Effects of attention deficit hyperactivity disorder signs and socio‐economic status on sleep bruxism and tooth wear among schoolchildren: structural equation modelling approach

Background The prevalence of both bruxism and attention deficit hyperactivity (ADHD) has increased in recent years. Aim This study evaluated the direct and indirect effects of signs of ADHD, reported by parents/caregivers and teachers, with sleep bruxism. In addition, this study explores the effects of socio‐economic status (SES) on sleep bruxism. Design This cross‐sectional study was performed in Diamantina, Brazil, with 851 randomly selected schoolchildren aged 6–12 years. The schoolchildren were underwent an oral examination for the evaluation of bruxism. Moreover, parents/caregivers fill out a form for the assessment of sleep bruxism and sociodemographic factors. Parents/caregivers and teachers responded to the Swanson, Nolan and Pelham scale – version IV (SNAP‐IV) for the assessment of ADHD signs. The structural equation modelling approach was used, and standardized coefficients to direct, indirect and total effects were calculated. Results ADHD signs had a significant moderate (SC = −0.19, P < 0.01) effect on sleep bruxism. SES had a significant indirect effect on bruxism via sucking habits. Moreover, SES had a significant direct (SC = −0.16, P = 0.01) and total effect on tooth wear (SC = −0.17, P < 0.01). Conclusion This study concluded that signs of ADHD and SES have a complex direct and indirect effects on sleep bruxism among schoolchildren.