The prevalence of bruxism and related factors in patients with multiple sclerosis: a comparative study / A prevalência do bruxismo e fatores relacionados em pacientes com esclerose múltipla: um estudo comparativo

ABSTRACT Objective: To determine the prevalence of bruxism and related factors in patients with multiple sclerosis (MS). Methods: Diagnosed with relapsing-remitting MS under the 2010-revised McDonald diagnostic criteria, 182 patients without MS exacerbations during the previous three months were included in the patient group, and 145 healthy individuals made up the control group in the study. Demographic data of the participants in both groups were determined. In the patient and control groups, the diagnosis of definite bruxism was made using the International Classification of Sleep Disorders (Diagnosis and Coding Manual, Second Edition). Results: Bruxism was found in 29.7% (n = 54) of the patients and in 12.4% (n = 18) of the controls, and the difference was statistically significant (p < 0.001). Of all patients, the onset of bruxism was found in 70.4% (n = 38) after the diagnosis and in 29.6% (n = 169) prior to the diagnosis of MS. Compared with those without bruxism, the mean age (p = 0.031) and the score of the Expanded Disability Status Scale (p = 0.001) were also significantly higher among MS patients with bruxism. Between MS patients with and without bruxism, no significant differences were found in terms of sex, marital status, educational status, employment, cigarette smoking, total number of exacerbations, number of exacerbations within the previous year, and drugs used. Conclusions: The frequency of bruxism was found to be higher in the patients with MS than in the controls. Bruxism is associated with age and the Expanded Disability Status Scale score in MS patients.

RESUMO Objetivo: Neste estudo, pretendeu-se determinar a prevalência de bruxismo e fatores relacionados em pacientes com esclerose múltipla (EM). Métodos: Diagnosticados com EM remitente recidivante sob os critérios de McDonald Diagnostic revisados em 2010, 182 pacientes sem ataques de EM durante os últimos três meses foram incluídos no grupo de pacientes, e 145 indivíduos saudáveis constituíram o grupo de controle no estudo. Os dados demográficos dos participantes dos dois grupos foram determinados. Nos grupos de pacientes e controle, o diagnóstico de bruxismo definitivo foi feito usando a Classificação Internacional de Distúrbios do Sono (1) (Manual de Diagnóstico e Codificação Segunda Edição). Resultados: O bruxismo foi detectado em 29,7% (n = 54) dos pacientes e observado dentro de 12,4% (n = 18) dos controles, e a diferença foi estatisticamente significante (p <0,001). De todos os pacientes, o tempo inicial de bruxismo foi encontrado em 70,4% (n = 38) após o diagnóstico e em 29,6% (n = 169) antes do diagnóstico. Em comparação com aqueles sem bruxismo, os níveis de idade média (p = 0,031) e o escore da Escala de Status de Incapacidade Expandida (p = 0,001) também foram significativamente maiores entre os pacientes com esclerose múltipla com bruxismo. Entre os pacientes com esclerose múltipla com e sem bruxismo, não foi encontrada diferença significativa em termos de sexo, estado civil, status educacional, emprego, tabagismo, número total de ataques, número de ataques no último ano e medicamentos utilizados. Conclusões: A freqüência de bruxismo foi maior em pacientes com esclerose múltipla do que nos controles. O bruxismo está associado à idade e ao escore da Escala de Status de Incapacidade Expandida (EDSS) em pacientes com EM.

Malocclusion and deleterious oral habits among adolescents in a developing area in northeastern Brazil

Although malocclusions represent a serious public health issue, there is insufficient information about this problem in adolescents in Brazil, especially in poorer areas. The purpose of this cross-sectional study was to estimate the prevalence of facial alterations, dental malocclusions, and deleterious oral habits (DOH) among adolescents in a developing area in northeastern Brazil and to test the hypothesis that the occurrence of DOH in infancy is associated with DOH during adolescence. The study included a probabilistic population-based sample of 2,060 Brazilian students aged 12-15 years. Facial characteristics (type of facial profile, facial symmetry, and passive lip sealing) and malocclusions (Angle and Dental Aesthetic Index, DAI) were evaluated. DOH in infancy and adolescence were evaluated by interviews with the parents and adolescents. Most adolescents presented with normal facial characteristics. The malocclusion prevalence (Angle) was 83%. The DAI ranged from 13 to 69 (mean ± SD: 25.9 ± 7.7). Orthodontic treatment was necessary in 45.1% of the sample. The most prevalent DOH in adolescents were nail biting, object biting, cheek/lip biting, and bruxism, which were associated with finger sucking during infancy (P < 0.05). We conclude that malocclusions and DOH are common among Brazilian adolescents and that finger sucking during infancy may be a good predictor of DOH occurrence during adolescence.

Signs, symptoms, parafunctions and associated factors of parent-reported sleep bruxism in children: a case-control study

Bruxism is the non-functional clenching or grinding of the teeth that may occur during sleep or less commonly in daytime. The aim of this study was to investigate the association between clinical signs and symptoms, parafunctions and associated factors of sleep bruxism in children. A population-based case-control study was carried out involving 120 children, 8 years of age, with sleep bruxism and 240 children without sleep bruxism. The sample was randomly selected from public and private schools in the city of Belo Horizonte, MG, Brazil. Groups were matched by gender and social class. The Social Vulnerability Index (SVI) drawn up by the city of Belo Horizonte was employed for social classification. Data collection instruments included clinical forms and pre-tested questionnaires. The diagnosis of sleep bruxism was supported by the American Association of Sleep Medicine (AASM) criteria. The McNemar test, binary and multivariate logistic regression models were used for statistical analysis. The risk factors associated with sleep bruxism included: primary canine wear (OR=2.3 IC 95% 1.2-4.3), biting of objects like pencils or pens (OR=2.0 IC 95% 1.2-3.3) and wake-time bruxism (tooth clenching) (OR=2.3 IC 95% 1.2-4.3). Children that present the parafunctions of object biting and wake-time bruxism were more susceptible to sleep bruxism.

Bruxismo é o ato não funcional de ranger os dentes enquanto se dorme ou apertar os dentes em vigília. O objetivo deste estudo foi investigar a associação entre sinais e sintomas clínicos associados ao bruxismo noturno em crianças. Foi desenvolvido um estudo de base populacional com desenho caso-controle, envolvendo 120 crianças, de 8 anos de idade, com bruxismo e 240 crianças sem bruxismo. A amostra foi selecionada de forma randomizada em escolas públicas e particulares da cidade de Belo Horizonte, Brasil. Os grupos caso e controle foram pareados por gênero e classe social. O Índice de Vulnerabilidade Social (IVS) desenvolvido pela prefeitura da cidade de Belo Horizonte foi utilizado para a classificação social. Como instrumentos de coleta foram utilizados: uma ficha clínica e um questionário pré-testados. O diagnóstico de bruxismo noturno foi baseado nos critérios da American Association of Sleep Medicine (AASM). Os testes estatísticos de McNemar, regressão logística binária e multivariada com modelo de regressão foram utilizados para análise dos dados. Foram considerados fatores de risco para o bruxismo noturno: desgaste em caninos decíduos (OR=2,3 IC 95% 1,2-4,3), morder objetos como lápis e canetas (OR=2,0 IC 95% 1,2-3,3) e apertar os dentes em vigília (OR=2,3 IC 95% 1,2-4,3). Crianças que apresentam outras parafunções tais como: morder objetos e apertar os dentes em vigília são mais susceptíveis ao bruxismo noturno.

Prevalence of bruxism and emotional stress and the association between them in Brazilian police officers

This study aimed to assess the prevalence of bruxism and emotional stress in Brazilian police officers, due to exposure to stressful situations, and to assess the relationship between the type of work done by a police officer and the presence of bruxism and emotional stress. A cross-sectional study was conducted at the Military Police of the State of São Paulo, Campinas, SP, Brazil. The final sample included 394 male police officers (mean age = 35.5 years). Bruxism was diagnosed by the presence of aligned dental wear facets associated with the presence of one of the following signs or symptoms: self-report of tooth-grinding, painful sensitivity of the masseter and temporal muscles, discomfort in the jaw musculature upon waking. The Stress Symptoms Inventory (SSI) was applied to evaluate emotional stress. The type of work done by the police was classified as organizational or operational, the latter being assumed as the more stressful since it exposes the police officer to life risk. The results showed a prevalence of bruxism of 50.2 percent and a prevalence of emotional stress of 45.7 percent. The Chi-square test indicated an association between stress and bruxism (P < .05). No significant association was found between emotional stress and type of work (P = .382) or between bruxism and work activity (P = .611). It could be concluded that emotional stress was associated with bruxism, independently of the type of work done by police officers.

Perfil de la oclusión del niño en edad preescolar. Factores de beneficio y riesgo / Occlusal profile of the preschool child. Benefit and risk factors

Se realizó un estudio transversal para identificar condiciones de beneficio y riesgo para el establecimiento de una oclusión normal, en una muestra representativa de preescolares ubicados en Unidades Educactivas Públicas y Privadas del Municipio Maracaibo, Estado Zulia, Venezuela. Se seleccionaron mediante muestreo bietápico estratificado, 443 niños en edades comprendidas entre los tres y seis años, a los cuales se les realizó examen clínico para el riesgo de aspectos antropométricos, relaciones de oclusión, características del proceso de erupción dentaria, periodo de desarrollo oclusal y los factores que puediesen afectar el recambio dentario. Asimismo, se realizó encuesta socioeconómica al padre o representante para establecer algunas características relacionadas con la calidad de vida del niño y su grupo familiar. Los resultados obtenidos permiten identificar un poder adquisitivo "bajo" en más del 50 por ciento de los padres, condición vinculada a la alta prevalencia de caries detectada en este grupo y el acceso mayoritario de este grupo a los servicios públicos de salud, donde reciben preferentemente atención odontológica de tipo mutiladora (exodoncias). Según los indicadores antropométricos considerados en el estudio (talla, peso, circunferencia cefálica) los individuos categorizados como "poder adquisitivo alto", presentaron una talla 2 cm. mayor y un peso promedio de 1 kg. más con respecto a las otras categorías. En cuanto a las condiciones clínicas estudiadas, los resultodos evidencian en forma global, características en su mayoría beneficiosas para el establecimiento de una oclusión normal. Más del 60 por ciento no presentaron evidencia de caries dental, presencia en ambas arcadas de espacios de crecimiento y primates, relación de segundos molares primarios en posición bilateral plano recto y escalón mesial. Se detectaron algunas condiciones de riesgo: bruxismo, succión digital, deglución atípica, respiración bucal y malposiciones individuales. El análisis comparativo, permite establecer diferencias en el perfil de oclusión de los niños dependiendo de sus características bioindividuales y sociales.