Understanding bruxism in children and adolescents.
International Orthodontics. 2015-12-01; 13(4): 489-506
DOI: 10.1016/j.ortho.2015.09.001
Lire sur PubMed
Article in English, French
Saulue P, Carra MC, Laluque JF, d’Incau E.
Screening for the various forms of bruxism in children and adolescents requires
a sound knowledge of the physiopathology of this parafunction in addition to the
etiologic and associated factors and comorbidities. The international literature
contains various suggestions for suitable treatment. The optimal therapeutic
approach often involves multidisciplinary management of these young patients.
Sleep bruxism (SB) is a common sleep disorder which can cause serious problems
to the stomatognathic system such as damaged teeth, headaches, muscle pain and
TMD. Dental professionals are responsible for the detection and prevention of
these harmful impacts on the patient’s oral health. However, SB is much more
than a question of worn teeth. Patients with SB consult for other medical
comorbidities such as nighttime breathing problems, insomnia, attention deficit
hyperactivity disorder, depression, moodiness and gastroesophogeal reflux before
any course of treatment is initiated. If a comorbidity is diagnosed, the
treatment approach will be aimed in the first instance at the medical disorder,
while concurrently managing the repercussions of SB. On the other hand, in as
far as the majority of young bruxers cease to grind their teeth before
adolescence or adulthood, it is feasible to adopt wait-and-see and
non-interventionist strategies for young children. However, it is preferable to
have a better understanding of SB, notably on account of its potential
association with psychological disorders during childhood. Daytime bruxism is
characterized by teeth clenching (TC). First-line treatment involves encouraging
patients to monitor their harmful parafunctional behavior and, consequently,
change and cease it. This protocol is not always easy to apply, particularly in
younger children. In such cases, cognitive-behavioral treatments and biofeedback
techniques can also be used in daytime bruxism.