Is awake bruxism a marker of vulnerability in childhood?

Abstract

Objective: To investigate the prevalence of probable awake bruxism in children and its association with emotional, behavioral, and contextual factors related to anxiety, emotional well-being, bullying, parental sense of coherence, and risk of sleep-disordered breathing. Methods: This cross-sectional study included 642 children aged 6 to 10 years enrolled in public schools in Piracicaba, São Paulo, Brazil. Data collection comprised three stages: (i) a questionnaire for parents/caregivers addressing children’s daytime and nighttime behaviors, family income, and parental education; (ii) a child questionnaire assessing emotional well-being and bullying; and (iii) an intraoral examination to identify clinical signs suggestive of bruxism. Validated instruments were used: the State-Trait Anxiety Inventory for Children (STAI-C) for anxiety, the Child Perceptions Questionnaire (CPQ8-10) for emotional well-being, the Olweus Bully/Victim Questionnaire (OBVQ) for bullying, the Sense of Coherence Scale (SOC-13) for parental sense of coherence, and the Pediatric Sleep Questionnaire (PSQ) for risk of sleep-disordered breathing. Data were analyzed using descriptive statistics and logistic regression, with odds ratios (OR) and 95% confidence intervals (CI) reported. Results: The prevalence of probable awake bruxism was 29.6%. Most children did not report significant emotional well-being impairment, increased risk of sleep-disordered breathing, or clinically significant anxiety. However, three-quarters of parentes/caregivers presented low sense of coherence, reflecting reduced perceived ability to cope with stress and daily challenges. Bullying experience was highly prevalent, reported by 84.4% participants. Conclusion: Probable awake bruxism showed high prevalence among children, reinforcing its clinical and epidemiological relevance Findings emphasize the importance of addressing bruxism from a multifactorial perspective integrating.