The prevalence of bruxism in children with profound intellectual and multiple disabilities; a systematic review and meta-analysis

Abstract

IntroductionBruxism is a repetitive masticatory muscle activity that may cause substantial morbidity and reduce the quality of life in children with profound intellectual and multiple disabilities. Assessment methods most commonly used were caregiver reporting and dental examination, This systematic review with meta-analysis aims to determine the prevalence of bruxism in children with profound intellectual and multiple disabilities and to describe the currently used assessment methods for bruxism in this population. MethodsWe conducted a systematic review and meta-analysis using a multi-component search strategy. We used a random effects model to calculate the prevalence and 95% confidence intervals for each study, for all studies combined, and specifically for Rett syndrome (RS), cerebral palsy (CP), Down syndrome (DS), and “other disorders (primarily Angelman syndrome and Prader-Willi syndrome).” ResultsThe prevalence for the entire group based on a random effects model was found to be 49% (95%CI 41-57%) with high heterogeneity (I2= 93%, p< 0.01), for RS 74% (95%CI 53-88%, I2=84%, p<0.01), CP 48% (95%CI 38-57%, I2=86%, p<0.01), DS 40% (95%CI 33-47%, I2=60%, p<0.01) and “other disorders” 40% (95%CI 18-67%, I2=98%, p<0.01). The group prevalences were not equal, indicating a significant difference (P-value=0.03), with a notably higher likelihood of RS. ConclusionWe observed a five-fold increased likelihood of bruxism in children with profound intellectual and multiple disabilities. The disorder with the highest prevalence was Rett syndrome, with a seven-fold increased likelihood of bruxism. The increased likelihood of bruxism in this vulnerable group of children demands clinicians pay heed to this substantial morbidity.