{
  "abstract": "The diagnosis of sleep bruxism (SB) in children primarily relies on parental reports, often supported by clinical assessment of tooth wear. However, clinicians frequently diagnose SB based solely on tooth wear, even without parental reports. As SB may go unnoticed by parents and tooth wear is a nonspecific clinical sign, diagnosing SB based exclusively on this sign risks potential overdiagnosis.This study aimed to evaluate the validity of tooth wear as an isolated diagnostic criterion for SB in children. Three hypotheses tested the construct validity of this approach: (i) children with parental reports of SB exhibit tooth wear more frequently; (ii) children with tooth wear experience more significant sleep disturbances; (iii) caregivers with sleep disorders report SB in children more often, yet caregiver sleep quality does not influence the presence of tooth wear.A sample included children with and without reports of SB. All children underwent clinical evaluation for tooth wear. Sleep quality was assessed using the Sleep Disturbance Scale for Children (SDSC), and caregiver sleep was evaluated using anamnesis. To test hypothesis: (i), the frequency of tooth wear was compared between children with and without reported SB; (ii) examined the associations between SB and tooth wear with SDSC scores; (iii) evaluated whether caregiver sleep quality was associated with child SB reports and tooth wear. Logistic regression was used for binary outcomes and negative binomial regression for count data, producing odds ratio (OR) and rate ratio (RR) values, respectively, with 95% confidence intervals (95%CI). Adjusted models were conducted, accounting for children’s age and sex, as well as caregivers’ sex, age, and marital status.93 children (48 girls) aged 3 to 10 years were included. From these, 45 children (48.4%) whose parents reported SB. Tooth wear was more frequent in children with SB (Adjusted OR; 95%CI = 3.71; 1.47 to 9.37), supporting the hypothesis (i). For the 2nd premise, the adjusted RR (95%CI) for the association between bruxism and SDSC total scores was 1.29 (1.17 to 1.42), statistically significant. For tooth wear, this association was not significant (adjusted RR = 1.06; 0.95 to 1.19). Moreover, we did not observe an interaction between SB and tooth wear. Caregivers with sleep disorders reported children’s SB more frequently than parents with a good sleep quality (adjusted OR; 95%CI = 3.79; 1.14 to 12.5), but this association was not observed with tooth wear (adjusted OR; 95%CI = 1.67; 0.54 to 5.21).Therefore, tooth wear is nonspecific for diagnosing SB and must not be used as a single indicator. Furthermore, since tooth wear has a benign course and is not progressive in many cases, the use of this indicator standalone to assess SB could represent potential overdiagnosis. However, as parental reports of bruxism are influenced by caregiver sleep quality (premise iii), but tooth wear is a more objective measure unaffected by this variable, using a combination of parent report and tooth wear can be a diagnostic strategy less affected by this possible bias.",
  "authors": [
    {
      "affiliations": [
        "Cruzeiro do Sul University, São Paulo, Brazil",
        "Guarulhos University, São Paulo, Brazil"
      ],
      "name": "Carlos Felipe Bonacina"
    },
    {
      "affiliations": [
        "São Paulo University, São Paulo, Brazil"
      ],
      "name": "Fausto Mendes"
    },
    {
      "affiliations": [
        "Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland"
      ],
      "name": "Isabel Olegário"
    },
    {
      "affiliations": [
        "Cruzeiro do Sul University, São Paulo, Brazil"
      ],
      "name": "Adriana Lira"
    }
  ],
  "title": "096 Is tooth wear a valid criterion for diagnosing sleep bruxism in children?",
  "uid": "2cdc5766-0bc3-5744-9dfe-aff1ea318cc7"
}