Bruxism (teeth grinding) in children

My son is 3 years-old. I noticed that he grinds his teeth when he sleeps. Is there an explanation for this behaviour?

Question:

Bruxism (a.k.a. teeth grinding) appears to be happening more often in children. Most commonly, children brux when they are sleeping, although some grind their teeth during waking hours. Sleeping bruxers are not usually aware of their habit. Occasionally, the child may complain of sore jaw muscles.

The exact cause of bruxism is unknown. Local, systemic, and/or psychological factors may play a role. Local factors may include an occlusal interference like premature contact between an upper and lower tooth, a high filling or crown, or some other irritating dental condition. Systemic factors may involve intestinal parasites such as pinworms, anal pruritis, nutritional deficiencies, allergies, or endocrine disorders. The psychological theory hypothesizes that bruxing can be a result of a personality disorder or increased stress.

Treating bruxism in children should begin with simple measures. First, any occlusal interferences should be identified and removed. If no interferences are noted, it might be prudent for the pediatrician to examine the child to rule out any systemic conditions. If these steps are not successful, a splint or mouthguard-type appliance can be fabricated to help protect the teeth. The wearing of this guard should be carefully monitored to ensure it is actually helpful and to make adjustments as oral changes and growth occur. In cases where psychological factors appear to play a role, referral to a child counselor or child development expert may be helpful.

A couple of fairly recent studies report some interesting findings regarding bruxism in children. It appears that grinding of the teeth can occur in association with other parasomnias such as night-time muscle cramps, bed-wetting, colic, drooling, and sleep talking. Sleep disturbances may be an underlying cause of these activities.

In addition, it is possible that children who are bed-wetters and children who brux may have similar sleep patterns. Interruptions in rapid eye movement (REM) sleep patterns may be a result of dehydration. If a person is dehydrated, there is an increase in sodium molecules circulating in the blood. This increase in sodium can be a destabilizing factor for REM patterns. Children who are well hydrated with water (not milk or juice) may stop bed-wetting and may stop bruxing as well.

You should first take your son to the dentist for an evaluation of his occlusion. An exam by your pediatrician may also be warranted. It is possible a mouthguard may be needed at some point, but some children outgrow bruxism. Be sure your son is drinking plenty of water during the day, especially during the hot summer months.

References:

Weideman et al., "The incidence of parasomnias in child bruxers versus nonbruxers" Pediatric Dentistry (1996) 18(7):456-460.

Pinkham et al., Pediatric Dentistry: Infancy Through Adolescence, W.B. Saunders Company (1999).

Braham et al., Textbook of Pediatric Dentistry, B.C. Decker Inc., (1988).

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