Provável bruxismo do sono em escolares: prevalência, fatores associados e impacto na qualidade de vida

Abstract

Sleep bruxism (SB) is a repetitive activity of the mandibular musculature characterized by grinding or clenching of teeth during sleep. This movement disorder can be influenced by psychosocial and environmental factors. Data regarding its association with quality of life in children are scarce. A cross-sectional, population-based study wasconducted to determine prevalence, to identify associated factors, and to evaluate the association between probable sleep bruxism (PSB) and oral health-related quality of life (OHRQoL) of schoolchildren. A total of 1,053 schoolchildren, 8 to 10 years of age, enrolled in public and private schools in Teresina, PI, Brazil, and their parents/guardians participated in the study. The diagnosis of PSB was based on the international consensus criteria (parent/guardian report associated with the clinicalexamination). Parents/guardians answered a questionnaire about socioeconomic and demographic aspects, general and health conditions and self-report of possible bruxism of sleep in themselves, besides the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ). The schoolchildren answered the Brazilian version of the questionnaire Child Perceptions Questionnaire (CPQ8-10). They wereclinically examined, at the school, by a single trained and calibrated examiner (kappa0.80). The following oral conditions were evaluated: tooth wear, dental caries experience (DMF-T/dmf-t), malocclusion (Dental Aesthetic Index - DAI), and dental injuries (Andreasen classification), as possible confounding variables. Data were analyzed using bivariate and multivariate Poisson regression with robust variance (p <0.05). The results showed that the prevalence of PSB in schoolchildren was 28%.The presence of oral respiratory pattern, use of luminous and sound stimuli during sleep, responsible for possible sleep bruxism were associated with PSB in schoolchildren (p <0.001). In the perception of schoolchildren, PSB was associated with the greatest negative impact on OHRQoL in the functional limitation domains (RR = 1.174, 95%CI = 1.03 - 1.34) and social welfare (RR = 1.211, 95%CI = 1.01 - 1.46) and total CPQ8-10 score (RR = 1.131, 95%CI = 1.01 - 1.27). In the perception of the parents/guardians, the greatest negative impact on the OHRQoL was associated with the presence of PSB in the child. It was identified in three P-CPQ domains: oral symptoms (RR = 1.331, 95%CI = 1.14 - 1.55), limitation (RR = 1.916, 95%CI = 1.66 - 2.21) and well-being (RR = 1.485, 95%CI = 1.25 - 1.79), and in score for overall PCPQ (RR = 1.513, 95%CI = 1.34 -1.71). This study concluded that the prevalence of PSB was relevant. The occurrence of this disorder was associated with the presence of respiratory pattern, use of light and sound stimuli during sleep, that are responsible or possible bruxism of sleep. In addition to it, PSB in schoolchildren is associated with greater negative impact in the self-reported OHRQoL and in the perception of parents/guardians.