The impact of bruxism on oral health and quality of life in school-aged children

Objective: This study aims to investigate the effects of bruxism on oral health and quality of life by evaluating children aged 8-14 with and without bruxism. The goal is to raise public awareness about this issue, contribute to the literature on the early diagnosis of bruxism, and support preventive measures against its consequences. Materials and Methods: This case-control study included 60 children, aged 8-14, who visited the Pediatric Dentistry Department at Karadeniz Technical University Faculty of Dentistry. Thirty of the participants had bruxism, and the remaining thirty served as a control group. A survey based on the American Academy of Sleep Medicine (AASM) diagnostic criteria was used for bruxism diagnosis. The study employed several tools: an informed parent consent form, a medical history form, a parent questionnaire on bruxism, an informed child consent form, the Helkimo Index for evaluating the relationship between bruxism and temporomandibular disorders, and the modified Child Perception Questionnaire (CPQ) for assessing quality of life related to oral health. Clinical examination forms were used for intraoral and extraoral evaluations of hard and soft tissues. Statistical analysis involved descriptive statistics recorded as mean, standard deviation, median, minimum-maximum, or frequency values (%), based on data characteristics. Normal distribution of the data was assessed using the Kolmogorov-Smirnov test. Group comparisons were made using Kruskal-Wallis or Mann-Whitney U, and Chi-square tests. A p-value of less than 0.05 was considered statistically significant. Results: No significant differences were found between the bruxism and control groups regarding gender, age distribution, systemic diseases, or medication use (p>0.05). There were no significant differences between the groups in terms of plaque, DMFT/dmft, or bleeding on probing (p>0.05). The Helkimo Index did not reveal a significant relationship between temporomandibular disorders and bruxism (p>0.05). However, significant relationships were found between bruxism and overjet (p=0.028; p<0.05), overbite (p=0.026; p<0.05), and maximum mouth opening (p=0.037; p<0.05). While there were no significant differences between groups in terms of wear on primary and permanent teeth (p>0.05), a significant difference was found in wear on permanent molars (p=0.017; p<0.05). There were no significant relationships between bruxism and Angle's malocclusion classification, midline, anterior-lateral open bite, or crossbite (p>0.05). Examination of the joint and muscles revealed significant differences in pain in chewing muscles upon waking (p=0.026; p<0.05), deviation (p=0.005; p<0.05), pain on mouth opening (p=0.034; p<0.05), and linea alba (p=0.024; p<0.05). However, no significant relationships were found between bruxism and pain in chewing muscles over the past thirty days, deflection, pain during lateral and protrusive movements, joint sounds, pain on palpation, teeth marks on the tongue, or parafunctional habits (p>0.05). A significant relationship was found between bruxism and quality of life, with bruxism patients having a lower quality of life compared to those without bruxism (p=0.04; p<0.05). Conclusion: This study suggests that bruxism in children and adolescents aged 8-14 affects oral health and quality of life by restricting maximum mouth opening, causing wear on permanent molars, and inducing pain in chewing muscles upon waking and during mouth opening. It is recommended to increase awareness of bruxism among children and parents, monitor it from an early age, and address its potential effects through treatment and preventive measures.