Dados do Trabalho

Título

Integral approach of bruxism and consequences in a family routine: a clinical case report

Introdução

Bruxism is a behavior characterized by masticatory muscle activity. It has a multifactorial etiology, being associated with sleep characteristics.

Objetivo

To report a clinical case of a young child with bruxism and the parents’ attitude.

Métodos

A 3-year-old female patient, an only child, was assisted by the Sleep Health Care Extension project at a Brazilian dental school. The main complaint of the parents was the noise produced by the child, grinding her teeth. A detailed anamnesis and clinical oral examination were performed and parents answered the Brazilian version of the Sleep Disorders Scale for Children (SDSC) and the Pediatric Daytime Sleepiness Scale (PDSS) were used. A seven-day sleep diary was given to parents to verify the child's habits at three different times during three months. After the first analysis of the sleep diary, the homeopathic tincture of Melissa Officinalles was prescribed at a dose of one drop per age in the evening after dinner. A multidisciplinary team accompanied the patient and a descriptive analysis of the follow-up data was carried out.

Resultados

In the first evaluation of the sleep diary, it was observed that the child had no sleep routine and the average of hours of sleep per night ranged from 5 to 8 hours. There were nocturnal awakenings and reports of nightmares. The SDSC score was 45 points, indicating the presence of sleep disorders. The PDSS presented a high score (24). The clinical dental examination revealed a deep palate and anterior open bite. Furthermore, the child had the habit of pacifier which presented bites on the bulb, characterizing the teeth grinding reported by the parents. During the weekly follow-up, the child presented aggressive behavior and, when contradicted, she ground her teeth, which made her mother very distressed. The mother herself reported that she ended up giving in to her daughter's wishes so that she would stop the grinding behavior. After one month of medication, it was verified an improvement in sleep routines was marked by fewer episodes of nocturnal awakes and nightmares. At the last evaluation, improvements in the scores on the SDSC and PDSS scales were verified.

Conclusões

Follow-up with a sleep diary, SDSC, PDSS, and homeopathic medication showed a positive approach in the behavior of this child with consequent improvement in the quality of life of the whole family.

Palavras -chave

Bruxism. Child Behavior. Drug Therapy