Bruxism in Childhood: A Scoping Review

ABSTRACT

Bruxism is characterized by repetitive clenching or grinding of teeth and jaw muscle activity. It is a complex condition with various factors contributing to its development and can exert abnormal loads on the stomatognathic system.

Aim

This scoping review aimed to explore various aspects of bruxism in children, including its causes, prevalence, diagnosis, and multidisciplinary treatment.

Methods

A comprehensive search was conducted in the PUBMED-MEDLINE database focused on studies published from 2018 to 2023.

Inclusion criteria encompassed

Cross-sectional, longitudinal, comparative studies, and randomized and non-randomized clinical trials published in English. Retained full texts were assessed and excluded if inclusion criteria were not met. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools for the different types of studies.

Results

Of 498 initial studies, 26 were selected for full reading and 19 met the inclusion criteria. Most studies were cross-sectional (14 studies) and showed a wide prevalence of sleep bruxism.

Conclusion

This scoping review highlights that bruxism is an important issue in children that should be observed by parents/guardians and evaluated by health professionals. Due to its multifactorial nature, a collaborative approach involving a diverse team of professionals is essential for the effective prevention and treatment of bruxism in pediatric patients.

KEYWORDS:

• Bruxism
• child
• diagnosis
• prevalence
• treatment

Introduction

Bruxism is a repetitive masticatory muscle activity involving clenching or grinding teeth or the bracing or thrusting of the mandible.¹ It manifests in two circadian phenotypes: sleep bruxism (SB), occurring during sleep, and awake bruxism (AB), observed during wakefulness.² If left untreated, bruxism can lead to dental damage (Figure 1a,b), periodontal trauma, muscle hypertrophy, temporomandibular disorders, and pain in the head, facial muscles, or teeth.^3,4 Socioeconomic issues like anxiety, depression, and low sleep quality are associated with this parafunctional habit.^5–8

Figure 1. Wear in the deciduous dentition in a pediatric patient. (a) occlusal wear in posterior teeth; (b) patient in occlusion showing the wear of the cusps of the deciduous elements.

Bruxism in children is a public health issue, as it can impact their development during this critical period.⁹ Recent studies have shown an increased prevalence of childhood bruxism, possibly linked to rising anxiety levels and technology usage,¹⁰ which were further exacerbated during the COVID-19 pandemic when school closures and excessive technology exposure negatively affected children’s quality of life.⁸

Scoping reviews are an approach to investigating and providing an overview of the evidence in a variety of fields, including bruxism. They identify key features or factors related to a concept, as a precursor to a systematic review, to identify and analyze knowledge gaps. Scoping reviews are essentially broader and more exploratory in nature compared to systematic reviews.¹¹

Given its multifactorial nature, treating bruxism requires a multidisciplinary approach involving various health care professionals such as pediatric and temporomandibular disorder dentists, pediatricians, psychologists, speech therapists, and physical therapists.¹² This study aimed to conduct a scoping review on the etiology, diagnosis, and treatment of bruxism in children.

Materials and Methods

This scoping review was guided by the Johanna Briggs Institute (JBI) Scoping Review Methodology Group.¹³ This type of study design was chosen because of the broad nature of the research question.¹¹ A quality assessment of the included studies was performed using the critical appraisal tools of the JBI, for cross-sectional, case controls and cohort studies,¹⁴ quasi experimental,¹⁵ and randomized control trials.¹⁶ Each of these check lists contained between eight and 13 items with four possible response categories: “yes,” “no,” “unclear” and “not applicable.” Two reviewers independently assessed the quality of the studies (CA and FA). Differing conclusions were resolved by discussion. An overall score for each study was calculated by summing the number of “yes” responses. A score of ≤ 30% was considered low quality, a score between 31 and 60% was moderate and a score ≥ 61% was high quality. No studies were excluded on the basis of methodological quality.

The main characteristics of the included studies were analyzed descriptively and summarized in a table. It was not possible to perform meta-analyses due to the heterogeneity of the studies.

A systematic search was conducted in the PUBMED-MEDLINE database with the following keywords: “child,” “bruxism,” “etiology,” “diagnosis,” and “treatment.” The inclusion criteria encompassed cross-sectional, longitudinal, comparative studies and randomized or non-randomized clinical trials conducted in children. The search was limited to studies published in English between 2018 and 2023. Specifically, cross-sectional, cohort studies, case-control studies, quasi experimental and randomized clinical trials were included. Case reports, literature and systematic reviews, animal studies, and in vitro studies were excluded to ensure relevance and focus. Additionally, studies involving children with mental or physical disabilities were not considered.

Results

A total of 498 studies were initially found. Among these, 472 studies were excluded based on an assessment of the title and abstract, as they did not meet the inclusion and exclusion criteria. Subsequently, 26 studies were selected for full reading, and ultimately, 19 were included in this scoping review. The characteristics of the included studies and their main results are presented in Table 1.

Table 1. Characteristics of the included studies.

Studies	Type of study	Sample characteristics	Diagnosis of bruxism/prevalence	Results	Quality score
Cross-sectional studies
Brancher et al.^Citation3	Cross-sectional Brazil	n = 583 schoolchildren 8 yrs old	Possible SB: international consensus^Citation2 Prevalence of SB: 30.83%.	Parental reports of emotional and behavioral problems were associated with a higher prevalence of SB in schoolchildren.	75%
Oh et al.^Citation4	Cross-sectional USA	n = 96 6–12 yrs mean age = 8.86 yrs range = 6–12 yrs Female: 50 Male: 46	SDSC- parents + FAIREST-15 clinical examination screening tool- includes 6 questions (breathing route, posture, concentration, and anxiety measures) Probable SB: 24%	Dentists should evaluate for tonsillar hypertrophy, restricted tongue mobility, and nasal obstruction in the evaluation of PSB, as these exam findings are highly prevalent in most cases.	100%
Ribeiro et al.^Citation6	Cross-sectional Brazil	n = 207 children Female:102 Male: 105 3–12 yrs Mean age:6.8 ± 4.2 yrs 3–5 yrs: 84(40.6%) 6–12 yrs:123(59.4%)	3 questionnaires for parents/guardians based on ICSD; Parents/guardians and children’s general info + CIRENS Prevalence of possible SB: .3–5 years: 31% .6–12-years: 35%	Nocturnal agitation and nightmares were associated with possible SB. In addition, young children with an evening chronotype had a tendency toward possible SB.	87.5%
Soares et al.^Citation7	Cross-sectional Brazil	n = 1.554 8–10 yrs old Female: 916(57.5%) Male: 673 (42.5%) Public schools	Diagnosis of possible SB: (PSQI-BR) – parents. Mild possible bruxism: 65.7%, moderate: 25.3%, severe: 9%	Boys with lip and object biting habits, headaches, and poor sleep quality presented a higher chance of possible severe sleep bruxism.	75%
Leal et al.^Citation17	Cross-sectional Brazil	n = 735 schoolchildren 8–10 yrs old Public and private schools	Parents/guardians answered: sociodemographic questionnaire, the SDSC and the CIRENS. Parafunctional habits were evaluated using the NOT-S Prevalence of probable SB: 9.1%	Probable sleep bruxism was influenced by the marital status of parents/guardians, sleep disorders, parafunctional habits, and a sedentary lifestyle.	87.5%
Duarte et al.^Citation18	Cross-sectional Brazil	n = 544 schoolchildren 8–10-yrs old Public schools urban:7 rural: 2	Daytime oral habits: evaluated by the NOT-S SBQ + demographic and socioeconomic characteristics- parents/caregivers NOT-S- daytime oral habits- children/parents Prevalence of possible SB: 21%	Possible SB in schoolchildren was independently associated with possible AB, snoring, sleep fragmentation, and daytime sleepiness.	87.5%
Lins et al.^Citation21	Cross-sectional Brazil	n = 151 6‐10 yrs old Mean age: 7.4	Parents/caregivers- questionnaires Clinical oral examination- 1 dentist PSB diagnosed: oral clinical evaluation + reports from parents/caregivers. Probable SB: 27.8% Female: 23 (15.2%) Male: 19 (12.5%)	The prevalence of PSB was revealed to be high and related to oral breathing. The pediatric dentist plays an important role in managing sleep bruxism and sleep-disordered breathing, conducting, and collaborating on its diagnosis and treatment.	62.5%
Alves et al.^Citation23	Cross-sectional Brazil	n = 103 ≤ 7 yrs old > 7 yrs old Mean age:7.36 ± 2.34 yrs	Questionnaire based on the criteria of the AASM during the dental care offered to their children. Prevalence of bruxism: 25.2%	The lack of knowledge impedes caregivers from seeking help and thus contributes to the worsening consequences of bruxism in adulthood.	37.5%
Bach et al.^Citation24	Cross-sectional Brazil	n = 551 7–8 yrs old Public schools	BRIAN-K Interview Salivary cortisol level; electrochemiluminescence Presence of dental wear: visual examination Diagnose of SB: AASM in the ICSD-3 Clinical examination Prevalence of SB:16%.	Higher levels of cortisol and disruption of biological rhythm was associated with SB in schoolchildren.	50%
Massignan et al.^Citation25	Cross-sectional Brazil	n = 935 2–5 (primary dentition): 373 8–10 yrs old (mixed dentition): 563 Public preschools	Questionnaires + Oral examination: tooth wear Prevalence of probable SB: Primary dentition: 22.3% Female: 200 (53.8%) Male: 172 (46.2%) Mixed dentition: 32.7% Female: 327 (58.1%) Male: 236 (41.9%)	The prevalence of probable SB is higher in mixed than in primary dentition and poor sleep quality is associated with probable SB in children aged 8–10 years.	100%
Topaloglu-Ak et al.^Citation26	Cross-sectional Turkey	n = 100 children 7–13 yrs old	Questionnaire CSHQ- parents Intraoral examination TMD: according to the Helkimo anamnestic + clinical dysfunction index Prevalence of SB: 60%.	SB, TMD and untreated dental caries might have a negative impact on children’s sleeping habits and characteristics. Pediatricians and pedodontists should collaborate to identify the causes and clinical features of sleeping habits and disorders to avoid adverse effects on the child’s stomatognathic system.	62.5%
Blumer et al.^Citation28	Cross-sectional Israel	n = 227 children 4–12 yrs old	Anamnestic variables: general state of health, oral habits, bruxism, esophageal reflux, sleep continuity, snoring)- Parents Clinical parameters: oral mucosa, palate, tonsils, tongue, floor of the mouth, angle classification, gingival health, caries risk) and presence of SRBD (through the PSQ).	Child caregivers from various fields (dentists, orthodontists, pediatric physicians, and school nurses) should actively inquire about disturbed sleep, medications for ADHD, snoring, and mouth breathing among young patients.	100%
Rubin et al.^Citation29	Cross-sectional Africa	n = 153 children 6–17 yrs old 6–12 yrs: 71 Female:46 Male: 25 13–17 yrs:82 Female: 44 Male: 38	Questionnaire Diagnosis of SB: AASM Diagnosed of SB: 26 (16.9%) SB: Female = 12 (13.3%) Male = 14 (22.2%) WB: Female = 36 (40%) Male = 21 (33.3%)	Gender and age did not impact the prevalence of bruxism, oral habits, or TMDs. SB and AB were unrelated to anamnestic symptoms or clinical findings in TMD.	62.5%
Case-control studies
Kuchler et al.^Citation20	Case-control Brazil	n = 151children 7–12 yrs old Ratio: 1:1.5 mean age: 9.34 yrs Female:70 Males:81 61 bruxers Female:28 Males:33 90 non-bruxers Female:42 Males:48	Interview + clinical examination Saliva samples	The genetic polymorphisms rs678397, rs1671064, and rs1815739 in ACTN3 are associated with bruxism and can contribute to the etiology of this condition in children.	50%
Clinical trials
Salgueiro et al.^Citation19	Randomized Controlled Trial Brazil	n = 76 children 6–12 yrs old 19 without bruxism Female: 9 (22%) Male: 10 (28.6%) 57 with bruxism Female:25 (71.4%) Male: 32 (78.0%)	G1: with SB -laser therapy over acupuncture points; G2: with SB- OS; G3: with SB-sham laser therapy using nontherapeutic light; G4: control group without SB. SB based on AASM: guardian’s report and presence of worn facets on permanent teeth Another clinical sign: presence of bitemarks on the buccal mucosa	Bite marks on the buccal mucosa can be used as a complementary sign for the clinical diagnosis of SB. Children with SB responded well to photobiomodulation therapy, as evidenced by the reduction of BF and reports of headaches.	46%
Dental treatment studies
Kolcaglu et al.^Citation27	Dental treatment of NB Turkey	n = 40 children 6–11 yrs old Average age: 8.6 Female: 22 Male: 18	Dental and periodontal treatments were completed before the study. Diagnosed with NB that indicated splint procedures. Randomly divided: Group I: 20 with soft OS Group II: 20 with hard OS. After the OS procedure, after 3 months, the BiteStrip® scores of the patients were measured once again to determine the changes in muscle activity.	Soft OS could reduce pain caused by NB on muscle and TMJ. In addition to the correlation of the use of BiteStrip® with the craniofacial structure in the diagnosis of bruxism, the use of the splinting procedure may not be sufficient for the prevention of bruxism in children.	56%
Prospective studies
Rostamani et al.^Citation5	Part of a longitudinal Canada	n = 1.946 mothers of children 1.5 to 7 yrs	Self-Administered Questionnaire SB: defined based on parental reports of audible nighttime SB.	When separation anxiety issues are detected in early childhood, it would be useful to target SB during the first year of elementary school.	55%
Lima et al.^Citation8	Prospective longitudinal cohort study Brazil	nT1 = 739 parents/caregivers of children (8–10 yrs) 10–11 months later nT2 = 105 Public and private schools Female: 57 (54.3%) Male: 48 (45.7%)	Diagnosis of bruxism: AASM + international consensus^Citation2 Incidence of SB: 29.5%. The incidence of SB between T1 and T2 was 36.2%. 66 children (62.9%) before the pandemic 74 (70.5%) during the pandemic	The percentage of children with sleep disorders and SB increased during the COVID-19 pandemic. A lower parental schooling level, greater access to one’s own electronic devices, and the occurrence of sleep disorders influenced the developing of SB during the pandemic.	64%
Clinical and genetic studies
Vieira et al.^Citation22	Clinical and genetic evaluation Brazil	n = 151 children mean age: 9.34 yrs Female: 70 Male: 81	Diagnosis of bruxism:international consensus^Citation2 Signs and symptoms related to bruxism: clinical examination SB: 61 (40.39%) Male: 33 (54.09%) Females: 28 (45.90%)	The study suggested that bruxism is the result of stress and could be detected early if surrogates of stress are evaluated.	25%

Yrs = years; SB= sleep bruxism, NB= nocturnal bruxism, CSHQ= Children’s Sleep Habits Questionnaire, TMD= temporomandibular disorders, TMJ= Temporomandibular joints, SRBD= sleep-related breathing disorders, PSQ= Pediatric Sleep Questionnaire, ADHD= attention deficit hyperactivity disorder, SBQ= Sleep Behavior Questionnaire, PSB= probable sleep bruxism, SDSC= Sleep Disturbance Scale for Children, (BRIAN-K) = Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids, AASM= American Academy of Sleep Medicine, ICSD-3= International Classification of Sleep Disorders − 3rd edition, CIRENS= Circadian Energy Scale, American Association of Sleep Medicine (AASM), CG: control group, OS= occlusal splint, PSQI-BR= Pittsburg Sleep Quality Index, NOT-S= Nordic Orofacial Test- Screening, ILIB= intravascular irradiation of blood, MFT= myofunctional therapy.

Thirteen of the selected studies were conducted in Brazil,^{3,6–8,17–25} two in Turkey,^26,27 and one each in the United States,⁴ Israel,²⁸ Canada,⁵ and Africa.²⁹

Among the included studies, 13 were cross-sectional studies,^{3,4,6,7,17,18,21,23–26,28,29} one was a case-control,²⁰ one was a randomized clinical trial,¹⁹ one was on dental treatment,²⁷ one was a prospective longitudinal cohort study,⁸ one was part of a longitudinal study,⁵ and one involved clinical and genetic evaluation.²²

The age range of the children in the studies varied from 1.5 to 17 years old.^{3–5,7,8,17–24,26–29} Additionally, two studies included two age groups: one comprising children with primary dentition aged 2 to 5 years old and another group with mixed dentition aged 8 to 10 years old.^6,25 Studies have shown that bruxism tends to increase during the child’s initial development and decrease during adolescence and adulthood.^5,30 Overall, the included studies did not find a significant statistical difference regarding age.^{4–6,17–20,22,26,28,29} However, in studies where such differences were observed, they can be explained by factors such as oral habits, lifestyle factors (including sleep duration and chronotype profile), anxiety, and respiratory problems.^7,9,24,25

Most of the included studies did not find a significant influence of gender on the prevalence of SB in children.^{3,4,6,17,18,21,24–26,28,28} However, it is worth noting that some studies suggest the male gender is more susceptible to SB in children,^7,23 which could be a potential risk factor.⁹

In this review, the studies from different countries have reported a prevalence of SB in children ranging from 9.1% to 40.3%.^{3,4,6,17,18,21–25,28,29} However, two recent studies found an even higher prevalence, with more than 60% of children affected by bruxism.^8,26 Furthermore, the prevalence increased to 70% during the COVID-19 pandemic.⁸

Quality Assessment

Among the cross-sectional studies, only one study that was assessed by the JBI checklist was classified as being of low quality,²² two of moderate^23,24 and eleven of high quality^{3,4,6,7,17,18,21,25,26,28,29} (see quality score in Table 1). The quasi-experimental²² study and the randomized controlled trial¹⁹ was classified as moderate quality. The case control study²⁰ and the two cohorts’ studies^5,8 were also classified as moderate quality.

For cross-sectional studies,^{3,4,6,7,17,18,21–26,28,29} a detailed description of the subjects and the study setting, sufficient coverage of the identified sample or the use of valid methods for identifying bruxism status were generally provided. However, some studies^21–24,29 did not present confounding factors or strategies for dealing with these confounding factors. The quasi-experimental²² study did not show a control group, a complete follow-up, or an adequate description of the participants who were lost to follow-up. In the randomized controlled trial,¹⁹ it was not presented whether the participants and the administration of the treatment were blinded, whether the evaluators were blinded to the results of the treatments, or whether there were reliable measures for follow-up.

For the case-control,²⁰ confounding factors or strategies for dealing with these confounding factors were not presented, as well as whether those involved in collecting data were trained. In the cohort studies,^5,8 both had problems with the reliability of the exposure measure, and it was unclear whether the results were measured validly and reliably.

Discussion

The aim of this scoping review was to offer a comprehensive overview of the literature relating to etiology, diagnosis, and treatment of SB and AB.

Etiology

The etiology of bruxism is widely acknowledged as multifactorial, extending beyond the realm of dentistry.² It is influenced by various factors, including changes in neurotransmitters such as dopamine and a range of biological and psychosocial contributors such as anxiety and personality traits.^10,31 Evidence also suggests a hereditary component in SB,²⁶ and specific genetic polymorphisms have been implicated in its development.²⁰ Additionally, associations have been found between bruxism and factors such as malocclusion, nutritional deficiencies, respiratory disorders, allergies, parasitic infections, oral habits, and poor sleep quality.³² Moreover, there may be a genetic predisposition for the co-occurrence of SB and sleep apnea.^22,28

Prevalence

In our review, the prevalence of SB showed a high variability between studies, which can be attributed to various factors, including the absence of standardized diagnostic criteria, methodological differences in assessment tools, cultural disparities of the studied population, and parafunctional habits associated, such as object biting or sucking or biting the lips or cheeks. Similarly, Machado et al.¹⁰ in their systematic review demonstrated that studies should employ validated and universal diagnostic criteria to ensure accurate assessment and facilitate comparisons between studies.

Two studies^8,26 showed the highest prevalence rates of SB, 40% and 60%. The first used a questionnaire to assess children in Brazil during the pandemic period and revealed an increase in children’s anxiety levels due to withdrawal from social interaction and excessive use of technology.⁸ The second used a questionnaire and also included a clinical assessment.²⁶ One issue is the lack of consensus on standardized questionnaires, which can lead to disparate results. In addition, the use of clinical evaluation can also increase the reliability of the study. Consequently, evidence-based studies should employ standardized diagnostic criteria to ensure accurate assessment and facilitate comparisons between studies.²⁶

Some authors have also highlighted the association between socioeconomic factors and SB. For instance, lower socioeconomic status and lower parental education levels have been linked to a higher prevalence of SB.^8,23,24

Signs and Symptoms

Children with bruxism may exhibit certain characteristics reported by parents/guardians, including audible tooth grinding or clenching sounds during sleep, headaches, orofacial pain upon waking, and discomfort while chewing or opening the mouth. Clinical signs and symptoms of bruxism can manifest as dental wear facets, fractures in restorations, impressions on the cheek mucosa and tongue caused by teeth, tenderness, and pain in the temporal and masseter muscles, head and teeth, which can be evaluated through clinical examinations in children.^4,20

Clinical features in children with SB or AB include clenching or grinding of teeth. Oral habits as nails/objects biting, sucking or biting the lips, cheeks, and tongue, finger sucking, and pacifier use^4,7,18,19,22 are also observed.

The literature provides evidence for various factors associated with bruxism in children, including emotional factors,²³ anxiety,⁵ higher levels of cortisol, disruption of biological rhythm,¹⁹ nocturnal agitation, nightmares,⁶ and low sleep quality.⁷

Diagnosis

An established international consensus provides classifications for different levels of diagnosis for SB and AB.² These categories encompass (a) SB or AB based on self-report alone, (b) probable SB or AB based on self-report and clinical inspection, (c) definite SB or AB based on self-report, clinical inspection, and polysomnography (preferably combined with audio/video recordings), and (d) definite SB or AB based on self-report, clinical inspection, and electromyography (preferably combined with ecological momentary assessment/experience sampling methodology).

Early identification of bruxism is crucial for promptly recognizing clinical features that may pose risks, such as tooth wear, dental damage, fractures, jaw muscle fatigue, and pain.⁴ In the present review, different diagnostic criteria for SB were utilized across the studies, including the Sleep Disturbance Scale for Children,^4,17 Children’s Sleep Habits Questionnaire,²² criteria from the American Association of Sleep Medicine,^6,8,23,24,29 Sleep Behavior Questionnaire,¹⁸ and Pittsburgh Sleep Quality Index.⁷ Some studies also employed self-questionnaires.^20,21,25,28

Polysomnography is considered the gold standard for diagnosing and assessing SB.^3,6,10,19,28 This method is a recognized test preferably combined with audio and video recordings in which the activities of the masticatory muscles are quantified for data from the electromyographic (EMG) channels of the masticatory muscles.³³ However, it is challenging to conduct as it requires patients to sleep in a clinic and is an expensive technique.²⁸ Consequently, most studies relied the diagnosis on parent/guardian reports of signs and symptoms during sleep or upon awakening, particularly tooth-grinding sounds during sleep.^{3,4,6,7,17,18,20,21,23–26,28,29} Another interesting diagnostic alternative is the BiteStrip®, a wireless device that is a precise tool for evaluating the excessive nocturnal activity of the masticatory muscles. It is designed for home use and records signal from forces exceeding an individual’s maximum bite force.^10,27

Treatment

Treating bruxism remains a challenge, primarily due to its multifactorial etiology. Various approaches have been explored as alternatives for treating bruxism in children. Acupuncture, a technique that stimulates specific points to promote muscle relaxation, pain relief, and reduction of inflammation, has been utilized.¹⁹ Photobiomodulation is a treatment for tissue repair and regeneration that uses low-level laser light therapy (LLLT) and was used on specific acupuncture points as an alternative treatment in the study by Salgueiro et al.¹⁹ It was also used because it is a painless technique, improving the children’s acceptance and reported successful outcomes in children with SB, including a reduction in bite forces and decreased reports of headaches.¹⁹ Another study that evaluated hard and soft occlusal splints showed that soft occlusal splints could reduce the pain caused by nocturnal bruxism in the muscles and temporomandibular joint.²⁷ However, this method has limitations, especially in children, as it depends on the patient’s cooperation.¹⁹

Parents’ and guardians’ involvement and attention during treatment are crucial for the success of any therapy for bruxism in children. Establishing a calm bedtime routine, creating a suitable sleep environment, avoiding electronic games before bedtime, and engaging in daily physical activities with the child are essential supportive measures in the treatment process.^7,8

Conclusion

Based on the analyzed literature, some conclusions can be drawn: (a) bruxism is an important issue in children that should be observed by parents/guardians and evaluated by health professionals; (b) early diagnosis and treatment by dental practitioners are crucial to prevent or minimize further damage to the stomatognathic system; (c) bruxism has a multifactorial etiology, necessitating a transdisciplinary approach involving parents/caregivers and different health care professionals for a comprehensive treatment; (d) early intervention is essential to alleviating symptoms, protecting dental structures, and improving the overall well-being of children with bruxism; and (e) continued research and evidence-based practices are necessary to enhance the understanding and treatment of bruxism in children.

Abbrevations

SB	=	sleep bruxism
AB	=	awake bruxism
JBI	=	Johanna Briggs Institute
LLLT	=	Low-level laser light therapy

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Cristine da Silva Furtado Amaral

Cristine Amaral – study design, search strategy, data extraction, and article writing.

Jennifer Guedes Sobral

Jennifer Sobral – study design and first-draft writing.

Flávia Cariús Tesch Ferreira Alves

Flávia Alves – figures, writing-reviewing, and editing.

Claudia Maria Pereira

Claudia Pereira – first-draft writing, writing-reviewing, and editing.

Flávio Rodrigues Ferreira Alves

Flávio Alves – first-draft writing, writing-reviewing, and editing.