Relationship Between Psychosocial Factors and Bruxism in Children and Adolescents: A Systematic Review

Bruxism in children and adolescents has traditionally been considered a dental condition, but growing evidence suggests it may reflect broader psychosocial influences. This systematic review examines the relationship between psychosocial and environmental factors and bruxism in pediatric populations. A comprehensive search of major scientific databases identified observational studies assessing bruxism in individuals under 18 years of age in relation to psychological and contextual variables. Thirty studies involving 20,657 children and adolescents were included. Across studies, anxiety and perceived stress emerged as the most consistently associated factors, particularly separation anxiety. Parental psychological distress, especially maternal anxiety and depression, was also strongly linked to childhood bruxism. Additional associated factors included family dysfunction, bullying victimization, excessive screen time, and exposure to childhood trauma. Associations were more frequently observed in studies relying on parent- or self-reported measures of bruxism, whereas objective sleep-based assessment did not confirm a clear direct relationship with anxiety. Overall, the findings indicate that pediatric bruxism is closely connected to emotional and environmental stressors. Rather than representing an isolated dental parafunction, it may function as a behavioral indicator of underlying emotional distress, highlighting the importance of adopting a broader biopsychosocial perspective in clinical assessment and management.