A maloclusão é um fator etiológico do bruxismo e dor orofacial em crianças de 7 a 8 anos de idade? um estudo transversal em escolares residentes na cidade de Pelotas

Abstract

The role of malocclusion as an etiological factor for bruxism and orofacial pain in children aged 7 to 8 years is still controversially discussed. Thus, the aim of this study was to investigate the association between occlusal factors and possible and probable sleep bruxism (SB) and self-reported orofacial pain in children aged 7 to 8 years who attend public schools and live in the city of Pelotas. In this study, 556 children were evaluated in the period between August 2015 and November 2016. Parents/caregivers were asked about sociodemographic aspects, if they heard any self-report from the child about orofacial pain, and if they noticed that their children grind or clench their teeth at night. Parents/caregivers also answered a questionnaire about stress, screen time, physical activity, and the child's sleep time. Occlusal factors were assessed using the Dental Aesthetics Index (DAI), orofacial pain complaints using the temporomandibular disorder (TMD) pain screening questionnaire, and the detection of probable SB was based on self-reported grinding or clenching of the teeth at night, in combination with clinical findings. The sample characteristics will be described according to the occlusal features and the exposure factors of the study. The analysis will also investigate the relationship between occlusal characteristics, possible and probable SB and painful TMD complaints and the influence of covariates. Direct, indirect and total standardized effects on painful TMD complaints were estimated. The Comparative Fit Index (CFI), the Tucker Lewis Index (TLI) and the root mean square error of approximation (RMSEA) were used to assess the fit of the analytical models. A total of 580 children were included. In this study, 62 female (21.7 %) and 65 male (22.0%) children presented malocclusion. Among those with malocclusion, daily screen time >2 hours/day was found in 104 (21.44%), behavioral, social and emotional problems in 44 (25.4%), pacifier use in 22 (78.57%) and finger-sucking habits in 9 (42.9%). Additionally, possible sleep bruxism was observed in 87 (30.0%) children, probable sleep bruxism in 20 (6.7%), and pain-related TMD in 27 (9.2%). Malocclusion had no direct effect on possible SB and TMD-related pain. Possible SB was negatively associated with TMD-related pain. When probable SB was defined as the mediator of interest, malocclusion did not directly affect the possible and probable SB neither TMD-related pain. A direct effect of possible and probable SB on pain-related TMD was observed. In none of the cases, the malocclusion have an indirect effect via bruxism on TMD-related pain.