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Does Your Child Grind His or Her Teeth at Night?

Bruxism, or the grinding of teeth, is remarkably common in children and adults.  For some children, this tooth grinding is limited to daytime hours, but nighttime grinding (during sleep) is most prevalent.  Bruxism can lead to a wide range of dental problems, depending on the frequency of the behavior, the intensity of the grinding, and the underlying causes of the grinding.

A wide range of psychological, physiological, and physical factors may lead children to brux.  In particular, jaw misalignment (bad bite), stress, and sleep apnea are all thought to contribute to bruxism, although grinding can also occur as a side effect of certain medications.

What are some symptoms of bruxism?

In general, parents can usually hear intense grinding – especially when it occurs at nighttime.  Subtle daytime jaw clenching and grinding, however, can be difficult to pinpoint.  Oftentimes, general symptoms provide clues as to whether or not the child is bruxing, including:

  • Frequent complaints of headache.
  • Injured teeth and gums.
  • Loud grinding or clicking sounds.
  • Rhythmic tightening or clenching of the jaw muscles.
  • Unusual complaints about painful jaw muscles – especially in the morning.
  • Unusual tooth sensitivity to hot and cold foods.

How can bruxism damage my child’s teeth?

Bruxism is characterized by the grinding of the upper jaw against the lower jaw.  Especially in cases where there is vigorous grinding, the child may experience moderate to severe jaw discomfort, headaches, and ear pain.  Even if the child is completely unaware of nighttime bruxing (and parents are unable to hear it), the condition of the teeth provides the pediatric dentist with important clues.

First, chronic grinders usually show an excessive wear pattern on the teeth.  If jaw misalignment is the cause, tooth enamel may be worn down in specific areas.  In addition, children who brux are more susceptible to chipped teeth, facial pain, gum injury, and temperature sensitivity.  In extreme cases, frequent, harsh grinding can lead to the early onset of temporomandibular joint disorder (TMJ).

What causes bruxism?

Bruxism can be caused by several different factors. Most commonly it will phase in and out for no particular reason before the age of seven. It can also be related to sleep apnea or tooth/jaw misalignment.  Pediatric dentists also notice that children tend to brux more frequently in response to life stressors.  If the child is going through a particularly stressful exam period or is relocating to a new school for example, nighttime bruxing may either begin or intensify.  If your child snores, has sleep trouble and is bruxing, the pediatrician should be alerted.

How is bruxism treated?

Bruxing spontaneously ceases by the age of thirteen in the majority of children.  In the meantime however, the pediatric dentist will continually monitor its effect on the child’s teeth and may provide an interventional strategy.

In general, the cause of the grinding dictates the treatment approach.  If the child’s teeth are badly misaligned, the pediatric dentist may take steps to correct this by referring the child for an orthodontic evaluation.

If bruxing seems to be exacerbated by stress, the pediatric dentist may recommend relaxation classes, professional therapy, or special exercises.  The child’s pediatrician may also provide muscle relaxants to alleviate jaw clenching and reduce jaw spasms.

In cases where young teeth are sustaining significant damage, the pediatric dentist may suggest a specialized nighttime dental appliance such as a nighttime mouth guard.  Mouth guards stop tooth surfaces from grinding against each other, and look similar to a mouthpiece a person might wear during sports.  Bite splints, or bite plates, fulfill the same function, and are almost universally successful in preventing grinding damage.

If you have questions or concerns about bruxism or grinding teeth, please contact your pediatric dentist.

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