Prevalence of tooth grinding in children and adolescents with neurodevelopmental disorders: A systematic review and meta-analysis.

AIM: To conduct a systematic review and meta-analysis on the prevalence of tooth grinding and/or clenching (TGC) in children and adolescents with a neurodevelopmental disorder or other developmental condition. METHODS: A search was performed in seven databases, two sources of grey literature and reference lists of included studies. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. We used random-effects models with Freeman-Tukey double arcsine transformation for the meta-analyses. RESULTS: After selection, 77 of the 2240 studies met inclusion criteria and were categorised by disability and type of TGC (reported, clinically observed and definitive). The pooled prevalence of reported TGC in individuals with attention-deficit hyperactivity disorder was 57.6% (95% CI [confidence interval]: 49.5-65.6), 50.4% (95% CI: 35.5-65.4) in individuals with autism spectrum disorder, 67% (95% CI: 59.2-74.8) in cerebral palsy and 68.2% (95% CI: 59.8-76.6) in Down syndrome. Pooled prevalence of clinically observed TGC was 57.5% (95% CI: 31.6-83.4) in autism spectrum disorder and 71.9% (95% CI: 52.4-91.4) in cerebral palsy. Individuals with attention-deficit hyperactivity disorder presented 39.8% (95% CI: 24-55.6) of definitive TGC. CONCLUSION: Prevalence of reported, clinically observed, and definitive TGC varies according to disabilities, although due to high heterogeneity the result should be interpreted with caution. Variations exist mainly due to sampling bias and the use of non-validated methods to assess TGC. CRD42020212640.

Communication-based behaviour support for adults with intellectual disabilities receiving dental care: A focus group study exploring dentists' decision-making and communication.

A better understanding of how communication-based behaviour supports are applied with adults with intellectual disabilities may reduce reliance on restrictive practices such as holding, sedation and anaesthesia in dentistry. In this study, we explore how communication is used by dentists who provide treatment for adults with intellectual disabilities. A descriptive qualitative study, adopting synchronous online focus groups, was undertaken with six expert dentists in Ireland. Members were contacted again in pairs or individually for further data collection, analysed using thematic content analysis. Two relevant categories emerged from the data, relating to the selection and application of communication-based behaviour support for adults with intellectual disabilities. Decision-making processes were explored. Building on these categories, a co-regulating process of communication emerged as the means by which dentists iteratively apply and adapt communicative strategies. This exploration revealed rationalist and intuitive decision-making. Implications for education, practice and research are identified.