Sir, I read the article by Beddis, Pemberton and Davies (BDJ 2018, 225: 497-501) with interest. Sleep bruxism is more common in children and less so in the elderly. Most dentists are able to make a correct diagnosis of sleep bruxism; however, they do not know the aetiology and management, especially in children. The diagnosis of sleep bruxism in children is difficult due to the lack of a diagnostic protocol for this population and the treatment has more limitations, as adequate use depends on the child's cooperation. The authors concluded 'dentists should be aware of the potential aetiology, pathophysiology and management strategies in order to better advise patients'.

Recently, Salgueiro et al.1 showed that photobiomodulation over acupuncture points proved to be an alternative treatment for children with sleep bruxism, leading to fewer reports of headache and a reduction in bite strength. The evaluation of masticatory muscle strength to quantify the force available for shredding and grinding food and bite force is indicative of the magnitude of masticatory muscle strength. At the same time, the author did a study on children with Down syndrome, but the experimental data have not yet been collected. Although the occlusal splint has been considered the gold standard for the management of bruxism, the adherence to the treatment by children and their parents is challenging in clinical practice. Kobayashi et al.2 found that this mode of photobiomodulation is another option that may assist the rapid intervention of pain symptoms, promoting a considerable degree of patient comfort moments after its application.

Photobiomodulation therapy has been used with positive results in temporomandibular disorders, as this non-invasive method has demonstrated positive results in problems related to muscle tissues. The incidence of sleep bruxism is manifesting in younger patients - we need to find more effective ways to manage it and photobiomodulation therapy is one of them.