Sleep bruxism, awake bruxism and headache in children and adolescents: a scoping review

A scoping review was carried out with the aim of mapping the existing literature on the association between sleep/awake bruxism and primary headache (migraine and tension headache) in children and adolescents. This scoping review followed the method proposed by Arksey & O’Malley and the Joanna Briggs Institute Manual for Evidence Synthesis and was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Extension for Scoping Reviews (PRISMA-ScR). The methods were registered in the Open Science Framework (<osf.io/8mtv4>). The following was the guiding question: “What does the literature say about the association between bruxism (sleep and awake) and primary headache (migraine and tension headache) in children and adolescents?”. Two independent researchers performed searches of the Cochrane Library, Embase, PubMed/Medline, Scopus and Web of Science electronic databases. Searches were conducted in August and September 2022 and updated in July 2023, leading to the retrieval of 6089 articles, 11 of which were selected for inclusion in the review. Sleep bruxism was associated with migraine as well as the frequency, duration, and intensity of migraine. Patients with tension headache are at increased risk for sleep bruxism and girls are more affected by both migraine and tension headache. In this scoping review, an association was found between primary headache (tension headache and migraine) and sleep bruxism. Awake bruxism was not investigated separately, making it difficult to determine its association with headache. The interaction between these variables is a complex phenomenon of unknown nature that merits further research.

Bruxism; Headache; Adolescent; Child

[1] Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. International consensus on the assessment of bruxism: report of a work in progress. Journal of Oral Rehabilitation. 2018; 45: 837–844.

[2] Lee YH. Relationship analogy between sleep bruxism and temporomandibular disorders in children: a narrative review. Children. 2022; 9: 1466.

[3] Ierardo G, Mazur M, Luzzi V, Calcagnile F, Ottolenghi L, Polimeni A. Treatments of sleep bruxism in children: a systematic review and meta-analysis. CRANIO®. 2021; 39: 58–64.

[4] Scarpini S, De Oliveira Lira A, Gimenez T, Raggio DP, Chambrone L, De Souza RC, et al. Associated factors and treatment options for sleep bruxism in children: an umbrella review. Brazilian Oral Research. 2023; 37: e006.

[5] Storari M, Serri M, Aprile M, Denotti G, Viscuso D. Bruxism in children: what do we know? Narrative review of the current evidence. European Journal of Paediatric Dentistry. 2023; 24: 207–210.

[6] Granja GL, Lacerda-Santos JT, Firmino RT, Jiao R, Martins CC, Granville-Garcia AF, et al. Occurrence of bruxism in individuals with autism spectrum disorder: a systematic review and meta-analysis. Special Care in Dentistry. 2022; 42: 476–485.

[7] Manfredini D, Ahlberg J, Lobbezoo F. Bruxism definition: past, present, and future—what should a prosthodontist know? The Journal of Prosthetic Dentistry. 2022; 128: 905–912.

[8] Matusz K, Maciejewska-Szaniec Z, Gredes T, Pobudek-Radzikowska M, Glapiński M, Górna N, et al. Common therapeutic approaches in sleep and awake bruxism—an overview. Polish Journal of Neurology and Neurosurgery. 2022; 56: 455–463.

[9] Senff J, Bonotto DV, Hilgenberg-Sydney PB, Sebastiani A, Scariot R, Oda LY. Childhood and adolescents sleep bruxism treatment: a systematic review. Sleep Science. 2023; 16: e344–e353.

[10] Soares JP, Moro J, Massignan C, Cardoso M, Serra-Negra JM, Maia LC, et al. Prevalence of clinical signs and symptoms of the masticatory system and their associations in children with sleep bruxism: a systematic review and meta-analysis. Sleep Medicine Reviews. 2021; 57: 101468.

[11] Alonso LS, Serra-Negra JM, Abreu LG, Martins IM, Tourino LFPG, Vale MP. Association between possible awake bruxism and bullying among 8- to 11-year-old children/adolescents. International Journal of Paediatric Dentistry. 2022; 32: 41–48.

[12] Manfredini D, Serra-Negra J, Carboncini F, Lobbezoo F. Current concepts of bruxism. The International Journal of Prosthodontics. 2017; 30: 437–438.

[13] Bulanda S, Ilczuk-Rypuła D, Nitecka-Buchta A, Nowak Z, Baron S, Postek-Stefańska L. Sleep bruxism in children: etiology, diagnosis and treatment—a literature review. International Journal of Environmental Research and Public Health. 2021; 18: 9544.

[14] Melo G, Duarte J, Pauletto P, Porporatti AL, Stuginski-Barbosa J, Winocur E, et al. Bruxism: an umbrella review of systematic reviews. Journal of Oral Rehabilitation. 2019; 46: 666–690.

[15] Vgontzas A, Pavlović J, Bertisch S. Sleep symptoms and disorders in episodic migraine: assessment and management. Current Pain and Headache Reports. 2023; 27: 511–520.

[16] Carvalho Ade M, Lima Mde D, Silva JM, Neta NB, Moura Lde F. Bruxism and quality of life in schoolchildren aged 11 to 14. Ciência & Saúde Coletiva. 2015; 20: 3385–3393. (In Portuguese)

[17] Craciun AE, Cerghizan D, Popsor S, Bica C. Bruxism in children and adolescents and its association with some possible aetiological factors. Current Health Sciences Journal. 2023; 49: 257–262.

[18] Kellier DJ, de Prado BM, Haagen D, Grabner P, Raj N, Lechtenberg L, et al. Validity of self-reported migraine in adolescents and children. Headache. 2023; 63: 634–641.

[19] Murali RV, Rangarajan P, Mounissamy A. Bruxism: conceptual discussion and review. Journal of Pharmacy & Bioallied Sciences. 2015; 7: S265–S270.

[20] Jahanimoghadam F, Tohidimoghadam M, Poureslami H, Sharifi M. Prevalence and risk factors of bruxism in a selected population of iranian children. Pesquisa Brasileira em Odontopediatria e Clínica Integrada. 2023; 23: e210224.

[21] da Costa SV, de Souza BK, Cruvinel T, Oliveira TM, Lourenço Neto N, Machado MAAM. Factors associated with preschool children’s sleep bruxism. CRANIO®. 2024; 42: 48–54.

[22] Castrillon EE, Exposto FG. Sleep bruxism and pain. Dental clinics of North America. 2018; 62: 657–663.

[23] Rodrigues MM, Vilanova LCP. Treatise on Pediatric Neurology. 1st edn. Publisher Atheneu: Rio de Janeiro. 2017.

[24] Dao JM, Qubty W. Headache diagnosis in children and adolescents. Current Pain and Headache Reports. 2018; 22: 17.

[25] Philipp J, Zeiler M, Wöber C, Wagner G, Karwautz AFK, Steiner TJ, et al. Prevalence and burden of headache in children and adolescents in Austria—a nationwide study in a representative sample of pupils aged 10–18 years. Journal of Headache and Pain. 2018; 20: 101.

[26] Orr SL. Headache in children and adolescents. Continuum. 2024; 30: 438–472.

[27] Bierhals IO, de Oliveira GSP, Santos IS, Halal CS, Tovo-Rodrigues L, Matijasevich A, et al. Relationship between sleep problems and headaches among adolescents: Pelotas 2004 Birth cohort. Sleep Medicine: X. 2023; 6: 100079.

[28] Silva BR, Oliveira AO, Diniz PRB, Valença MM, Silva LC, Santos CF, et al. Headaches and the quality of life in adolescents. Headache Medicin. 2015; 6: 19–23.

[29] Qubty W, Gelfand AA. Psychological and behavioral issues in the management of migraine in children and adolescents. Current Pain and Headache Reports. 2016; 20: 69.

[30] Nieswand V, Richter M, Gossrau G. Epidemiology of headache in children and adolescents—another type of pandemia. Current Pain and Headache Reports. 2020; 24: 62.

[31] Olesen J. Headache classification committee of the international headache society (IHS) the international classification of headache disorders, 3rd edition. Cephalalgia. 2018; 38: 1–211.

[32] Lakshmikantha KM, Nallasamy K. Child with headache. Indian Journal of Pediatrics. 2018; 85: 66–70.

[33] O’Donnell DM, Agin A. Management of headaches in children and adolescents. Current Problems in Pediatric and adolescent Health Care. 2021; 51: 101034.

[34] Prado IM, Abreu LG, Pordeus IA, Amin M, Paiva SM, Serra-Negra JM. Diagnosis and prevalence of probable awake and sleep bruxism in adolescents: an exploratory analysis. Brasilian Dental Journal. 2023; 34: 9–24.

[35] Berlin B. Oh, my aching head: treating headaches. New Jersey Medicine. 1997; 94: 49–51.

[36] Monica WS. Headaches caused by bruxism. The Annals of Otology, Rhinology, and Laryngology. 1959; 68: 1159–1162.

[37] Heyer GL, Rose SC, Merison K, Perkins SQ, Lee JEM. Specific headache factors predict sleep disturbances among youth with migraine. Pediatric Neurology. 2014; 51: 489–493.

[38] Castroflorio T, Bargellini A, Rossini G, Cugliari G, Deregibus A. Sleep bruxism in adolescents: a systematic literature review of related risk factors. European Journal of Orthodontics. 2017; 39: 61–68.

[39] Arksey H, O’Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology. 2005; 8: 19–32.

[40] World Health Organization. Adolescent health. 2023. Available at: https://www.who.int/health-topics/adolescent-health#tab=tab_1 (Accessed: 18 August 2023).

[41] Yaghini O, Mohammad Amir Shahkarami S, Mahmoodian T, Haj Hashemi E. Comprehensive assessment of the relative frequency of sleep disorders in migraine and non migraine in 6- to 14-year-old children. Iranian Journal of Child Neurology. 2010; 4: 33–36.

[42] Bruni O, Fabrizi P, Ottaviano S, Cortesi F, Giannotti F, Guidetti V. Prevalence of sleep disorders in childhood and adolescence with headache: a case-control study. Cephalalgia. 1997; 17: 492–498.

[43] Masuko AH, Villa TR, Pradella- Hallinan M, Moskczynski AJ, de Souza CD, Tufik S, et al. Prevalence of bruxism in children with episodic migraine—a case control study with polysomnography. BMC Research Notes. 2014; 7: 298.

[44] Miller VA, Palermo TM, Powers SW, Scher MS, Hershey AD. Migraine headaches and sleep disturbances in children. Headache. 2003; 43: 362–368.

[45] Liljeström MR, Jä T, Le Bell Y, Alanen P, Anttila P, Metsä Honkala L, et al. Signs and symptoms of temporomandibular disorders in children with different types of headache. Acta Odontologica Scandinavica. 2001; 59: 413–417.

[46] Vendrame M, Kaleyias J, Valencia I, Legido A, Kothare SV. Polysomnographic findings in children with headaches. Pediatric Neurology. 2008; 39: 6–11.

[47] Carra MC, Huynh N, Morton P, Rompré PH, Papadakis A, Remise C, et al. Prevalence and risk factors of sleep bruxism and wake-time tooth clenching in a 7- to 17-yr-old population. European Journal of Oral Sciences. 2011; 119: 386–394.

[48] Wänman A, Agerberg G. Headache and dysfunction of the masticatory system in adolescents. Cephalalgia. 1986; 6: 247–255.

[49] Wänman A, Agerberg G. Mandibular dysfunction in adolescents II. Prevalence of signs. Acta Odontologica Scandinavica. 1986; 44: 55–62.

[50] Nilner M. Relationships between oral parafunctions and functional disturbances and diseases of the stomatognathic system among children aged 7–14 years. Acta Odontologica Scandinavica. 1983; 41: 167–172.

[51] Atsü SS, Güner S, Palulu N, Bulut AC, Kürkçüoğlu I. Oral parafunctions, personality traits, anxiety and their association with signs and symptoms of temporomandibular disorders in the adolescents. African Health Sciences. 2019; 19: 1801–1810.

[52] Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ, et al. Bruxism defined and graded: an international consensus. Journal of Oral Rehabilitation. 2013; 40: 2–4.

[53] Carneiro AF, Cavalcante Neto PG, Ferreira JFIS, Garcia BF, Silva FDAC, Leal PRL. The prevalence of headache and psychosocial factors associated among medical students in a university of northeast Brazil. Revista de Medicina. 2019; 98: 168–179. (In Portuguese)

[54] Luvsannorov O, Anisbayar T, Davaasuren M, Baatar O, Batmagnai K, Tumurbaatar K, et al. The prevalence of headache disorders in children and adolescents in Mongolia: a nationwide schools-based study. Journal of Headache and Pain. 2020; 21: 107.

[55] Okamura MN, Goldbaum M, Madeira W, Cesar CLG. Prevalence of headache and associated factors among adolescents: results of a population-based study. Brazilian Journal of Epidemiology. 2020; 23: e200067. (In Portuguese)

[56] Carra MC, Huynh NT, El-Khatib H, Remise C, Lavigne GJ. Sleep bruxism, snoring, and headaches in adolescents: short-term effects of a mandibular advancement appliance. Sleep Medicine. 2013; 14: 656–661.

[57] Sousa HCS, Lima MDM, Dantas Neta NB, Tobias RQ, Moura MS, Moura LFAD. Prevalence and associated factors to sleep bruxism in adolescents from Teresina, Piauí. Brazilian Journal of Epidemiology. 2018; 21: e180002. (In Portuguese)

[58] Martins IM, Vale MP, Alonso LS, Abreu LG, Tourino LFPG, Serra-Negra JMC. Association between probable awake bruxism and school bullying in children and adolescents: a case-control study. Pediatric Dentistry. 2022; 44: 284–289.

[59] Figueirôa T, Raposo J, Soares L, Oliveira L, Menezes V, Colares V, et al. Association between bullying and both awake and sleep bruxism in school adolescents: a cross-sectional study. Pesquisa Brasileira em Odontopediatria e Clínica Integrada. 2024; 24: e230157.

[60] Molina OF, Peixoto MG, Eid NLM, Aquilino RN, Rank RCIC. Headache and bruxing behavior types in craniomandibular disorders (Cmds) patients. Revista Neurociências. 2011; 19: 449–457.