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.                                                    Photo by Chris J. Davis on Unsplash
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. 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.

The child may experience:

• Moderate to severe jaw discomfort, headaches, and ear pain
• 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. 
• 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?

• Most commonly, “bad bite” or jaw misalignment promotes grinding
• Life stressors such as a stressful exam period or is relocating to a new school 
• Children with certain developmental disorders and brain injuries may be at particular risk for grinding especially with certain medications. 

Pediatric dentist can provide a protective nighttime mouthpiece and provide other suggestions and strategies to help alleviate bruxing and its sequela. In consultation with a medical professional, a pediatric dentist may suggest an alternative brand of a specific medication to see if bruxism improves. 

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.