Prevalance And Related Factors Of Bruxism In Children, A Preliminary Study

Prevalance And Related Factors Of Bruxism In Children, A Preliminary Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalance And Related Factors Of Bruxism In Children, A Preliminary Study Sibel Acar, Sedanur Eroglu Efe This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6289771/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective Bruxism is a parafunctional habit that is frequently seen in children and it’s characterized by unconsciously clenching and grinding the teeth. The aim of this study was to determine the prevalence of bruxism in children aged 3–12 years in USAK, Turkey and to evaluate the factors associated with bruxism. Materials and Methods A cross-sectional study was conducted to the parents of 346 children aged 3–12 years who attended to the paediatric dentistry department within 3 months. The children were diagnosed with bruxism by a questionnaire based on the American Academy of Sleep Medicine criteria administered to the parents. With this questionnaire consisting of 6 questions, factors related to bruxism were also questioned. Data were analysed by SPSS version22 for Windows( SPSS, Chicago;Il.,USA ). Chi square and Fisher’s Exact tests were used to assess statistical differences between categorical variables. Results The prevalence of bruxism was %24,9. There was a significant correlation between bruxism and pain around the temple and gums in wake up in the morning. Bruxism was more common in children who were reported to be stressed by their families. Statistically significant relationship was found between stress and bad habits such as nail biting, thumb sucking. Conclusion The prevalence of bruxism was high in childhood and was associated with many factors. Early diagnose and treatment of bruxism is important to reduce the incidence of future temporomandibular dysfunction. children prevalence bruxism stress Introduction Bruxism is considered as an involuntary, dysfunctional activity of the masticatory system and is characterized by clenching or grinding of the teeth( 1 ). Two different types of bruxism have been described; nocturnal bruxism (characterized as rhythmic or non-rhythmic) and diurnal bruxism (characterized by repetitive or sustained tooth contact and/or by supporting or pushing the mandible)( 2 ). Bruxism is a common habit especially in the pediatric population and mixed dentition. It can be considered as a normal behavior; but it can be considered as a disease with the presense of severe dental abrasions, muscle pain, grinding sounds that disturb family members and sleep disorders( 3 ). Many different methods can be used in the diagnosis of bruxism. A questionnaire method based on parental reports is often used in the diagnosis of bruxism and is supported by the American Academy of Sleep Medicine (AASM)( 4 ). Polysomnography technique applied in sleep laboratories is considered the gold standard in the diagnosis of sleep bruxism, nevertheless its high cost and difficulty in applying it in children are disadvantageous( 5 ). Clinical symptoms such as tooth wear are not sufficient to diagnose bruxism alone, it may occur due to many reasons. Diagnosis of bruxism in children is often based on teeth grinding sounds reported by parents, which is an easy and reliable method( 3 , 6 ). The prevalence of bruxism (day and night) varies between 2% and 40%.( 6 – 8 ) The prevalence of bruxism is higher in children in the general population and decreases with increasing age compared to the majority in the literature( 8 , 9 ). There is no consensus on the effect of gender on the prevalence of bruxism( 3 , 7 , 8 ). Bruxism has a multifactorial etiology and is more common in individuals with a stressful character( 10 , 11 ). Among the systemic factors, asthma, intestinal parasites, central nervous system diseases, allergies and some drugs can cause bruxism( 12 , 13 ). Tooth wear, fracture of restorations, periodontal damage, masseter muscle hypertrophy, joint pain and temporomandibular disorders may occur as a result of bruxism( 1 , 14 ). Nocturnal bruxism has been associated with respiratory problems and dental caries, among many other factors( 15 ). The aim of this study was to determine the prevalence of bruxism in children aged 3–12 years in USAK and to evaluate the relationship of bruxism with oral parafunctions, stress, and temporal and gingival pain. Materials and Methods This study was approved by the Faculty of Medicine Ethics Committee, in USAK University( 121-13-13) . Parents/guardians signed an informed consent statement(Human Ethics and Consent to Participate Form). A cross-sectional study was conducted to the parents of 346 children aged 3-12 years who attended to the paediatric dentistry department within 3 months. Participation was voluntary. A questionnaire form was given to 400 patients in total. However, 54 were excluded because of incomplete or incompatible answers and other sleep disturbances. The study was continued with the remaining 346 patients. Children were divided into 3 groups according to their age . These groups consist of the children aged 3-6, 7-9 and 10-12 years old. Eligibility criteria Inclusion criteria • Parents/carers of children aged 3-12 years awaiting treatment at a pediatric dentistry clinic of the USAK University. • Parents/carers accompanying the child on the first visit to the dentist. Exclusion criteria • illiterate parents/caregivers; • Parents/caregivers with special needs (psychological, psychiatric or neurological disorders) that preclude reliable responses. • Children with any mental disorders, sleep problems such as obstructive sleep apnea and sleep epilepsy. Data collecting A questionnaire according to the criteria of the American Academy of Sleep Medicine (AASM) was created(4). The self-administered questionnaire was completed by the parents in the waiting room of the pediatric clinic, without any assistance from the researcher. Nocturnal bruxism was diagnosed based on the reports of the parent/caregiver, which is a criterion of the AASM for children in this age group. The diagnosis of nocturnal bruxism was supported by the classification criteria recommended by the AASM. The AASM criteria are(16): Parents who report a teeth grinding sound at night; No other medical or mental disorders (sleep-related epilepsy is responsible for abnormal movements during sleep); and No other sleep disorders (obstructive sleep apnea syndrome). After completing the questionnaire, it was returned to the researcher immediately. The questionnaire included 6 questions about diurnal or nocturnal bruxism, parafunctional habits, pain and stress (Table Ⅰ). It also included general information about children such as age, gender and systemic status. Those who answered 'yes' to at least one of the first and second questions were considered as bruxists. Nocturnal and diurnal bruxism were evaluated together. The following data on parents/guardians were recorded: whether they suffered from nocturnal bruxism and whether they had knowledge of nocturnal bruxism and its causes. Intraoral examination was performed by a single specialist. Dental caries were recorded using the World Health Organization criteria (dft and DMFT indices). Decayed, missing and filled teeth were counted and classified according to age groups. The number of dental caries was also categorized: no caries(caries-free , 1-3 caries, 4-6 caries and more than 7 caries. Statistical analysis Data were analyzed with SPSS version22 for Windows (SPSS, Chicago;Il.,USA). Descriptive analyzes were performed for age, gender, presence of bruxism, systemic disease, pain, parafunctional habits, and stress. Chi-square and Fisher's Exact tests were used to evaluate statistical differences between categorical variables. Spearman rho correlation was performed to show the relationship of the variables with bruxism. Results A total of 346 children (175 girls, 171 boys) and their parents participated in the study. The frequency analysis of the responses to the survey questions is shown in Table 1 . Children who were reported to have bruxism while asleep or awake by their parents were considered bruxist. The prevalence of bruxism was found to be 24,9%. Bruxism was detected in 11 children both asleep and awake. While the prevalence of nocturnal bruxism was 22,3%, this rate was 6,4% in diurnal bruxism. Table 1 Frequency analysis of the answers to the questions YES NO Q1 Have you noticed that your child clenches and grinds their teeth in sleep? 77 (%22.3) 269 (%77.7) Q2 Have you noticed your child clenching and grinding their teeth while awake? 22 (%6.4) 324 (%93.6) Q3 Does your child feel pain around the temple when he wakes up? 22 (%6.4) 324 (%93.6) Q4 Does your child feel a pain in the teeth and gums in the morning? 74 (%21.4) 272 (%78.6) Q5 Does your child have parafunctional habits such as nail biting, pen biting, thumb sucking? 87 (%25.1) 259 (%74.9) Q6 Is your child stressed? 110 (%31.8) 236 (%68.2) The frequency of age groups, gender and presence of bruxism are shown in Table 2 . The frequency of bruxism was found to be higher among children aged 3–6 years. Among the children with bruxism, it seems most common in children aged 7–9 years. However, no statistically significant relationship was found between the age group and bruxism. Despite the prevalence of bruxism was higher in boys, no significant relationship was found between gender and bruxism. Table 2 Demographic characteristics of the samples Variables Frequency (n) % Gender Male (171) – 49.4% Female (175) – 50.6% Age 3–6 years (95) – 27.5% 7–9 years (174) – 50.3% 10–12 years (77) – 22.3% Bruxism Present (86) – 24.9% Absent (260) – 75.1% The association of bruxism with age, gender, oral parafunction, and pain in the temple and gums upon waking in the morning were given in Table 3 . A positive correlation was found between the pain in the temple area when waking up in the morning and bruxism (p = 0,037). In addition, a significant correlation was found between pain in the teeth and gums upon waking up in the morning and bruxism (p = 0,015). Table 3 Factors associated with bruxism Bruxism present N (%) Bruxism absent N (%) Total N Gender Male 47 (27.4%) 124 (72.6%) 171 Female 39 (22.2%) 136 (77.8%) 175 Age 3–6 years 29 (30.5%) 66 (69.5%) 95 7–9 years 41 (23.5%) 133 (76.5%) 174 10–12 years 16 (20.7%) 61 (79.3%) 77 Oral parafunctions yes 25 (28.7%) 62 (71.3%) 87 no 61 (23.5%) 198 (76.5%) 259 Stress yes 42 (38.1%) 68 (61.9%) 110 no 44 (18.6%) 192 (81.4%) 236 Temporal pain yes 10 (45.4%) 12 (54.6%) 22 no 76 (23.4%) 248 (76.6%) 324 Teeth and gums pain yes 27 (36.4%) 47 (63.6%) 74 no 59 (21.6%) 213 (78.4%) 272 Oral parafunctions such as nail biting and thumb sucking were also found in 29% of the children with bruxism, but no statistically significant relationship was found between bruxism and oral parafunctions. It was determined that the majority of children who were not stressed did not have bruxism. A significant relationship was found between bruxism and stress (p < 0,005). It was determined that children with bad habits such as nail biting and thumb sucking were mostly stressed (p < 0,005). Bruxism was found in 16,6% of children with a systemic disease other than those excluded from the study. There was no statistically significant relationship between systemic disease and bruxism. Only 10% of parents with a child with bruxism applied to the clinic with a complaint of bruxism. It has been reported that children whose application reason is bruxism are often stressed (p = 0,032). It has been determined that dental caries is high in children with bruxism. 40,7% of patients with bruxism have a dft value above 7. Dental caries results by age groups are shown in Table 4 . Dental caries was detected in all patients aged 3–6 years, 87,8% of patients aged 7–9 years, and 75% of patients aged 10–12 years. Table 4 Distribution of the number of caries and dft scores in patients with bruxism by age groups Age group Caries free 1–3 caries 4-6 caries > 7 caries Dft 3–6 years 0 5 13 11 6.17 ± 3.05 7–9 years 5 13 12 11 5.29 ± 3 10–12 years 4 8 3 1 4.06 ± 2.81 Discussion Bruxism is defined as repetitive jaw-muscle activity characterized by clenching/grinding and pushing or exerting force on the mandible( 2 ). Bruxism is a habit that effects masticatory system and temporomandibuler joint so that early diagnosis is valuable( 17 ). Questionnaires, anamnesis from parents, extraoral and intraoral clinical examination and various devices can be used to diagnose bruxism( 18 ). The diagnosis of bruxism with polysomnographic records is considered the gold standard, but it is expensive and difficult to access( 5 ). It is thought that anamnesis obtained from parents who are close to their children while sleeping and who are conscious of the sound of teeth grinding at night gives reliable results in diagnosing bruxism in children( 19 ). The questionnaire method, which is based on parent reports, which is frequently used in the diagnosis of bruxism, is supported by many studies and is recommended by AASM ( 3 , 6 , 20 , 21 ). Tooth wear may be thought as a diagnostic symptom but it can be caused by many different reasons, it can show personal differences due to the fact that the bite is more in the primary dentition and the structure of the saliva. Therefore, it is stated that tooth wear should not be used as a diagnostic criterion for bruxism( 22 ). Consequently, a questionnaire with AASM criteria are the most accurate diagnostic criteria among the tests evaluated( 23 ). This study contributes to literature on the prevalence of bruxism and related factors in children aged 3–12 years. The prevalence of bruxism in children ranges from 14% to 36,8% in the literature( 24 , 25 ). This wide range may be related to the change in the prevalence of bruxism according to age groups. It is stated in most of the studies that bruxism is seen in children at younger ages and the prevalence of bruxism decreases with age( 8 , 9 , 26 ). On the other hand, in some studies, it was observed that the prevalence of bruxism increased in children with increasing age( 6 , 27 ). In this study, the prevalence of bruxism was found to be 24,9% and it seems to decrease with age, in the line with the literature. The prevalence of nocturnal bruxism was 22,3%. In systematic reviews, the prevalence of nocturnal bruxism was found to be around 30%, which is consistent with this result( 8 , 28 ). Some studies indicate that bruxism is more common in mixed dentition( 7 , 19 , 29 ). Occlusal irregularities and early contacts in mixed dentition may be related to this condition. On the contrary, there are studies reporting that bruxism is more common in primary dentition( 8 , 26 ). Consistent with previous studies, bruxism was reported more frequently in primary dentition in the current study. It may be the result of parents' close relationships with children in this age group. It may also be related to getting older; as children get older, their parents visit their bedrooms less. The gender has not a significant effect on bruxism( 3 , 7 , 8 ). Clementino et al. found the prevalence of bruxism to be higher in girls than boys( 30 ). On the contrary, the prevalence of bruxism was found higher in boys( 31 ). In the present study, bruxism was observed more frequently in boys, nonsignificantly. Serra Negra et al. stated that oral parafunctions such as nail and pencil biting were associated with bruxism( 21 ). One other study reported that children with oral parafunctions were less likely to develop bruxism( 7 ). This may be a particular result of the habit of thumb sucking, it may prevents children from clenching their teeth. In aggreement with the literature, no significant relationship was found between bruxism and oral parafunctions in this study. Many authors have argued that stress has an effect on bruxism( 6 , 28 ). Oliveira et al. have shown that anxiety and stress are especially present in patients with bruxism( 32 ). It has been reported that children tend to release the tension accumulated during the day, have chronic bruxism during sleep( 25 ). In accordance with the literature, the prevalence of bruxism was found to be significantly higher in children who were reported to be stressed by their parents in the present study. Some studies reported that patients with bruxism experience more headaches when they wake up in the morning( 31 , 33 ). In this study, bruxism was found to be effective in the complaints of pain in the temporal region when waking up in the morning, and this result was found to be statistically significant. It has been stated that bruxism may be effective in the formation of dental caries( 12 , 34 ). While Motta et al( 34 ) detected dental caries in 76,9% of children with bruxism, Antunes et al( 12 ) found the prevalence of dental caries was to be 33,3% in children with bruxism, and these findings were higher than controls. In agreement with these studies, the present study reported a high rate of dental caries in children with bruxism. The reason for these high caries rates may be related to the exposure of dentin due to occlusal wear on teeth as a result of tooth grinding. The early treatment of bruxism may reduce the incidence of Temporomandibular Disorders in the future( 35 ). Therefore, it is important to diagnose bruxism in childhood and to seek treatment alternatives. In the current study, only 10% of parents were aware of their child's complaints of bruxism. This may be related to the fact that parents have difficulty on understanding the problems associated with bruxism. This result shows us the need to raise awareness on society about bruxism in children. More researches are needed on childhood bruxism. Study Limitations One of the limitations of this study can be considered as the diagnosis of nocturnal bruxism based on parental reports, although parental reports were accepted by the AASM( 4 ). Many parents sleep in separate rooms with their children, so they may not be aware that the child is grinding their teeth at night. Therefore, it should be considered that the prevalence of bruxism may have been found to be less than the actual number. Another limitation is the small sample size of the study. Some results from this study may be meaningful with a larger number of children. It has been planned as a pilot study. To clarify the results in the main study, a larger sample size will be considered. Conclusion According to the results of this study, the prevalence of bruxism in children living in USAK was found to be 24,9%. There were no significant relationship between bruxism and gender&age. In children with bruxism; The pain in the temple area is more common The children with bruxism are more stressed according to parent reports. It seems there is a relationship between bruxism and dental caries. Declarations Human Ethics and Consent to Participate declaration was specified in Materials&Methods section. There was no Funding to declarate. Clinical trial number: not applicable. Consent to Publish declaration: not applicable. Author contributions: S.A. conceived the idea, S.A. and S.E. collected and analyzed the data, S.A. and S.E. led the writing and revised the manuscript and gave final approval of the version to be published and agreed to be accountable for all aspects of the study. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6289771","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":448646649,"identity":"0f939588-ccd6-4e3d-8e0c-b93e9a0913a2","order_by":0,"name":"Sibel Acar","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABFUlEQVRIie2RsWrDMBCGzwjk5dKuWlq9gkzBGQLxq0gYmqXtHEgggoAzhayBPkW2jjWGZFHzDMreIZ2aLqUyDqEFubRbofqm08996I4DCAT+IgQBbFM9gvyUf680nVTpusCTQtuck4KJhp8ofNYprYQ+P783r3b30M+yeF5aGPaU5nPrU0R1lgsJebLc3q60MjlB3OYCzEBpGguvQjBlEogE03FKQSiym5RFReUU/2R8it2DhInkBndOmSDy5+4hem9XoMLUrV9JYTBySsWQuSTS7Uq9C5Nik6wMTZaq2Ag0dy5ZD64Keu0fbPFU7vfDEb80xL68FaMsntXJuHexIGv/YM1fX17HS7Ve0gP+ojcQCAT+Ax9/iVZQ3K7CowAAAABJRU5ErkJggg==","orcid":"","institution":"Izmir Tınaztepe University","correspondingAuthor":true,"prefix":"","firstName":"Sibel","middleName":"","lastName":"Acar","suffix":""},{"id":448646650,"identity":"79177553-da64-4e37-aa3d-6f7257f0d593","order_by":1,"name":"Sedanur Eroglu Efe","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Sedanur","middleName":"Eroglu","lastName":"Efe","suffix":""}],"badges":[],"createdAt":"2025-03-23 18:23:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6289771/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6289771/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82130920,"identity":"fa3621da-048d-4a7e-88c5-9a02408d9130","added_by":"auto","created_at":"2025-05-07 05:32:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":531454,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6289771/v1/c00f3323-b477-4935-85fa-13a62e00c504.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalance And Related Factors Of Bruxism In Children, A Preliminary Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBruxism is considered as an involuntary, dysfunctional activity of the masticatory system and is characterized by clenching or grinding of the teeth(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Two different types of bruxism have been described; nocturnal bruxism (characterized as rhythmic or non-rhythmic) and diurnal bruxism (characterized by repetitive or sustained tooth contact and/or by supporting or pushing the mandible)(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBruxism is a common habit especially in the pediatric population and mixed dentition. It can be considered as a normal behavior; but it can be considered as a disease with the presense of severe dental abrasions, muscle pain, grinding sounds that disturb family members and sleep disorders(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMany different methods can be used in the diagnosis of bruxism. A questionnaire method based on parental reports is often used in the diagnosis of bruxism and is supported by the American Academy of Sleep Medicine (AASM)(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Polysomnography technique applied in sleep laboratories is considered the gold standard in the diagnosis of sleep bruxism, nevertheless its high cost and difficulty in applying it in children are disadvantageous(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Clinical symptoms such as tooth wear are not sufficient to diagnose bruxism alone, it may occur due to many reasons. Diagnosis of bruxism in children is often based on teeth grinding sounds reported by parents, which is an easy and reliable method(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe prevalence of bruxism (day and night) varies between 2% and 40%.(\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) The prevalence of bruxism is higher in children in the general population and decreases with increasing age compared to the majority in the literature(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). There is no consensus on the effect of gender on the prevalence of bruxism(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBruxism has a multifactorial etiology and is more common in individuals with a stressful character(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Among the systemic factors, asthma, intestinal parasites, central nervous system diseases, allergies and some drugs can cause bruxism(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTooth wear, fracture of restorations, periodontal damage, masseter muscle hypertrophy, joint pain and temporomandibular disorders may occur as a result of bruxism(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Nocturnal bruxism has been associated with respiratory problems and dental caries, among many other factors(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe aim of this study was to determine the prevalence of bruxism in children aged 3\u0026ndash;12 years in USAK and to evaluate the relationship of bruxism with oral parafunctions, stress, and temporal and gingival pain.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThis study was approved by the Faculty of Medicine Ethics Committee, in USAK University(\u003cem\u003e121-13-13)\u003c/em\u003e. Parents/guardians signed an informed consent statement(Human Ethics and Consent to Participate Form).\u003c/p\u003e\n\u003cp\u003eA cross-sectional study was conducted to the parents of 346 children aged 3-12 years who attended to the paediatric dentistry department within 3 months. Participation was voluntary. A questionnaire form was given to 400 patients in total. \u0026nbsp;However, 54 were excluded because of incomplete or incompatible answers and other sleep disturbances. The study was continued with the remaining 346 patients. Children were divided into 3 groups according to their age . These groups consist of the children aged 3-6, 7-9 and 10-12 years old.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEligibility criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eInclusion criteria\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u0026bull; Parents/carers of children aged 3-12 years awaiting treatment at a pediatric dentistry clinic of the USAK University.\u003c/p\u003e\n\u003cp\u003e\u0026bull; Parents/carers accompanying the child on the first visit to the dentist.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eExclusion criteria\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u0026bull; illiterate parents/caregivers;\u003c/p\u003e\n\u003cp\u003e\u0026bull; Parents/caregivers with special needs (psychological, psychiatric or neurological disorders) that preclude reliable responses.\u003c/p\u003e\n\u003cp\u003e\u0026bull; Children with any mental disorders, sleep problems such as obstructive sleep apnea and sleep epilepsy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collecting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA questionnaire according to the criteria of the American Academy of Sleep Medicine (AASM) was created(4).\u0026nbsp;The self-administered questionnaire was completed by the parents in the waiting room of the pediatric clinic, without any assistance from the researcher.\u003c/p\u003e\n\u003cp\u003eNocturnal bruxism was diagnosed based on the reports of the parent/caregiver, which is a criterion of the AASM for children in this age group. The diagnosis of nocturnal bruxism was supported by the classification criteria recommended by the AASM. The AASM criteria are(16):\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eParents who report a teeth grinding sound at night;\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eNo other medical or mental disorders (sleep-related epilepsy is responsible for abnormal movements during sleep); and\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eNo other sleep disorders (obstructive sleep apnea syndrome).\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eAfter completing the questionnaire, it was returned to the researcher immediately.\u003c/p\u003e\n\u003cp\u003eThe questionnaire included 6 questions about diurnal or nocturnal bruxism, parafunctional habits, pain and stress (Table Ⅰ). It also included general information about children such as age, gender and systemic status. Those who answered \u0026apos;yes\u0026apos; to at least one of the first and second questions were considered as bruxists. Nocturnal and diurnal bruxism were evaluated together. The following data on parents/guardians were recorded: whether they suffered from nocturnal bruxism and whether they had knowledge of nocturnal bruxism and its causes.\u003c/p\u003e\n\u003cp\u003eIntraoral examination was performed by a single specialist. Dental caries were recorded using the World Health Organization criteria (dft and DMFT indices). Decayed, missing and filled teeth were counted and classified according to age groups. The number of dental caries was also categorized: no caries(caries-free , 1-3 caries, 4-6 caries and more than 7 caries.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were analyzed with SPSS version22 for Windows (SPSS, Chicago;Il.,USA). Descriptive analyzes were performed for age, gender, presence of bruxism, systemic disease, pain, parafunctional habits, and stress. Chi-square and Fisher\u0026apos;s Exact tests were used to evaluate statistical differences between categorical variables. Spearman rho correlation was performed to show the relationship of the variables with bruxism.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 346 children (175 girls, 171 boys) and their parents participated in the study. The frequency analysis of the responses to the survey questions is shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Children who were reported to have bruxism while asleep or awake by their parents were considered bruxist. The prevalence of bruxism was found to be 24,9%. Bruxism was detected in 11 children both asleep and awake. While the prevalence of nocturnal bruxism was 22,3%, this rate was 6,4% in diurnal bruxism.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency analysis of the answers to the questions\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHave you noticed that your child clenches and grinds their teeth in sleep?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77 (%22.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e269 (%77.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHave you noticed your child clenching and grinding their teeth while awake?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (%6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e324 (%93.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoes your child feel pain around the temple when he wakes up?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (%6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e324 (%93.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoes your child feel a pain in the teeth and gums in the morning?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74 (%21.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e272 (%78.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoes your child have parafunctional habits such as nail biting, pen biting, thumb sucking?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87 (%25.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e259 (%74.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQ6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIs your child stressed?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e110 (%31.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e236 (%68.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe frequency of age groups, gender and presence of bruxism are shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. The frequency of bruxism was found to be higher among children aged 3\u0026ndash;6 years. Among the children with bruxism, it seems most common in children aged 7\u0026ndash;9 years. However, no statistically significant relationship was found between the age group and bruxism. Despite the prevalence of bruxism was higher in boys, no significant relationship was found between gender and bruxism.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics of the samples\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n) %\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(171) \u0026ndash; 49.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(175) \u0026ndash; 50.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u0026ndash;6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(95) \u0026ndash; 27.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u0026ndash;9 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(174) \u0026ndash; 50.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u0026ndash;12 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(77) \u0026ndash; 22.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBruxism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePresent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(86) \u0026ndash; 24.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbsent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(260) \u0026ndash; 75.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe association of bruxism with age, gender, oral parafunction, and pain in the temple and gums upon waking in the morning were given in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. A positive correlation was found between the pain in the temple area when waking up in the morning and bruxism (p\u0026thinsp;=\u0026thinsp;0,037). In addition, a significant correlation was found between pain in the teeth and gums upon waking up in the morning and bruxism (p\u0026thinsp;=\u0026thinsp;0,015).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors associated with bruxism\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBruxism present\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBruxism absent\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47 (27.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e124 (72.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e171\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39 (22.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e136 (77.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e175\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u0026ndash;6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29 (30.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e66 (69.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u0026ndash;9 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41 (23.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e133 (76.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e174\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u0026ndash;12 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (20.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61 (79.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eOral parafunctions\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25 (28.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62 (71.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61 (23.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e198 (76.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e259\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eStress\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42 (38.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68 (61.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44 (18.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e192 (81.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e236\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eTemporal pain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (45.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12 (54.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76 (23.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e248 (76.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e324\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTeeth and gums pain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (36.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47 (63.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59 (21.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e213 (78.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e272\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e Oral parafunctions such as nail biting and thumb sucking were also found in 29% of the children with bruxism, but no statistically significant relationship was found between bruxism and oral parafunctions. It was determined that the majority of children who were not stressed did not have bruxism. A significant relationship was found between bruxism and stress (p\u0026thinsp;\u0026lt;\u0026thinsp;0,005). It was determined that children with bad habits such as nail biting and thumb sucking were mostly stressed (p\u0026thinsp;\u0026lt;\u0026thinsp;0,005).\u003c/p\u003e \u003cp\u003eBruxism was found in 16,6% of children with a systemic disease other than those excluded from the study. There was no statistically significant relationship between systemic disease and bruxism. Only 10% of parents with a child with bruxism applied to the clinic with a complaint of bruxism. It has been reported that children whose application reason is bruxism are often stressed (p\u0026thinsp;=\u0026thinsp;0,032).\u003c/p\u003e \u003cp\u003eIt has been determined that dental caries is high in children with bruxism. 40,7% of patients with bruxism have a dft value above 7. Dental caries results by age groups are shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Dental caries was detected in all patients aged 3\u0026ndash;6 years, 87,8% of patients aged 7\u0026ndash;9 years, and 75% of patients aged 10\u0026ndash;12 years.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of the number of caries and dft scores in patients with bruxism by age groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCaries free\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026ndash;3 caries\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4-6 caries\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;7 caries\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDft\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e6.17\u0026thinsp;\u0026plusmn;\u0026thinsp;3.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u0026ndash;9 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e5.29\u0026thinsp;\u0026plusmn;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;12 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e4.06\u0026thinsp;\u0026plusmn;\u0026thinsp;2.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eBruxism is defined as repetitive jaw-muscle activity characterized by clenching/grinding and pushing or exerting force on the mandible(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Bruxism is a habit that effects masticatory system and temporomandibuler joint so that early diagnosis is valuable(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Questionnaires, anamnesis from parents, extraoral and intraoral clinical examination and various devices can be used to diagnose bruxism(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe diagnosis of bruxism with polysomnographic records is considered the gold standard, but it is expensive and difficult to access(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). It is thought that anamnesis obtained from parents who are close to their children while sleeping and who are conscious of the sound of teeth grinding at night gives reliable results in diagnosing bruxism in children(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). The questionnaire method, which is based on parent reports, which is frequently used in the diagnosis of bruxism, is supported by many studies and is recommended by AASM (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Tooth wear may be thought as a diagnostic symptom but it can be caused by many different reasons, it can show personal differences due to the fact that the bite is more in the primary dentition and the structure of the saliva. Therefore, it is stated that tooth wear should not be used as a diagnostic criterion for bruxism(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Consequently, a questionnaire with AASM criteria are the most accurate diagnostic criteria among the tests evaluated(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study contributes to literature on the prevalence of bruxism and related factors in children aged 3\u0026ndash;12 years. The prevalence of bruxism in children ranges from 14% to 36,8% in the literature(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). This wide range may be related to the change in the prevalence of bruxism according to age groups. It is stated in most of the studies that bruxism is seen in children at younger ages and the prevalence of bruxism decreases with age(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). On the other hand, in some studies, it was observed that the prevalence of bruxism increased in children with increasing age(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). In this study, the prevalence of bruxism was found to be 24,9% and it seems to decrease with age, in the line with the literature.\u003c/p\u003e \u003cp\u003eThe prevalence of nocturnal bruxism was 22,3%. In systematic reviews, the prevalence of nocturnal bruxism was found to be around 30%, which is consistent with this result(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Some studies indicate that bruxism is more common in mixed dentition(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Occlusal irregularities and early contacts in mixed dentition may be related to this condition. On the contrary, there are studies reporting that bruxism is more common in primary dentition(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Consistent with previous studies, bruxism was reported more frequently in primary dentition in the current study. It may be the result of parents' close relationships with children in this age group. It may also be related to getting older; as children get older, their parents visit their bedrooms less.\u003c/p\u003e \u003cp\u003eThe gender has not a significant effect on bruxism(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Clementino et al. found the prevalence of bruxism to be higher in girls than boys(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). On the contrary, the prevalence of bruxism was found higher in boys(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). In the present study, bruxism was observed more frequently in boys, nonsignificantly.\u003c/p\u003e \u003cp\u003eSerra Negra et al. stated that oral parafunctions such as nail and pencil biting were associated with bruxism(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). One other study reported that children with oral parafunctions were less likely to develop bruxism(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). This may be a particular result of the habit of thumb sucking, it may prevents children from clenching their teeth. In aggreement with the literature, no significant relationship was found between bruxism and oral parafunctions in this study.\u003c/p\u003e \u003cp\u003eMany authors have argued that stress has an effect on bruxism(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Oliveira et al. have shown that anxiety and stress are especially present in patients with bruxism(\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). It has been reported that children tend to release the tension accumulated during the day, have chronic bruxism during sleep(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). In accordance with the literature, the prevalence of bruxism was found to be significantly higher in children who were reported to be stressed by their parents in the present study.\u003c/p\u003e \u003cp\u003eSome studies reported that patients with bruxism experience more headaches when they wake up in the morning(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). In this study, bruxism was found to be effective in the complaints of pain in the temporal region when waking up in the morning, and this result was found to be statistically significant.\u003c/p\u003e \u003cp\u003eIt has been stated that bruxism may be effective in the formation of dental caries(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). While Motta et al(\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e) detected dental caries in 76,9% of children with bruxism, Antunes et al(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) found the prevalence of dental caries was to be 33,3% in children with bruxism, and these findings were higher than controls. In agreement with these studies, the present study reported a high rate of dental caries in children with bruxism. The reason for these high caries rates may be related to the exposure of dentin due to occlusal wear on teeth as a result of tooth grinding.\u003c/p\u003e \u003cp\u003eThe early treatment of bruxism may reduce the incidence of Temporomandibular Disorders in the future(\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Therefore, it is important to diagnose bruxism in childhood and to seek treatment alternatives. In the current study, only 10% of parents were aware of their child's complaints of bruxism. This may be related to the fact that parents have difficulty on understanding the problems associated with bruxism. This result shows us the need to raise awareness on society about bruxism in children. More researches are needed on childhood bruxism.\u003c/p\u003e\n\u003ch3\u003eStudy Limitations\u003c/h3\u003e\n\u003cp\u003eOne of the limitations of this study can be considered as the diagnosis of nocturnal bruxism based on parental reports, although parental reports were accepted by the AASM(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Many parents sleep in separate rooms with their children, so they may not be aware that the child is grinding their teeth at night. Therefore, it should be considered that the prevalence of bruxism may have been found to be less than the actual number. Another limitation is the small sample size of the study. Some results from this study may be meaningful with a larger number of children. It has been planned as a pilot study. To clarify the results in the main study, a larger sample size will be considered.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAccording to the results of this study, the prevalence of bruxism in children living in USAK was found to be 24,9%. There were no significant relationship between bruxism and gender\u0026amp;age. In children with bruxism;\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eThe pain in the temple area is more common\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eThe children with bruxism are more stressed according to parent reports.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eIt seems there is a relationship between bruxism and dental caries.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003eHuman Ethics and Consent to Participate declaration was specified in Materials\u0026amp;Methods section. There was no Funding to declarate. Clinical trial number: not applicable. Consent to Publish declaration: not applicable.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u0026nbsp;\u003c/strong\u003eS.A. conceived the idea, S.A. and S.E. collected and analyzed the data, S.A. and S.E. led the writing and revised the manuscript and gave final approval of the version to be published and agreed to be accountable for all aspects of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e The author received no financial support for the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest:\u003c/strong\u003e\u0026nbsp; None of authors have any conflicts of interest to report.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eALFAYA T de A, TANNURE PN, BARCELOS R, DIP EC, GOUV\u0026Ecirc;A CVD. UEMOTO L,. Clinical management of childhood bruxism. RGO - Revista Ga\u0026uacute;cha de Odontologia. 2015;63(2).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ et al. Bruxism defined and graded: An international consensus. J Oral Rehabil. 2013;40(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSerra-Negra JM, Ramos-Jorge ML, Flores-Mendoza CE, Paiva SM, Pordeus IA. Influence of psychosocial factors on the development of sleep bruxism among children. Int J Paediatr Dent. 2009;19(5).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSateia MJ. International Classification of Sleep Disorders 3rd Ed. Darien, IL USA: American Academy of Sleep Medicine. 2014. Chest. 2014;146(5).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVieira-Andrade RG, Drumond CL, Martins PA, Corr\u0026ecirc;a-Faria P, Gonzaga GC, Marques LS et al. 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Understanding bruxism in children and adolescents | Comprendre les bruxismes chez l\u0026rsquo;enfant et l\u0026rsquo;adolescent. Int Orthod. 2015;13(4).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBach S, de Moreira L, Goettems FP, Brancher ML, Oses LC, da Silva JP. RA, Salivary cortisol levels and biological rhythm in schoolchildren with sleep bruxism. Sleep Med. 2019;54.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMengatto CM, Coelhode-Souza FH, De Souza OB. Sleep bruxism: Challenges and restorative solutions. Vol. 8, Clinical, Cosmetic and Investigational Dentistry. 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAntunes LAA, Castilho T, Marinho M, Fraga RS, Antunes LS. Childhood bruxism: Related factors and impact on oral health-related quality of life. Spec Care Dentist. 2016;36(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNADLER SC. Bruxism, a classification: critical review. J Am Dent Assoc. 1957;54(5).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ede La Hoz-Aizpurua JL, D\u0026iacute;az-Alonso E, Latouche-Arbizu R, Mesa-Jim\u0026eacute;nez J. Sleep bruxism. Conceptual review and update. Med Oral Patol Oral Cir Bucal. 2011;16(2).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRodrigues JA, Azevedo CB, Chami VO, Solano MP, Lenzi TL. Sleep bruxism and oral health-related quality of life in children: A systematic review. 30, Int J Pediatr Dent. 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBuysse DJ, Young T, Edinger JD, Carroll J, Kotagal S. Clinicians\u0026rsquo; use of the International Classification of Sleep Disorders: results of a national survey. Sleep. 2003;26(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAchmad H, Wahyuni S, Ramadhany YF. A review the relationship of bruxism with temporomandibular disorders in children. Syst Reviews Pharm. 2020;11(6).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStrausz T, Ahlberg J, Lobbezoo F, Restrepo CC, Hublin C, Ahlberg K et al. Awareness of tooth grinding and clenching from adolescence to young adulthood: A nine-year follow-up. J Oral Rehabil. 2010;37(7).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRestrepo C, Manfredini D, Castrillon E, Svensson P, Santamaria A, Alvarez C et al. Diagnostic accuracy of the use of parental-reported sleep bruxism in a polysomnographic study in children. Int J Paediatr Dent. 2017;27(5).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInsana SP, Gozal D, McNeil DW, Montgomery-Downs HE. Community based study of sleep bruxism during early childhood. Sleep Med. 2013;14(2).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSerra-Negra JM, Paiva SM, Auad SM, Ramos-Jorge ML, Pordeus IA. Signs, symptoms, parafunctions and associated factors of parent-reported sleep bruxism in children: A case-control study. Braz Dent J. 2012;23(6).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLussi A, Kohler N, Zero D, Schaffner M, Megert B. A comparison of the erosive potential of different beverages in primary and permanent teeth using an in vitro model. Volume 108. European Journal of Oral Sciences; 2000.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePalinkas M, De Luca Canto G, Rodrigues LAM, Bataglion C, Si\u0026eacute;ssere S, Semprini M et al. Comparative capabilities of clinical assessment, diagnostic criteria, and polysomnography in detecting sleep bruxism. J Clin Sleep Med. 2015;11(11).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoettems ML, Poletto-Neto V, Shqair AQ, Pinheiro RT, Demarco FF. Influence of maternal psychological traits on sleep bruxism in children. Int J Paediatr Dent. 2017;27(6).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGomes MC, Neves \u0026Eacute;T, Perazzo MF, de Souza EGC, Serra-Negra JM, Paiva SM et al. Evaluation of the association of bruxism, psychosocial and sociodemographic factors in preschoolers. Braz Oral Res. 2018;32.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSoares KAN, Melo RMCS, Gomes MC, Perazzo MF, Granville-Garcia AF, Menezes VA. Prevalence and factors associated to bruxism in preschool children. J Public Health (Germany). 2016;24(3).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMassignan C, de Alencar NA, Soares JP, Santana CM, Serra-Negra J, Bolan M et al. Poor sleep quality and prevalence of probable sleep bruxism in primary and mixed dentitions: a cross-sectional study. Sleep Breath. 2019;23(3).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMachado E, Dal-Fabbro C, Cunali PA, Kaizer OB. Prevalence of sleep bruxism in children: A systematic review. Dent Press J Orthod. 2014;19(6).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRibeiro MB, Manfredini D, Tavares-Silva C, Costa L, Luiz RR, Paiva S et al. Association of possible sleep bruxism in children with different chronotype profiles and sleep characteristics. Chronobiol Int. 2018;35(5).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eClementino MA, Siqueira MB, Serra-Negra JM, Paiva SM, Granville-Garcia AF. The prevalence of sleep bruxism and associated factors in children: a report by parents. Eur Archives Pediatr Dentistry. 2017;18(6).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSousa HCS, De Lima M, de Neta DM, Tobias NBD, De Moura RQ, Moura MS. L de FA de D. Prevalence and associated factors to sleep bruxism in adolescents from Teresina, Piau\u0026iacute;. Revista Brasileira de Epidemiologia. 2018;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ede Oliveira MT, Bittencourt ST, Marcon K, Destro S, Pereira JR. Sleep bruxism and anxiety level in children. Braz Oral Res. 2015;29(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMiamoto CB, Pereira LJ, Ramos-Jorge ML, Marques LS. Prevalence and predictive factors of sleep bruxism in children with and without cognitive impairment. Braz Oral Res. 2011;25(5).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMotta LJ, Bortoletto CC, Marques AJ, Mesquita Ferrari RA, Santos Fernandes KP, Bussadori SK. Association between respiratory problems and dental caries in children with bruxism. Indian J Dent Res. 2014;25(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlamoudi N. Correlation between oral parafunction and temporomandibular disorders and emotional status among Saudi children. J Clin Pediatr Dentistry. 2001;26(1).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"children, prevalence, bruxism, stress","lastPublishedDoi":"10.21203/rs.3.rs-6289771/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6289771/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eBruxism is a parafunctional habit that is frequently seen in children and it\u0026rsquo;s characterized by unconsciously clenching and grinding the teeth. The aim of this study was to determine the prevalence of bruxism in children aged 3\u0026ndash;12 years in USAK, Turkey and to evaluate the factors associated with bruxism.\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted to the parents of 346 children aged 3\u0026ndash;12 years who attended to the paediatric dentistry department within 3 months. The children were diagnosed with bruxism by a questionnaire based on the American Academy of Sleep Medicine criteria administered to the parents. With this questionnaire consisting of 6 questions, factors related to bruxism were also questioned. Data were analysed by SPSS version22 for Windows(\u003cem\u003eSPSS, Chicago;Il.,USA\u003c/em\u003e). Chi square and Fisher\u0026rsquo;s Exact tests were used to assess statistical differences between categorical variables.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe prevalence of bruxism was %24,9. There was a significant correlation between bruxism and pain around the temple and gums in wake up in the morning. Bruxism was more common in children who were reported to be stressed by their families. Statistically significant relationship was found between stress and bad habits such as nail biting, thumb sucking.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe prevalence of bruxism was high in childhood and was associated with many factors. Early diagnose and treatment of bruxism is important to reduce the incidence of future temporomandibular dysfunction.\u003c/p\u003e","manuscriptTitle":"Prevalance And Related Factors Of Bruxism In Children, A Preliminary Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-28 13:10:43","doi":"10.21203/rs.3.rs-6289771/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f53ec63c-75c2-48e1-b37f-37033b0cebee","owner":[],"postedDate":"April 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-05-07T05:08:32+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-28 13:10:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6289771","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6289771","identity":"rs-6289771","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}