When you look in on your sleeping child, you want to hear the sounds of sweet dreams: easy breathing and perhaps an occasional sigh. But some parents hear the harsher sounds of gnashing and grinding teeth, called bruxism, which is common in kids.
Bruxism is the medical term for the grinding of teeth or the clenching of jaws. Bruxism often occurs during deep sleep or while under stress. Two to three out of every 10 kids will grind or clench, experts say, but most outgrow it.
Though studies have been done, no one knows why bruxism happens. But in some cases, kids may grind because the top and bottom teeth aren't aligned properly. Others do it as a response to pain, such as an earache or teething. Kids might grind their teeth as a way to ease the pain, just as they might rub a sore muscle. Many kids outgrow these fairly common causes for grinding.
Stress — usually nervous tension or anger — is another cause. For instance, a child might worry about a test at school or a change in routine (a new sibling or a new teacher). Even arguing with parents and siblings can cause enough stress to prompt teeth grinding or jaw clenching.
Some kids who are hyperactive also experience bruxism. And sometimes kids with other medical conditions (such as cerebral palsy) or on certain medications can develop bruxism.
Many cases of bruxism go undetected with no adverse effects, while others cause headaches or earaches. Usually, though, it's more bothersome to other family members because of the grinding sound.
In some circumstances, nighttime grinding and clenching can wear down tooth enamel, chip teeth, increase temperature sensitivity, and cause severe facial pain and jaw problems, such as temporomandibular joint disease (TMJ). Most kids who grind, however, do not have TMJ problems unless their grinding and clenching is chronic.
Lots of kids who grind their teeth aren't even aware of it, so it's often siblings or parents who identify the problem.
Some signs to watch for:
If you think your child is grinding his or her teeth, visit the dentist, who will examine the teeth for chipped enamel and unusual wear and tear, and spray air and water on the teeth to check for unusual sensitivity.
If damage is detected, the dentist may ask your child a few questions, such as:
The exam will help the dentist determine whether the grinding is caused by anatomical (misaligned teeth) or psychological (stress) factors and come up with an effective treatment plan.
Most kids outgrow bruxism, but a combination of parental observation and dental visits can help keep the problem in check until they do.
In cases where the grinding and clenching make a child's face and jaw sore or damage the teeth, dentists may prescribe a special night guard. Molded to a child's teeth, the night guard is similar to the protective mouthpieces worn by football players. Though a mouthpiece may take some getting used to, positive results happen quickly.
Whether the cause is physical or psychological, kids might be able to control bruxism by relaxing before bedtime — for example, by taking a warm bath or shower, listening to a few minutes of soothing music, or reading a book.
For bruxism that's caused by stress, ask about what's upsetting your child and find a way to help. For example, a kid who is worried about being away from home for a first camping trip might need reassurance that mom or dad will be nearby if anything happens.
If the issue is more complicated, such as moving to a new town, discuss your child's concerns and try to ease any fears. If you're concerned, talk to your doctor.
In rare cases, basic stress relievers aren't enough to stop bruxism. If your child has trouble sleeping or is acting differently than usual, your dentist or doctor may suggest further evaluation. This can help determine the cause of the stress and an appropriate course of treatment.
Childhood bruxism is usually outgrown by adolescence. Most kids stop grinding when they lose their baby teeth. However, a few kids do continue to grind into adolescence. And if the bruxism is caused by stress, it will continue until the stress is relieved.
Because some bruxism is a child's natural reaction to growth and development, most cases can't be prevented. Stress-induced bruxism can be avoided, however, by talking with kids regularly about their feelings and helping them deal with stress. Take your child for routine dental visits to find and, if needed, treat bruxism.
Dr. Daniel Ravel, DDS