A Prospective Observational Case-Control Study on the Association Between Child and Parental Stress and Bruxism in Children Aged 8-11 Years

This study is a prospective observational case-control study designed to investigate the association between perceived stress levels in children and their parents and the presence of clinically diagnosed bruxism in children aged 8-11 years. Participants will be recruited from children presenting to the Department of Pediatric Dentistry at Bezmialem Vakıf University Faculty of Dentistry for dental treatment.

Children will be allocated into two groups based on clinical evaluation: a bruxism group consisting of children diagnosed with bruxism, and a control group consisting of children without clinical signs of bruxism. Bruxism diagnosis will be established using parental reports and standardized clinical examination findings, including tooth wear assessed according to the Smith and Knight Tooth Wear Index, temporomandibular joint findings, masticatory muscle symptoms, and intraoral soft tissue signs.

Perceived stress levels in children will be assessed using the Perceived Stress Scale for Children (8-11 years). Parenting-related stress will be evaluated using the Parenting Stress Scale. Parents' own perceived stress levels will be measured using the Perceived Stress Scale (PSS). Parental awareness of the child's stress and anxiety will be assessed using the parent form of the Screen for Child Anxiety Related Emotional Disorders (SCARED) developed by Birmaher et al.

All assessments will be conducted at baseline during the clinical visit. The primary outcome is the association between child perceived stress levels and bruxism status. Secondary outcomes include associations between parental stress-related measures and child bruxism status. Statistical analyses will be performed to evaluate group differences and associations between stress measures and the presence of bruxism.