Sleep bruxism in children is characterized by grinding and involuntary teeth clenching. It is natural to be concerned if you hear your child grinding their teeth in their sleep. Bruxism in children lasts about four seconds and can occur up to six times per hour. Typically, the parents notice the condition first because they can hear the grinding noises at night.
Many kids have it, but most outgrow it without lasting problems.
If your child is around 3 to 5 years old, I would not be overly concerned about it because some scholars have indicated that sleep grinding at that age could produce physiological wear to allow the growth and development of the jaw. It can become more of a concern if you hear or notice your older children grinding their teeth at least three times per week for two months because repetitive masticatory muscle activity can cause serious health complications. Typically, the incidence of sleep grinding decreases from ten years old onwards.
Causes of Sleep Bruxism in Children
Kids grind their teeth for a few reasons:
- pain, such as from an earache or teething
- temporomandibular joint disorder (TMD)
- erupting adult teeth in the mixed dentition period, typically between 6 to 12 years old
- misaligned teeth
- stress (worry about a test or a change in routine) and social anxiety disorder (arguing with parents and siblings can cause enough stress to prompt teeth grinding or jaw clenching)
- medical reasons like hyperactivity, cerebral palsy, attention-deficit disorder, gastroesophageal reflux, sleep apnea or hypoxia secondary to airway obstruction
- taking some types of medicines like antidepressants and psychotropic drugs for anxiety
- frequent snoring and mouth breathing, which could be a sign of upper airway obstruction
- daytime bad habits and parafunction like lip, pen and nail-biting
- frequent nightmare
- second-hand smoke
- genetic reason and personality trait (it runs in families). Studies have indicated a positive correlation between the concentration of catecholamines in the urine and sleep bruxism. Disturbances in the GABAergic and glutamatergic systems of the brain also have a positive correlation with sleep bruxism
Many times, bruxism is not noticed and does not cause problems. Often, it’s more bothersome to other family members because of the grinding sound.
But sometimes, it can cause:
- worn down tooth enamel or chipped teeth
- sensitive teeth
- face, ear, or jaw pain
- sleep disturbance that can cause behavioural problems and medical issues because they are not getting the rest children need
It can be challenging to pinpoint the cause of bruxism. I may use a method of elimination to determine the cause. I need to examine the patient systematically to determine the causes and risks, then provide treatment to the patient accordingly if the reasons are a concern.
Treatment for Bruxism
Most kids will outgrow sleep bruxism, but they still need to be monitored by the dentist. Grinding can damage both primary and secondary teeth and affect current and future oral health. The treatment approach can include monitoring and
- a nighttime mouthguard
- an examination by a pediatrician if medical reasons like tonsilitis and airway obstruction are suspected
- reduction of the stressors – parents’ roles are vital because they could be the ones who can help to eliminate the stressors like high expectations and excessive extracurricular activities like piano lessons or sports
- referral for mental health counselling
- improve your child’s sleep hygiene by making sure their room is dark and quiet, limiting their time on cell phone and computer
- Soothing bedtime activities like brushing teeth, taking a warm bath, cuddling together with your child, reading stories and soft music
- provision of nutritious diet low in added sugars but avoid hard snacks like corn chips, popcorn and chewing gum
- stretching exercises and facial massage techniques
- orthodontic treatment to align the teeth and create proper arch forms that can help healthy orofacial development
- elimination of parafunction and bad habits like nail and pen biting
- acupuncture and photomodulation of the (acupoint) trigger points
- Stop using a pacifier if the kid is still using it after 2.5 years
- Hydroxyzine medication before bed for two months for older children
Combining the above treatment modalities is often needed if the condition is severe. We love to see children at Affinity Dental Care.