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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 traumatic brain injury 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, “bad bite” or jaw misalignment promotes grinding.  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.

Children with certain developmental disorders and brain injuries may be at particular risk for grinding.  In such cases, the pediatric dentist may suggest botulism injections to calm the facial muscles, or provide a protective nighttime mouthpiece.  If the onset of bruxing is sudden, current medications need to be evaluated.  Though bruxing is a rare side effect of specific medications, the medication itself may need to be switched for an alternate brand.

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.  Some of the available options include: altering the biting surface of teeth with crowns, and beginning occlusal treatment.

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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I just wanted to send an update.
We got Sidney's tongue tie and lip tie revised 2 weeks ago today. Her top lip is looking great, she has great mobility and the stretches have really helped her lip muscles loosen up. I'm so pleased with the results.
Her tongue has gotten hard to stretch as she has figured out how to wiggle her tongue around to avoid the fingers, which I'm taking as a great sign. She's really learning how to move it around. When I eventually get under her tongue, there seems to be a bit of reattachment/regrowth, but since the mobility is there I'm not concerned. Just more motivation to keep up on the stretches, which she only mildly complains about these days.
I'm so happy to have a skilled dentist here in town to help her little mouth out. Keep up the good work.

Callie S.

Dear Dr. Boldt,
We've just made it to the two week mark since our tongue tie and upper lip revision with you. I just wanted to thank you for doing such a thorough revision and going deep enough to really make a difference. Since the night of the revision my son Denzel (5.5 months) began sleeping 9 hours continuously out of 12 through the night (as opposed to his usual 3-4 before needing to nurse) he also began pooping daily as opposed to every few days. Nursing is now pain free and his upper lip is no longer STIFF. I am so grateful to have someone in Edmonton skilled enough to understand and rectify his tt with Laser.

Denzel's Mom

Great experience! The staff are wonderful and it was easy to get an appointment at a time that suited us. My kids (5&7) loved the video games in the waiting area and the TV on the ceiling in the exam room.

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