform polysomnography evaluation. Memory biases	Association between clinical examination and parents’ questionnaire for SB diagnosis
Serra-Negra et al,⁷ 2010	Bruxism was prevalent in 35.3% (n = 230)	More than half of children without SB (55.2%) were of low socioeconomic background	The study did not perform clinical or polysomnography evaluations in children. Memory biases	The high prevalence of 35.3% reveals the need for further research on the subject
Lam et al,⁸ 2011	SB ≥ 3 episodes per week, showed a prevalence of 5.9% in children from Hong Kong	SB was more prevalent among boys and decreased with age. It was associated with several medical conditions, neuropsychiatric sequelae and sleep disorders	The study did not perform polysomnography evaluation. Memory biases	Further prospective studies are needed to assess the association between SB and other medical conditions
Insana et al,⁹ 2013	36.8% of preschool children and 49.6% of first graders reported episodes of bruxism at least once a week	Pediatric sleep bruxism may function as a warning sign for potential adverse health conditions	The study did not perform polysomnography evaluation. Memory biases	Future research may benefit from objective measurement of SB

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