A global bibliometric analysis on the relationship between tinnitus and temporomandibular disorders.

BACKGROUND AND OBJECTIVES: This global bibliometric review aimed to investigate trends in publications relating to tinnitus and TMD. METHODS: A search was performed in eight databases (June/2022), by independent researchers with relevant keywords about tinnitus and TMD, without restriction of date or language. Original research or case report/series evaluating prevalence, association and risk related to tinnitus and TMD were included. Independent examiners selected studies by title and abstract and performed data extraction. Data about publication and researchers, study population, objective, study design and diagnostic criteria for tinnitus and TMD were exported to VintagePoint® for bibliometric analyses. Data about the direct association between tinnitus and TMD were extracted. RESULTS: One hundred and seventeen articles from 25 countries were included, most observational (68.4%) and evaluating association (N = 60; 44.8%). Among the 60 studies of association, 22 (36.6%) presented results of a direct association between the presence/absence of tinnitus and the presence/absence of TMD. Brazil (19.5%) and the United States (12.7%) were the countries with the most publications, and Dentistry (48.6%) was the main publication area. A growth in publications in Dentistry was observed in the past 30 years and in the past 10 years in Medicine. Half of the studies included the elderly population (50.2%). The main diagnostic criterion for both tinnitus (37.8%) and TMD (28%) was general questionnaires and/or self-report. CONCLUSION: There is a growing trend in publications relating to tinnitus and TMD, especially in Dentistry, with a predominance of observational and association studies in the elderly population using questionnaires and/or self-report. More research with robust diagnostic methods and other study designs should be encouraged in the future.

Probable sleep and awake bruxism in adolescents: A path analysis.

BACKGROUND: Bruxism has a multifactorial etiology, including the influence of sleep characteristics and chronotypes. AIM: To identify the pathways that influence the occurrence of probable sleep bruxism (PSB) and probable awake bruxism (PAB) in adolescents. DESIGN: A total of 403 adolescents, aged 12-19 years, participated in the study. Parents/caregivers filled out a questionnaire about sociodemographic issues and the adolescent's health conditions, and the adolescents about sleep characteristics, occurrence of bruxism (based on previous study and the International Consensus of Bruxism), and chronotype (Circadian Energy Scale). Clinical examinations were performed. Statistical analysis included descriptive analysis and path analysis. RESULTS: PSB and PAB are related to each other, with moderate and positive correlation (ß = .390). Poor sleep quality and higher household income had a direct effect on both PSB (ß = -.138; ß = .123, respectively) and PAB (ß = -.155; ß = .116, respectively). Chronotype had a direct effect on PSB, in such a way that adolescents with a morningness chronotype tend to have PSB (ß = -.102). Adolescents that drool on the pillow (ß = .184) and/or have agitated sleep (ß = .104) tend to have PSB. CONCLUSION: Poor sleep quality, household income, morningness chronotype profile, drooling on the pillow, and agitated sleep influence the paths taken by PSB. PAB was influenced by the quality of sleep and family income.

Situational diagnosis of policies in Latin American and Caribbean countries for the use of fluoride and reduction of sugar consumption.

Policy evaluation and guidance on fluoride use and sugar consumption in Latin American and Caribbean countries (LACC) may provide a scientific evidence basis for policymakers, dental professionals, civil society organizations and individuals committed to improving public oral health. A cross-sectional study was conducted to evaluate the extent of implementation of policies/guidelines on fluoride use, and sugar consumption in LACC. The study had two stages. First a questionnaire covering four major areas was developed: fluoridation of public water supplies; salt fluoridation; fluoride dentifrices, and sugar consumption. Then, the questionnaire was applied to collect data among representative participants in public oral health from LACC. Ninety-six participants from 18 LACC answered the questionnaire. One-hundred seventy documents were attached, and 285 links of websites were provided by the respondents. Implementation of policies and guidelines on water and table salt fluoridation and processed and ultra-processed food consumption were found in most countries, with some issues in the consensus and coverage. Thus, differences were identified in the extent of implementation of public oral health strategies on sugar consumption and fluoridation among the countries. There is no consensus on the policies in LACC to reduce sugar consumption and for the use of fluoride. A few policies and guidelines were applied in isolated countries, with a variety of strategies and standards. For future actions, it will be important to encourage the development of strategies and public policies within countries, and to evaluate the effectiveness of existing policies in reducing dental caries and in improving oral health in LACC.

Sleep disturbances are associated with feeding practices and age in preterm infants.

BACKGROUND: Preterm infants are under risk of several shortcomings including sleep disturbances (SD). This cross-sectional study evaluated factors associated with SD in preterm and low birth weight infants in a reference center for preterm children at a University Hospital, southeastern Brazil. METHODS: A hundred-four dyads of mothers-infants 0-3 years participated. Mothers answered an online questionnaire (Google Forms®) evaluating childbirth characteristics, gestational age, breastfeeding, bottle feeding, non-nutritive sucking habits and sociodemographic information. The Brazilian version of the Brief Infant Sleep Questionnaire (BISQ) evaluated SD. Bivariate and Logistic Regression analyses were performed (p < 0.05). RESULTS: SD was present in 45.2% of the sample. Multivariate Logistic Regression Model showed that infants breastfed ≥3 times at night had 5.006 more chances to have SD (CI 95% = 1.229-20.400) compared to those who did not breastfeed at night. Infants who were bottle-fed 3 ≥ times at night had 6.952 more chances to have SD (CI = 95% = 1.364-35.427) compared to those who were bottle fed less frequently. The chance of SD decreased 6.6% (CI 95% = 0.889-0.982) for each increase of a month in infant's age, and infants from families with higher income had 3.535 more chances to have SD (CI 95% = 1.006-12.416). CONCLUSION: The younger the child, a higher frequency of night feeding and belonging to higher income families were associated with SD. Recognizing the associated factors with SD in newborns and infants can aid families to better deal with this issue, promote better sleep quality and individualized counseling.

Diagnosis and prevalence of probable awake and sleep bruxism in adolescents: an exploratory analysis.

The aims of this study were to perform an exploratory analysis of probable awake (AB) and sleep bruxism (SB) prevalence using of different diagnosis criteria based on the International Consensus; evaluate the associations between self-report and clinical signs/symptoms in adolescents. Participated in this cross-sectional study 403 adolescents aged 12- to 19-years-old enrolled in public and private schools from Belo Horizonte, Brazil. Parents/caregivers answered a questionnaire about sociodemographic status and adolescents' health status. Adolescents answered a questionnaire evaluating AB (e.g., grinding and clenching) and SB (e.g., grinding, bracing, and thrusting) activities and frequent headaches. A clinical examination was performed on adolescents to evaluate bruxism clinical signs/symptoms (pain upon palpation on masseter and temporal, linea alba, indentation on the tongue and attrition wear severity). Descriptive statistics and Pearson's Qui-square test were performed (P≤0.05). Adolescents mean age was 14.3±1.5 years, and 58.1% were female. Self-report of SB was identified in 31% of participants and self-report of AB in 51.6%. Almost all adolescents (99%) presented at least one tooth with attrition wear (98.5% on enamel and 0.5% on dentin), with a mean number of 12.4±5.7 teeth. Depending on the diagnosis criteria, the prevalence of probable SB and AB varied from 0- 99% and 0.2- 99%, respectively. A high inconsistency was found for the prevalence of probable AB and SB in adolescents, which were influenced by the different clinical sings/symptoms used as diagnosis criteria. Frequent headaches and pain upon palpation on masseter and temporal muscle were associated to self-report of AB and SB among adolescents.

Diagnosis and prevalence of probable awake and sleep bruxism in adolescents: an exploratory analysis

Abstract The aims of this study were to perform an exploratory analysis of probable awake (AB) and sleep bruxism (SB) prevalence using of different diagnosis criteria based on the International Consensus; evaluate the associations between self-report and clinical signs/symptoms in adolescents. Participated in this cross-sectional study 403 adolescents aged 12- to 19-years-old enrolled in public and private schools from Belo Horizonte, Brazil. Parents/caregivers answered a questionnaire about sociodemographic status and adolescents' health status. Adolescents answered a questionnaire evaluating AB (e.g., grinding and clenching) and SB (e.g., grinding, bracing, and thrusting) activities and frequent headaches. A clinical examination was performed on adolescents to evaluate bruxism clinical signs/symptoms (pain upon palpation on masseter and temporal, linea alba, indentation on the tongue and attrition wear severity). Descriptive statistics and Pearson's Qui-square test were performed (P≤0.05). Adolescents mean age was 14.3±1.5 years, and 58.1% were female. Self-report of SB was identified in 31% of participants and self-report of AB in 51.6%. Almost all adolescents (99%) presented at least one tooth with attrition wear (98.5% on enamel and 0.5% on dentin), with a mean number of 12.4±5.7 teeth. Depending on the diagnosis criteria, the prevalence of probable SB and AB varied from 0- 99% and 0.2- 99%, respectively. A high inconsistency was found for the prevalence of probable AB and SB in adolescents, which were influenced by the different clinical sings/symptoms used as diagnosis criteria. Frequent headaches and pain upon palpation on masseter and temporal muscle were associated to self-report of AB and SB among adolescents.

Resumo Os objetivos deste estudo foram realizar uma análise exploratória da prevalência de provável bruxismo em vigília (BV)e do sono (BS) utilizando diferentes critérios de diagnóstico baseados no Consenso Internacional; avaliar a associação entre o autorrelato e os sinais/sintomas clínicos em adolescentes. Participaram deste estudo transversal 403 adolescentes de 12 a 19 anos de idade matriculados em escolas públicas e privadas de Belo Horizonte, Brasil. Os pais/responsáveis responderam um questionário sobre dados sociodemográficos e estado de saúde dos adolescentes. Os adolescentes relataram atividades do BV (ranger e apertar) e BS (ranger, bracing e thrusting) e dores de cabeça frequentes. Um exame clínico foi realizado nos adolescentes para avaliar os sinais/sintomas clínicos do bruxismo (dor à palpação nos músculos masseter e temporal, marcas de endentação na língua e linha alba, desgaste dentário por atrição). Análises descritiva e teste Qui-quadrado de Pearson foram realizados (P≤0,05). A média de idade dos adolescentes foi de 14,3±1,5 anos e 58,1% eram do sexo feminino. O autorrelato de BS foi identificado em 31% dos participantes e o autorrelato do BV em 51,6%. Quase a totalidade dos adolescentes (99%) apresentaram pelo menos um dente com desgaste dentário (98,5% em esmalte; 0,5% em dentina), com média de 12,4±5,7 dentes acometidos. Dependendo do critério de diagnóstico, a prevalência do provável BS e BV variou de 0- 99% e 0,2- 99%, respectivamente. Uma grande inconsistência foi identificada na prevalência de provável BV e BS em adolescentes, que foram influenciadas pelos diferentes sinais/sintomas usados como critério de diagnóstico. Dores de cabeça frequentes e dor à palpação no masseter e temporal foram associados ao autorrelato de bruxismo em crianças e adolescentes.

Tooth wear due to dental attrition among 12-year-old adolescents / Desgaste dentário por atrição entre adolescentes de 12 anos de idade

Aim: To evaluate the prevalence and distribution of tooth wear due to dental attrition among 12-year-old adolescents according to their gender, reports of tooth grinding during sleep/while awake (bruxism), and sleep features related to sleep-disordered breathing. Methods: A cross-sectional study was conducted with 172 adolescents from southeast Brazil. Parents/caregivers answered questions about sociodemographic characteristics; reports of adolescents' tooth grinding during sleep, and sleep features (e.g. sleep duration and position, snoring, drooling on the pillow) in the previous two weeks. Adolescents self-reported the occurrence of tooth clenching/grinding while awake in the previous two weeks. Tooth wear due to dental attrition was assessed by a previously calibrated researcher, using a validated 5-point analogical ordinal occlusal/incisal tooth wear grading scale, with scores ranging from 0 (no wear) to 4 (loss of crown height ≥ 2/3), depending on tooth wear severity. Descriptive statistics and the Mann-Whitney test (p < 0.05) were performed to identify differences in tooth wear due to the distribution of dental attrition, according to adolescents' characteristics. Results: Most adolescents were female (58.0%) and 81.6% of the participants presented tooth wear due to dental attrition within the enamel. Adolescents who snored had a higher number of incisors with tooth wear due to dental attrition (p = 0.035). Females showed a higher number of canines with tooth wear due to dental attrition (p = 0.020). Adolescents whose parents reported tooth grinding during sleep presented a higher number of bicuspids with tooth wear due to dental attrition (p = 0.001). Conclusion:Tooth wear due to dental attrition within the enamel was observed in most adolescents. The distribution, depending on specific groups of teeth, was higher among female adolescents, adolescents' whose parents reported tooth grinding, and adolescents who snored during sleep.

Objetivos: Avaliar a prevalência e distribuição de DDA entre adolescentes de 12 anos de acordo com o sexo, relato de ranger de dentes durante o sono e vigília (bruxismo) e características relacionadas a desordens respiratórias do sono.Método: Desenvolveu-se um estudo transversal com 172 adolescentes do sudeste do Brasil. Seus pais/responsáveis responderam um questionário contendo informações sociodemográficas, relato sobre os filhos rangerem os dentes durante o sono e hábitos do sono dos filhos (duração do sono, posição que dorme, roncar, babar no travesseiro) nas duas últimas semanas. Adolescentes relataram ocorrência de ranger/apertar de dentes durante a vigília nas duas últimas semanas. DDA foi avaliado por um pesquisador previamente calibrado através de uma escala analógica ordinal de cinco pontos de desgaste dentário para faces oclusal/incisal previamente validada, com escores variando de 0 (sem desgaste) a 4 (perda da coroa em altura ≥ 2/3), dependendo da gravidade do desgaste. Análises descritivas e teste de Mann-Whitney (p < 0,05) foram realizados para identificar as diferenças na distribuição de DDA de acordo com as características dos adolescentes.Resultados: A maioria dos adolescentes eram meninas (58,0%) e 81,6% dos participantes apresentaram DDA em esmalte em algum elemento dentário. Adolescentes que rocavam apresentavam mais incisivos com DDA (p = 0.035). Meninas apresentaram maior número de caninos com DDA (p = 0.020). Adolescentes que rangiam os dentes durante a noite apresentaram maior número de pré-molares com DDA (p = 0.001).Conclusão: Desgaste dentário por atrição em esmalte foi observado na maioria dos adolescentes. A distribuição, dependendo de grupos de dentes específicos, foi maior entre meninas, adolescentes que roncavam durante o sono e que rangiam os dentes durante o sono.

Situational diagnosis of policies in Latin American and Caribbean countries for the use of fluoride and reduction of sugar consumption

Abstract Policy evaluation and guidance on fluoride use and sugar consumption in Latin American and Caribbean countries (LACC) may provide a scientific evidence basis for policymakers, dental professionals, civil society organizations and individuals committed to improving public oral health. A cross-sectional study was conducted to evaluate the extent of implementation of policies/guidelines on fluoride use, and sugar consumption in LACC. The study had two stages. First a questionnaire covering four major areas was developed: fluoridation of public water supplies; salt fluoridation; fluoride dentifrices, and sugar consumption. Then, the questionnaire was applied to collect data among representative participants in public oral health from LACC. Ninety-six participants from 18 LACC answered the questionnaire. One-hundred seventy documents were attached, and 285 links of websites were provided by the respondents. Implementation of policies and guidelines on water and table salt fluoridation and processed and ultra-processed food consumption were found in most countries, with some issues in the consensus and coverage. Thus, differences were identified in the extent of implementation of public oral health strategies on sugar consumption and fluoridation among the countries. There is no consensus on the policies in LACC to reduce sugar consumption and for the use of fluoride. A few policies and guidelines were applied in isolated countries, with a variety of strategies and standards. For future actions, it will be important to encourage the development of strategies and public policies within countries, and to evaluate the effectiveness of existing policies in reducing dental caries and in improving oral health in LACC.

Impact of Confinement by COVID-19 in Awake and Sleep Bruxism Reported by Portuguese Dental Students.

Confinement by COVID-19 was a stressful period that could potentially trigger awake bruxism (AB) and/or sleep bruxism (SB) behaviors. This study aims to characterize the AB and SB behaviors reported by Portuguese dental students before the pandemic and during the first period of mandatory confinement by COVID-19. Dental students were included in this longitudinal study. They answered the Portuguese validated version of the Oral Behavior Checklist (OBC) before the COVID-19 pandemic emerged (T1) and one month after mandatory confinement started in Portugal (T2). Descriptive statistics and the linear-by-linear association test were performed to assess changes over time (p ≤ 0.05). Sixty-four dental students (mean age 22.5 ± 2.8 years; 81.5% females) completed the study protocol. Considering AB, there was a general increase of the behavior from T1 to T2. The percentage of participants who reported to "grind their teeth when waking up" just few times decreased (p < 0.001) and the percentage of participants who reported "feeling discomfort/tension in the facial muscles when waking up just few times" increased (p = 0.019). Considering SB, there was a significant decrease of the behavior in all samples. The number of "None" report to grinding teeth during sleep or when waking up increased (p = 0.012). An increase in the self-reporting of feeling discomfort in masticatory muscles when awake or sleeping was observed (p = 0.028). The percentage of participants who did "not remember" any AB or SB activity decreased (p < 0.050). The confinement due to COVID-19 resulted in a forced change in dental students' lifestyles that resulted in an increase of reported AB and a decrease of reported SB. Clinical Significance: In case of confinement periods, students should be encouraged to try normalizing their daily life by creating healthy routines and, by doing so, reducing the possible predisposition to bruxism and its consequences.

Facial Type, Sex and Skin Color of Pediatric Patients Are Associated with Dental Students' Empathy and Self-Confidence During Dental Care.

Purpose: To assess the levels of empathy and self-confidence of pre- and post-doctoral dental students during the dental care of children of different facial types, sex and skin color.
Methods: A cross-sectional survey was conducted with 170 Brazilian dental students. Photos of four mesofacial pediatric patients of different sex (male, female) and skin color (white, black) were digitally altered to dolichofacial and brachyfacial facial types. The 12 photos obtained (four originals and eight digitally altered) were projected during lectures and students reported their level of empathy (scores from zero to 10) and self-confidence (not confident/confident) using a structured questionnaire, based exclusively on children's appearance. Bivariate analysis and Poisson robust regression were performed (P <0.05).
Results: Students' lower empathy was observed among brachyfacial children (preva- lence ratio [PR] = 0.940; 95 percent confidence interval [95 percent CI] = 0.904 to 0.978). Female (PR=1.202; 95 percent CI=1.162 to 1.243) and black children (PR=1.068; 95 percent CI=1.035 to 1.103) received students' higher empathy scores. Higher percentages of self-confidence were associated with mesofacial (P =0.049), female (P <0.001), and black (P =0.001) children. Students' lower self-confidence was associated with brachyfacial (PR=1.106; 95 percent CI=1.066 to 1.147), male (PR=1.202; 95 percent CI=1.165 to 1.239) and white (PR=1.056; 95 percent CI =1.025 to 1.088) pediatric patients.
Conclusions: Brachyfacial children were associated with dental students' lower levels of empathy and self-confidence while female and black children received higher levels of empathy and self-confidence. However, dental students felt less confident regarding the dental care of white children.

Possible sleep bruxism, smartphone addiction and sleep quality among Brazilian university students during COVID-19 pandemic.

Objectives: To evaluate the association of sleep bruxism activity with smartphone addiction and sleep quality among university students during COVID-19 pandemic. Material and Methods: A cross-sectional online survey with 546 university students in social distancing was conducted (May 29th to June 2nd 2020). Participants should be undergraduate and graduate students enrolled in Brazilian public/private universities. A self-completed questionnaire collected sociodemographic characteristics, academic information, and severity of possible sleep bruxism (PSB) activities (grinding, bracing, and thrusting). Students answered the Brazilian version of Pittsburgh sleep quality index (PSQI-BR) and short form of the smartphone addiction scale (SAS-SV). Descriptive statistics and multinomial logistic regression were performed (p=0.05). Results: Sample mean age was 24.9 (±5.5) years. Students with higher scores of PSQI-BR were more likely to present severe PSB-bracing (OR=1.154; 95%CI=1.057-1.260), severe PSB-grinding (OR=1.133; 95%CI=1.048-1.225) and severe PSB-thrusting (OR=1.197;95%CI=1.107-1.294). Students who had children presented 3 times more chance (OR=3.193; 95%CI=1.236-8.250) to report severe PSB-thrusting. Being female increased the chance of reporting moderate (OR=3.315; 95%CI=1.333-8.914) and severe (OR=2.940; 95%CI=1.116-7.747) PSB-thrusting. Students not enrolled in distance learning presented 2 times more chance (OR=2.638; 95%CI=1.233-5.649) of reporting moderate PSB-grinding. Students with higher scores in SAS-SV had a slight increase in the chance of presenting mild (OR=1.042; 95%CI=1.009-1.077) and moderate (OR=1.065; 95%CI=1.018-1.115) PSB-bracing, as well as mild (OR=1.044; 95%CI=1.011-1.078) and moderate (OR=1.041; 95%CI=1.005-1.077) PSB-thrusting. Conclusion: Smartphone addiction, worse sleep quality, having children, female sex and not being enrolled in distance learning were associated possible sleep bruxism during COVID-19 pandemic.

Can children's oral hygiene and sleep routines be compromised during the COVID-19 pandemic?

BACKGROUND: During COVID-19 pandemic, children are confined at home, with changes in family routines. AIM: Evaluate sleep disorders among Brazilian and Portuguese children during social distancing, and its association with parental perception of child's oral hygiene. DESIGN: In this cross-sectional study, Portuguese and Brazilian parents/caregivers of 3- to 15-year-old children, practicing social distancing due to COVID-19 pandemic, answered an online questionnaire, from April 24-26, 2020, evaluating sociodemographic characteristics, child's school activities online, child's sleep quality during social distancing. Two questions from the questionnaire, developed based on previous studies, evaluated the parental perception of child's oral hygiene quality and routine changes during social distancing. Parents/caregivers answered five domains of the Portuguese-language version of the Sleep Disturbances Scale for Children, evaluating sleep-breathing disorders, disorders of arousal, sleep-wake transition disorders, disorders of excessive somnolence and sleep hyperhidrosis. Descriptive, Linear-by-linear association, Kruskal-Wallis and post hoc analysis were performed (P ≤ .05). RESULTS: Participated in the study 253 parents/caregivers, 50.2% from Brazil. Most parents (72.2%) reported changes in child's routine during social distancing. Sleep breathing disorders (P = .019), sleep-wake transition disorders (P = .022), and disorders of excessive somnolence (P < .001) were associated with poor oral hygiene during social distancing. CONCLUSION: Sleep disorders are associated with poor oral hygiene during social distancing.

Protocolo clínico para o bruxismo infantil: uma proposta em construção / Clinical protocol for childhood bruxism: a proposal under construction

Introdução: O bruxismo tem sido objeto de estudo no decorrer de décadas e ainda é polêmica a abordagem em diferentes faixas etárias. Objetivo: O objetivo deste manuscrito é apresentar uma proposta de protocolo clínico de bruxismo do sono e vigília para crianças e adolescentes. Materiais e Métodos: Foi realizado um protocolo clínico a partir de uma revisão crítica da literatura sobre o bruxismo do sono e em vigília em crianças e adolescentes. Foram abordados o conceito atual de bruxismo, os principais fatores associados, anamnese e principais sinais clínicos, considerando as peculiaridades das diferentes etapas da vida infantojuvenil: bebês, crianças e adolescentes. Resultados: O bruxismo precisa ser abordado de forma diferenciada por faixa etária. Uma anamnese bem detalhada, o conhecimento do desenvolvimento fisiológico do paciente infantojuvenil, seus possíveis comportamentos, a presença de dores de cabeça e dores nos músculos faciais merecem atenção especial pelo cirurgião dentista. Conclusão: O bruxismo merece cuidados distintos por faixa etária.

Introduction: Bruxism has been the object of study for decades and the approach in different age groups is still controversial. Objective: The aim of this paper is to present a clinical protocol proposal for awake and sleep bruxism in children and adolescents. Materials and Methods: A clinical protocol was carried out based on a critical review of the literature of sleep and awake bruxism in children and adolescents. The current concept of bruxism, the main associated factors, the anamnesis, and main clinical signs/symptoms were addressed considering the peculiarities of the different life stages: babies, children, and adolescents. Results: Bruxism needs to be approached differently by age group. A very detailed anamnesis, knowledge of child/adolescent's physiological development, their behavior, and the occurrence of headaches and pain in the facial muscles deserves special attention by dentist. Conclusion: Bruxism deserves different care by age group.

Association of facial type with possible bruxism and its related clinical features in adolescents: A cross-sectional study.

OBJECTIVES: The assessment of bruxism and its clinical characteristics is acknowledged in literature. This study aimed to evaluate the association of adolescents' facial patterns with bruxism and its related clinical features in the form of signs and symptoms. MATERIALS AND METHODS: Four hundred and three adolescents answered a questionnaire evaluating sleep bruxism (SB) and awake bruxism (AB). Parents/caregivers answered a questionnaire evaluating the adolescents' sleep features (drooling on the pillow, snoring). Adolescents' facial (dolichofacial/brachyfacial/mesofacial) and clinical features (pain in masseter/temporal muscle, indentations marks on the tongue, linea alba, tooth attrition, mouth's maximum opening and masseter electrical activity) were evaluated. Multinomial regression was performed. Odds ratio (OR) and confidence intervals (CI) were provided. RESULTS: Brachyfacial adolescents were less likely to present possible AB compared to mesofacials (OR=0.46, CI=0.21-0.98). Brachyfacial adolescents were more likely to present pain in the temporal muscle (OR=6.59, CI=2.18-19.87) and a higher number of posterior teeth with attrition (OR=1.25, CI=1.02-1.57) compared to mesofacials. Dolichofacial adolescents were more likely of not presenting pain in the masseter muscle (OR=2.23, CI=1.03-4.83), had a higher mouth's maximum opening (OR=1.43, CI=1.04-1.97), had a higher number of posterior teeth with attrition (OR=1.17, CI=1.00-1.37) and were more likely to drool on the pillow (OR=2.05, CI=1.15-3.67) compared to mesofacials. Dolichofacial adolescents were more likely of not presenting pain in the temporal muscle (OR=6.36, CI=2.30-17.54), to present themselves without marks on the tongue (OR=2.26, CI=1.09-4.69) and present a higher mouth's maximum opening (OR=2.09, CI=1.40-3.13) compared to brachyfacials. CONCLUSION: Bruxism and its clinical features differ among dolichofacial, brachyfacial and mesofacial adolescents.

Use of distraction techniques for the management of anxiety and fear in paediatric dental practice: A systematic review of randomized controlled trials.

OBJECTIVE: To determine whether distraction techniques (DT) reduce children's/adolescent's anxiety and fear during dental treatment. METHODS: Randomized controlled trials (RCTs) in which any type of DT were used to manage dental anxiety and dental fear in children/adolescents were included. A systematic search of PubMed, Web of Science, Scopus, Cochrane Library, Lilacs, and Google Scholar was conducted. Two independent reviewers selected studies, extracted data, assessed methodological quality of studies using the Cochrane Collaboration's Risk of Bias tool (CCRBT), and approached certainty of evidence using GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Data were analysed descriptively. RESULTS: Twenty studies covering several types of DT (audio, audiovisual, instruments camouflage, biofeedback, dental operating microscope, toys) were included. Qualitative analysis showed with very low certainty of evidence that DT effectively reduced dental anxiety and fear depending on the distraction type, instrument used to measure dental anxiety and dental fear, and dental procedure. CCRBT evaluation identified many methodological issues in included studies. CONCLUSION: There is a very low certainty of evidence that DT can be effective in managing children's/adolescents' dental fear and anxiety during dental treatment. The heterogeneity of methodologies and findings in the studies, however, suggests more robust, and well-executed RCTs are needed.

Knowledge of parents/caregivers about the sleep bruxism of their children from all five Brazilian regions: A multicenter study.

BACKGROUND: Sleep bruxism (SB) is a masticatory muscle activity that affects children. Parents' knowledge is important for its identification and report to dentists. AIM: To investigate parents' knowledge about SB among their children. DESIGN: A cross-sectional study included 1325 parents of children from dental clinics of seven institutions from all regions of Brazil. Parents answered questions about child's sleep, knowledge about SB and its occurrence among children and parents. SB definition given by parents was dichotomized as "correct"/"incorrect", based on the American Academy of Sleep Medicine definition. Descriptive, bivariate and multivariate analyses were performed (P < 0.05). RESULTS: Most parents (57.3%) did not know what SB is and 88.9% would like to receive more information. SB prevalence among parents was 15.4% and 24.0% among children. Between parents who correctly defined SB, its prevalence increased to 27.5% among parents and 40.6% among children. Parents whose children had/have SB, who would like to receive more information about SB and were from the North, Central-West, Southeast, and South regions were more likely to define SB correctly (P > 0.05). CONCLUSION: There is a lack of knowledge of parents about SB. SB among children, parents' interest in receiving more information and their location were factors associated to their knowledge.

Possible sleep bruxism, circadian preference, and sleep-related characteristics and behaviors among dental students.

Objective: To assess sleep bruxism prevalence and its association with circadian preference and sleep-related characteristics among dental students. Methods: Dental students of the Federal University of Minas Gerais participated in this cross-sectional study. Participants answered a scale assessing individuals' circadian preference, and a questionnaire regarding sleep-related characteristics and behaviors, history of muscle ache in the temporomandibular area, and history of bruxism. Results: One hundred fifty-two students participated in the study. Sleep bruxism was reported by 11.3%. Most students (63.2%) were classified as intermediary, 34.9% as morningness, and 1.3% as eveningness. Individuals who reported muscle ache in the temporomandibular area in the morning (PR = 3.5; 95% CI = 1.1-11.5) were more likely to be in the group with sleep bruxism. Conclusion: Muscle ache in the temporomandibular area is an important associated factor with sleep bruxism among dental students. Special attention should be paid to dental students' circadian preference.

Association among chronotype, dietary behaviours, and caries experience in Brazilian adolescents: Is there a behavioural pattern?

BACKGROUND: Dental caries (DC) remains a public health issue. Chronotype, diet, and oral hygiene may influence its development. OBJECTIVE: To investigate the association of chronotype, diet, oral hygiene, and DC among 12-year-olds. METHODS: A cross-sectional study with 245 adolescents was conducted in public and private schools in southeast Brazil. Sociodemographics, dietary and oral hygiene habits were collected through a self-reported questionnaire. Chronotype was assessed using the Portuguese version of the Puberty and Phase Preference Scale (PPPS). Subjects were examined for DC (WHO criteria). Bivariate and multivariate analyses were performed (P < 0.05). RESULTS: DC was present in 42.0% of the sample. In the bivariate analysis, a higher DMFT was associated with living in rural areas (P = 0.006), parents'/caregivers' lower schooling (P = 0.008), and a not daily intake of vegetables (P = 0.033). Chronotype was not associated with DMFT scores. The Poisson regression model showed that adolescents who did not have breakfast regularly (PR = 1.55; 95% CI = 1.17-2.08; P = 0.003), lived in rural areas (PR = 2.20; 95% CI = 1.59-3.04; P < 0.001) and did not consume vegetables daily (PR = 1.55; 95% CI = 1.11-2.17; P = 0.009) were more likely to present a higher DMFT. CONCLUSIONS: DC is associated to living in rural areas and dietary habits, such as not having breakfast regularly and lack of daily intake of vegetables.