Teeth grinding or bruxism is a condition in which children consciously or unconsciously grind, clench, or gnash their teeth. Unconsciously grinding the teeth while awake is called awake bruxism, and during sleep is called sleep bruxism.
Mild bruxism may not require treatment. However, children with extreme and frequent teeth grinding may need treatment to avoid complications, such as teeth damages, headache, and jaw pain.
Read this post to know about the causes, risk factors, symptoms, diagnosis, treatment, and prevention of bruxism in children.
Causes Of Teeth Grinding In Children
The exact causes for teeth grinding in children are not known. It could be due to genetic, psychological, or physical factors. Some children may grind their teeth during the day since they find it enjoyable.
Sleep bruxism could be due to chewing-related activity and movement related to sleep arousals. This is considered a sleep-related movement disorder and is often associated with other sleep problems, such as sleep apnea and snoring.
Awake bruxism could occur due to the following reasons (1).
- Stress and tension
- Pain is some part of the body
- Incorrect alignment of the upper and lower teeth
In most children, awake bruxism can be a habit or coping strategy when they are deeply concentrated on something or emotional. This can be like a childhood habit, and most of them grow out of it.
Risk Factors For Bruxism
The following factors may increase the risk for teeth grinding in children (2).
- Positive family history of bruxism
- Anxiety and other mental health disorders
- Mouth breathing
- Night tremors (rhythmic movements) of the jaw
- Gastroesophageal reflux disease (GERD)
- Aggressive, hyperactive, or competitive personality type
- Attention deficit hyperactivity disorder (ADHD)
- Psychiatric medications
- Caffeinated beverages
- Sleep-related disorders and sleep apnea
Some children may develop teeth grinding without displaying any risk factors. You may seek medical care to identify the exact cause of bruxism in your child.
Symptoms And Signs Of Teeth Grinding
The signs and symptoms of bruxism may vary depending on its type and severity, and could consist of the following (3).
- Visible teeth grinding or clenching
- Audible grinding sounds
- Damaged teeth’s enamel
- Flattened teeth
- Chipped or fractured teeth
- Loose teeth
- Gum recession
- Tooth sensitivity and pain
- A locked jaw that may not close or open entirely due to tired or tight jaw muscles
- Facial or jaw pain and soreness, especially in the morning.
- Headache in the side of the head (temples)
- Hypertrophy of masticatory muscles
- Sleep disturbances
- Damage to the inner cheek tissue
Early diagnosis and interventions may help to prevent permanent teeth damages and worsening of underlying conditions.
Diagnosis Of Bruxism
Detailed history and clinical examination may help to identify the signs of bruxism in children. Dentists may evaluate the child on several visits to determine whether it is a progressive condition and the type of possible treatment plan.
X-rays and some additional tests could often be ordered to look for damage to the teeth and the jawbones. This may help exclude the diagnosis of other dental issues, temporomandibular joint (TMJ) problems, and other health issues causing similar symptoms.
Depending on the findings of the diagnostic procedures, referrals to sleep medicine specialists and psychologists could be made to identify any related health problems.
Treatment For Teeth Grinding
Many children may not require treatment since they may outgrow the condition in a short time. They may need some training and awareness to change the habitual teeth grinding. However, severe and progressive teeth grinding requires treatment, which may include the following (4).
1. Dental approaches
Dental approaches are ways to correct or preserve teeth in children with bruxism. Although dental strategies help to reduce the risk of tooth damage, they may not prevent bruxism.
Common dental approaches used in bruxism may include:
- Mouthguards and splints keep the teeth separated and prevent damages from clenching or grinding. Soft or hard acrylic materials are used to construct splints and guards that fit over your child’s teeth.
- Dental correction is done by reshaping the chewing surfaces of teeth crowns. It is usually required for children with tooth wear (loss of tooth substance not caused by dental caries).
Medications may help to reduce bruxism in some children. However, more research is needed to evaluate their effectiveness. The following medications under physician’s supervision could be prescribed for children with bruxism.
- Botox injections (a form of botulinum toxin) may reduce jaw clenching. This may reduce headache and pain in some children.
- Muscle relaxants may reduce teeth grinding in sleep if they are taken before bedtime.
- Anti-anxiety medications or antidepressants are often prescribed to reduce anxiety or stress that may cause bruxism.
3. Other treatments
The following treatments may help to deal with some causes or risk factors of bruxism in children.
- Stress and anxiety management therapies and counseling may reduce bruxism in some children.
- Behavioral therapy may help to reduce the teeth grinding habits.
- Biofeedback is a therapy to change the teeth grinding habits by controlling the body. This method uses sensor devices, usually integrated into splints to sense grinding or clenching, and give a paired stimulus such as a sound, vibration, or taste to make the person aware of grinding.
- Medications and procedures to control or cure underlying conditions, such as mental health disorders, GERD, and sleep disorders, reduce bruxism in some children.
Prevention Of Bruxism In Children
The following tips may be helpful to control or prevent bruxism in some children (5).
- Reduce stress through meditation, exercise, listening to music, and other activities the child finds relaxing.
- Avoid caffeinated drinks such as coffee, tea, and soft drinks.
- Practice good sleep habits from a young age.
- Do not let the child chew anything other than edible items. For instance, chewing a pen or pencil may increase the risk of developing bruxism.
- If any medications lead to bruxism, you may inform the pediatrician to change the prescription.
- Treat any childhood mental disorders or dental problems.
Bruxism may not cause life-threatening complications. However, permanent teeth damage, jaw pain, and headache can cause persistent discomfort. Using force or punishment to correct teeth grinding is not recommended, and it may exacerbate the stress and anxiety in children. Therefore, speak to a dentist or a pediatrician if you notice constant jaw clenching and teeth grinding in your child.
2. Teeth grinding; BetterHealth Channel; Victoria State Government
3. Teeth grinding (bruxism); National Health Service
4. Bruxism (teeth grinding); St. Clair Hospital
5. Teeth Grinding (Bruxism); Familydoctor; American Academy of Family Physicians
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