Tratamento e controle do bruxismo do sono na infância: uma revisão narrativa da literatura

Abstract

Bruxism is defined as a masticatory muscle activity, regulated by the central nervous system, which presents a possible risk factor for negative consequences to the oral health. Sleep bruxism (SB) is characterized by the grinding and clenching of teeth during the night. The incidence of cases of SB in children is increasing and its prevalence varies between 27,8% to 40% in Brazilian studies. The etiology of BS is multifactorial and, therefore, its diagnosis must often be interdisciplinary, as well as its treatment and control. In addition to the various possibilities of harm caused by BS in childhood, it can lead to a worse quality of life for the child. Therefore, an adequate and efficient therapeutic approach for the control of the condition is of fundamental importance, taking into account risk factors, systemic and behavioral changes, as well as the protection of the anatomical structures involved. Thus, the objective of the present study was to carry out a narrative review of the literature on the main treatment and control alternatives for BS in childhood. According to the studies analyzed, there are several treatment possibilities that can currently be considered, namely: use of intraoral devices, psychological treatment, treatment of respiratory disorders, advice on sleep hygiene, pharmacological treatment and natural or homeopathic treatment. The therapy of choice should be based on the identification of the probable factor that is causing, triggering or exacerbating bruxism and, after a careful anamnesis and analysis of these factors, the appropriate treatment must be proposed or the patient referred to a trained professional. Evidence to date shows the impossibility of developing a specific treatment protocol for BS in childhood, and its management should be based on the control of signs and symptoms and the prevention of harmful consequences to orofacial structures. Interdisciplinary work between dental surgeons, pediatricians, otolaryngologists, neurologists, psychologists, physiotherapists and naturopathic or homeopathic specialists is of utmost importance in order to jointly design a holistic treatment for the patient.