Prevalence and risk factors of sleep bruxism and wake-time tooth clenching in a 7- to 17-yr-old population.

Sleep-related bruxism (SB) and wake-time tooth clenching (TC) have been associated with temporomandibular disorders (TMDs), headache, and sleep and behavioral complaints. This study aimed to assess the prevalence and risk factors of these signs and symptoms in a 7- to 17-yr-old population (n = 604) seeking orthodontic treatment. Data were collected by questionnaire and by a clinical examination assessing craniofacial morphology and dental status. Sleep-related bruxism was reported by 15% of the population and TC was reported by 12.4%. The SB group (n = 58) was mainly composed of children (67.3% were ≤12 yr of age) and the TC group (n = 42) was mainly composed of adolescents (78.6% were ≥13 yr of age). The craniofacial morphology of over 60% of SB subjects was dental class II and 28.1% were a brachyfacial type. Compared with controls (n = 220), SB subjects were more at risk of experiencing jaw muscle fatigue [adjusted OR (AOR) = 10.5], headache (AOR = 4.3), and loud breathing during sleep (AOR = 3.1). Compared with controls, TC subjects reported more temporomandibular joint clicking (AOR = 5), jaw muscle fatigue (AOR = 13.5), and several sleep and behavioral complaints. Sleep- and wake-time parafunctions are frequently associated with signs and symptoms suggestive of TMDs, and with sleep and behavioral problems. Their clinical assessment during the planning of orthodontic treatment is recommended.

Associations between sleep-disordered breathing symptoms and facial and dental morphometry, assessed with screening examinations.

INTRODUCTION: Chronic snoring is considered abnormal in a pediatric population. This disorder is often attributed to enlarged tonsils and adenoids, but multiple anatomic obstructions should also be considered. Facial and dental morphometry associations with various sleep-disordered breathing symptoms were investigated at an orthodontic clinic. METHODS: Parents or guardians were asked to complete a 4-part questionnaire on behalf of their children (n = 604; <18 years of age), including medical and dental history, bruxism and temporomandibular disorder habits, sleep and daytime behavior, and sleep duration and quality. All subjects underwent a clinical screening assessment by the same orthodontist to identify standard dental, skeletal, functional, and esthetic factors. RESULTS: In contrast to sleep-disordered breathing or sleep apnea in adults, which is predominantly associated with obesity, sleep-disordered breathing symptoms in this pediatric cohort were primarily associated with adenotonsillar hypertrophy, morphologic features related to a long and narrow face (dolichofacial, high mandibular plane angle, narrow palate, and severe crowding in the maxilla and the mandible), allergies, frequent colds, and habitual mouth breathing. CONCLUSIONS: Because of the recognized impact of pediatric snoring on children's health, the determination of these good predictors can help in preventing and managing sleep-disordered breathing. If a health professional notices signs and symptoms of sleep-disordered breathing, the young patient should be referred to a sleep medicine specialist in conjunction with an orthodontist if there are dentoskeletal abnormalities.