Bladder and bowel dysfunction in children with sleep bruxism

There is little evidence of a direct relationship between sleep bruxism and enuresis nocturna, and whether this enuresis is monosymptomatic or non-monosymptomatic nocturnal enuresis (MNE or NMNE) is unknown. The aim of the study is to investigate the type and frequency of nocturnal enuresis and other lower urinary tract symptoms (LUTS) in children with sleep bruxism.

The children who applied consecutively to the Department of Pediatric Dentistry were included in this study. Sleep bruxism was determined by history and confirmed by clinical examination by pedodontist. LUTS were evaluated using the Dysfunctional Voiding and Incontinence Symptom Scale (DVISS). Patients with total DVISS score above 8.5 were accepted as having lower urinary tract dysfunction (LUTD). The relationship between bruxism and the presence of LUTD and LUTS was investigated. Patients with and without sleep bruxism were compared using the Mann-Whitney U test and Crosstab on SPSS 16.0.

A total of 184 consecutive children were included in the study. Sleep bruxism was present in 77 (41.8%) children and absent in 107 (58.2%) (control group). LUTD was detected in 19 (24.7%) children with bruxism and 11 (10.3%) without bruxism. The mean total score of DVISS, which was 5.43 in bruxers vs. 2.67 in non-bruxers, was significantly higher in the bruxism group (p = 0.012). NMNE, pain during voiding, intermittent urination, urination after voiding, urge incontinence, and constipation were significantly more common in children with bruxism (p values were 0.005, 0.025, 0.002, 0.0001, and 0.002, respectively).

LUTD with enuresis nocturna and daytime symptoms (NMNE) is more common in children with sleep bruxism and LUTS can be easily questioned with a simple validated questionnaire.