Bruxism in Down Syndrome patients


Bruxism had been defined as, a repetitive masticatory muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible and can occur during the day or during sleep. The prevalence of bruxism in the general population has been reported to be between 8% to 31.4% (Manfredini et al., 2013)

The main aim of this review was to assess the prevalence in bruxism in patients with Down Syndrome.


A protocol was registered with the PROSPERO database. Searches were conducted in the CINHAL, Embase, Medline/PubMed, PsychInfo, Scopus and Web of Sciences databases. Observational and cross-sectional studies reporting on the prevalence of Down Syndrome were considered. Two reviewers extracted data independently with study quality being assessed using the Newcastle-Ottawa Scale (NOS). Meta-analyses were undertaken using both the fixed and random effects models.


  • 8 studies involving 416 patients were included.
  • 3 studies were conducted in Brazil, 2 in England and one each in Australia, Mexico and the USA.
  • The reported prevalence ranged from 11.4% to 51.8%.
  • Meta-analysis (8 studies) found a pooled prevalence of bruxism in Down syndrome patient of : –
    • 33% (95% CI: 22 to 45%) [random-effects model].
    • 35% (95%CI: 31 to 45%) [fixed-effects model].


The authors concluded: –

This systematic review and meta-analysis provide evidence of a significant prevalence of bruxism among individuals with DS. The findings highlight the association of bruxism with other oral health issues and specific chromosomal abnormalities. Comprehensive oral health assessments, including diagnostic procedures like Polysomnography, are essential for addressing the unique oral health needs of individuals with DS. Further studies are recommended with a valid tool for the diagnosis.


The authors registered a protocol with the PROSPERO database, although the registration date is shown to be the same month as the paper was received by the journal. A good range of databases was searched with 8 small studies with sample sizes of between 22 – 112 being included providing an estimate of the prevalence of bruxism of 33% (95% CI: 22 to 45%) using a random effects model. An earlier review focussing on children and adolescents by Kaddem et al (Dental Elf – 27th Apr 2022) included 9 studies related to down syndrome individuals 5 of which are included in this current review producing a much larger estimate for reported clenching and grinding of teeth of 68.2% (95%CI: 59.8 to 76.6%). The studies included in this current review are mainly cross-sectional and use a range of diagnostic measures so require caeful interpretation. Future studies would benefit from a common framework for assessment and outcome measures.


Primary Paper  

Alam MK, Alsharari AHL, Shayeb MAL, Elfadil S, Cervino G, Minervini G. Prevalence of bruxism in down syndrome patients: A systematic review and meta-analysis. J Oral Rehabil. 2023 Jul 28. doi: 10.1111/joor.13563. Epub ahead of print. PMID: 37507203.

Review protocol in PROSPERO

Other references

Manfredini D, Winocur E, Guarda-Nardini L, Paesani D, Lobbezoo F. Epidemiology of bruxism in adults: a systematic review of the literature. J Orofac Pain. 2013 Spring;27(2):99-110. doi: 10.11607/jop.921. PMID: 23630682.

Dental Elf – 27th Apr 2022

Tooth grinding in children and adolescents with neurodevelopmental disorders



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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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