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Low Birth Weight and Bruxism Among Brazilian Children: A Prospective Cohort Study
Erika Bárbara Abreu Fonseca Thomaz1,2, Elisa Miranda Costa1,3, Érica Martins Valois2
1Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil.
Insights
Low birth weight (LBW) is a risk factor for childhood bruxism, independent of breastfeeding and pacifier use. Shorter exclusive breastfeeding (EBF) and pacifier use also directly increase bruxism risk in children.
Area of Science:
- Pediatric Dentistry
- Oral Health Research
- Developmental Pediatrics
Background:
- Childhood bruxism is multifactorial, influenced by socioeconomic status, psychological factors, and lifestyle.
- The association between perinatal factors, specifically low birth weight (LBW), and childhood bruxism requires further investigation.
- Identifying early risk factors for bruxism is crucial for timely intervention and prevention strategies.
Purpose of the Study:
- To investigate the impact of LBW on childhood bruxism.
- To assess the mediating roles of exclusive breastfeeding (EBF) for 6 months, pacifier use, and mental health in the LBW-bruxism relationship.
- To adjust for socioeconomic status (SES) in the analysis of LBW and bruxism.
Main Methods:
- A prospective cohort study involving 673 Brazilian children followed from birth to 7-9 years old.
- LBW (defined as <2500g) data collected from medical records post-childbirth.
- Bruxism assessed via parental/guardian reports of teeth grinding or clenching; analyzed using structural equation modeling.
Main Results:
- LBW demonstrated a significant total (SC=0.199, p=0.045) and direct effect (SC=0.207, p=0.037) on childhood bruxism.
- Exclusive breastfeeding (EBF) showed a direct effect (SC=-0.190, p=0.043) and an indirect effect mediated by pacifier use (SC=0.082, p=0.028) on bruxism.
- The overall model construct exhibited adequate and significant results (SC > 0.3, p < 0.001).
Conclusions:
- LBW is identified as a potential risk factor for childhood bruxism, with the relationship not explained by EBF, pacifier use, or mental health.
- Shorter duration of EBF and continued pacifier use are direct risk factors for bruxism in schoolchildren.
- Preventive strategies should emphasize prenatal care, promote 6-month EBF, and discourage pacifier use.
Background:
Bruxism in childhood is a multifactorial condition, involving socioeconomic status (SES), psychological conditions and lifestyle habits capable of acting, interacting or mediating the development of oral health outcomes. The link between perinatal factors, like low birth weight (LBW) and bruxism remains unclear. Identifying early risk factors may offer a key opportunity for intervention.
Objective:
To evaluate the effects of LBW on bruxism in childhood, considering adjustment for SES and mediation by exclusive breastfeeding (EBF) for 6 months, pacifier use and mental health problems.
Methods:
This Brazilian prospective cohort included 673 live birth children followed up at 7-9 years old. LBW (< 2500 g) was obtained from the medical record after childbirth. Bruxism was reported by the children's parents/guardians as the habit (current or previous) of clenching or grinding teeth during the day or night. The analyses used structural equation modelling, estimating standardised coefficients (SC) (α = 5%).
Results:
LBW showed a total (SC = 0.199; p = 0.045) and direct effect (SC = 0.207; p = 0.037) on childhood bruxism. EBF had a direct effect (SC = -0.190; p = 0.043) and an indirect effect on bruxism, mediated by pacifier use (SC = 0.082; p = 0.028). The construct showed all adequate (SC > 0.3) and significant (p< 0.001).
Conclusion:
LBW is a potential risk factor for bruxism in childhood, but this relationship is not explained by EBF, pacifier use or mental health problems. Shorter EBF duration and pacifier use are direct risk factors for bruxism in schoolchildren. Prevention should focus on prenatal care, promoting EBF for 6 months and avoiding pacifier use.
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