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Are lower urinary tract conditions more common in children with sleep bruxism?

Published:November 30, 2022DOI:https://doi.org/10.1016/j.jpurol.2022.11.024

      Summary

      Introduction

      Sleep bruxism is a parasomnia caused by rhythmic and non-rhythmic activity of the masticatory muscles during sleep. Prevalence of sleep bruxism is reported up to 40.6% in the literature. Sleep bruxism is a multifactorial issue and associated with multiple dental complications, sleep-related disorders, and psychosocial problems. We aimed to investigate if children with sleep bruxism suffer more from lower urinary tract conditions.

      Materials and methods

      Prospectively 128 children were included in this study. Sixty-four children constituted in the bruxism group and 64 children constituted in the control group. Children who admitted to the pediatric dentistry clinic with bruxism symptoms were recruited in the bruxism group. Control group constituted of consecutive 64 children who admitted to the pediatric dentistry clinic for routine dental examination. Parents were asked to fill out a questionnaire including Dysfunctional Voiding and Incontinence Scoring System (DVISS) form. Children's demographic data, presence of urinary frequency, presence of urgency, behaviour of voiding postponement, presence of daytime urinary incontinence, presence of enuresis nocturna, presence of fecal incontinence, presence of constipation, status of circumcision, and presence of bruxism related symptoms were recorded. Children with a DVISS score above 8 were considered to have functional voiding disorder. All children underwent a dental examination.

      Results

      The mean age of children was 73.3 ± 26.9 months. For all children (n = 128), the girl to boy ratio was 40:88. Mean DVISS score was 2.5 ± 3.8 and the mean QOL score was 0.1 ± 0.4 for all children. Eight (6.3%) children were found to have functional voiding disorder based on the DVISS score. There was no statistically significant difference for any lower urinary tract condition between the bruxism group and the control group (Table). Children with bruxism significantly had more tooth wear and masseter muscle hypertrophy (<0.001 and < 0.05).

      Discussion

      Sleep bruxism has been linked to a number of health issues including dental, systemic and psychosocial problems. Tooth wears, fatigue/pain in chewing muscles, gum recession, facial pain, masseter muscle hypertrophy and temporomandibular joint damage are the main complications of bruxism. Moreover, bruxism has been associated with systemic diseases and sypmtoms like asthma, respiratory illnesses, enuresis nocturna, anxiety, and stress.

      Conclusions

      Summary TableLower urinary tract characteristics according to groups.
      Bruxism Group Control Group p value
      (n = 64) (n = 64)
      Urinary frequency (n, %)
       Yes 10 (15.6%) 11 (17.2%) 0.881
       No 54 (84.4%) 53 (82.8%)
      Urgency (n, %)
       Yes 39 (60.9%) 35 (54.7%) 0.474
       No 25 (39.1%) 29 (45.3%)
      Voiding Postponement (n, %)
       Yes 20 (31.2%) 17 (26.6%) 0.559
       No 44 (68.8%) 47 (73.4%)
      Daytime urinary incontinence (n, %)
       Yes 3 (4.7%) 7 (10.9%) 0.188
       No 61 (95.3%) 57 (89.1%)
      Enuresis nocturna (n, %)
       Yes 7 (10.9%) 6 (9.4%) 0.770
       No 57 (89.1%) 58 (90.6%)
      DVISS Score (median, min–max) 1 (0–12) 1 (0–25) 0.675
      QOL Score (median, min–max) 0 (0–3) 0 (0–2) 0.239
      Functional voiding disorder (n, %)
       Yes 3 (4.7%) 5 (7.8%) 0.465
       No 61 (95.3%) 59 (92.2%)

      Keywords

      Abbreviations:

      DVISS (Dysfunctional Voiding and Incontinence Scoring System), QOL (Quality of Life)
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