It is natural to be concerned if you notice your child grinding their teeth in their sleep. This is called sleep bruxism, and studies estimate anywhere from 6% up to almost 50% of children engage in bruxism during the night. Bruxism is believed to be more common in childhood2 and it can start as soon as the teeth grow in.
Grinding or clenching teeth may be an involuntary response to stress and anxiety. During sleep, adults and children may engage in teeth grinding without being fully aware they are doing it.
Bruxism is not considered dangerous in and of itself, but the constant grinding or clenching of teeth can cause jaw pain and damage to the teeth over time. We examine the causes and risks of sleep bruxism in children and discuss some strategies to prevent this nighttime habit.
What Is Bruxism?
Bruxism is the repetitive grinding or clenching of teeth. There are two distinct types of bruxism: sleep bruxism and awake bruxism. Awake bruxism is believed to be more common and usually consists primarily of teeth clenching without grinding.
More than 80% of people with sleep bruxism may not realize they grind their teeth during sleep. It may be difficult to identify sleep bruxism in children unless they share a bedroom with a sibling or a caregiver.
Why Do Kids Grind Their Teeth?
Bruxism in children likely occurs due to a combination of psychological factors, family history, and environmental triggers. It runs in families, though it is not yet clear whether this is due to genetics or a third factor such as a similar upbringing. Studies have also found that male children are more likely to engage in bruxism, although more research needs to be done to confirm this. People who are predisposed to bruxism may be triggered by one or more additional factors, such as stress or secondhand smoke.
Stress appears to be closely tied to sleep bruxism, though more research is needed to determine whether stress causes bruxism or vice versa. One study of toddlers found that those who faced stressful events were more likely to have sleep bruxism. For school-age children, bruxism may be a way of coping with the stress of homework, chores, and getting good grades.
Researchers have found higher levels of self-reported stress as well as stress-related hormones in people with sleep bruxism, though additional studies have failed to replicate these findings.
Though research is inconclusive, there is some evidence of a link between anxiety levels and sleep bruxism in children. Children who are naturally restless and who worry more about doing well in school appear more likely to engage in bruxism.
Researchers note that symptoms may evolve over time as children develop, which may be why the connection is not evident at first glance. For example, toddlers who experience more severe separation anxiety are more likely to develop sleep bruxism in elementary school.
Other Sleep and Mental Health Disorders
Along with stress and anxiety, bruxism seems to occur more in children with certain other conditions, such as attention deficit hyperactivity disorder (ADHD) or migraines. Bruxism also goes hand in hand with sleep disturbances, including parasomnias, snoring, and sleep-related breathing disorders. However, it is difficult to say whether these are a cause or an effect of teeth grinding at night.
Bruxism is more common in children with misaligned teeth and those who wear fixed orthodontic appliances. However, according to the American Academy of Sleep Medicine, there is not enough evidence to confirm dental issues as a cause of bruxism. Bruxism is also more common in people who breathe primarily through their mouth.
Secondhand smoke is another risk factor for developing bruxism in childhood. Research suggests that even moderate exposure to secondhand smoke increases the risk of bruxism in children.
What Are the Effects of Bruxism?
Bruxism can increase the risk of developing:
- Fractured teeth, receding gums, and other problems in the teeth and jaw
- Temporomandibular joint disorder
- Eating disorders
- Mental health disorders such as depression and anxiety
- Sleep problems
The sounds produced by grinding and clenching teeth may also lead to sleep disruptions for your child or others in the bedroom.
Signs Your Child May Be Grinding Their Teeth at Night
Some common symptoms and signs your child might be experiencing teeth grinding during the night include:
- Tooth Damage: Check for fractures, wearing down of the teeth, or receding gums.
- Sensitive Teeth: Children who grind their teeth may be more sensitive to hot or cold food and drinks.
- Jaw Pain or Headaches: Constant pressure from clenched teeth may result in headaches, jaw pain, and occasionally clicking sounds or increased size of the jaw muscles.
- Grinding Sounds: Check on your child during the night and see if you can hear any grinding noises. You could also opt for a baby monitor if you are worried about disrupting their sleep.
Diagnosing Bruxism in Children
To be diagnosed with bruxism, your child must show tooth grinding sounds while asleep, coupled with corresponding tooth wear, morning jaw pain, headaches, and/or a locking jaw. These signs may be noticed by a dentist during a routine appointment, or they may be identified by a doctor if your child complains of morning pain or poor sleep. Since sleep bruxism occurs during the night, dentists rely heavily on parent reports of grinding or clenching noises during the child’s sleep.
Your care provider may also ask about current stressors to obtain a fuller picture of potential precipitating factors. More rarely, they may refer your child for polysomnography, an overnight sleep exam, to check for signs of bruxism or other sleep disorders.
Treatments for Bruxism
Treating bruxism focuses on controlling damage to the teeth and reducing side effects such as pain and headaches. Improving sleep quality and addressing sources of stress may help make bruxism more manageable.
Your dentist can help fit your child with a nightguard or splint to protect your teeth while they sleep. The splint may fit over the top or bottom teeth, and may be designed to reposition the jaw in addition to shielding the teeth from friction. Nightguards and splints appear to be effective at treating bruxism, although the bruxism may not fully go away and symptoms may return if your child does not use the splint.
Managing stress may help reduce teeth grinding. Talk to your child about what may be occuring in their life that is causing them distress, such as a recent move or academic obligations. If necessary, reach out to a professional mental health professional or your child’s school counselor for additional support.
Sleep Hygiene and Bedtime Routine
Sleep bruxism is closely tied to sleep quality. You can improve your child’s sleep by ensuring your child’s room is dark and quiet, limiting the time they spend on electronic media, and providing them with a nutritious diet low in added sugars.
Establishing a bedtime routine can set the stage for sleep and help your child feel confident and secure at bedtime. Some examples of soothing bedtime activities are:
- Eating a nutritious snack before bed
- Brushing teeth
- Taking a warm bath
- Cuddling together with your child
- Reading stories
- Singing or soft music
Working on relaxing the face muscles during the day can sometimes reduce nighttime bruxism. To soothe painful jaws and teeth, use a cold or hot compress and encourage your child to drink water and avoid hard foods and chewing gum. Ask your doctor about stretching exercises and facial massage techniques.
There is some evidence that homeopathic remedies or medication may help reduce sleep bruxism in children, but more research is needed into the efficacy and possible side effects. Always talk to your doctor before starting any new medication, even if it is marketed as natural or sold over the counter. As bruxism is not considered harmful apart from its secondary effects on the teeth and jaw, your doctor should weigh whether taking medication is worth the potential side effects.
When to Talk to Your Doctor or Dentist
Talk to your dentist or pediatrician if you notice symptoms of bruxism in your child, such as heightened mouth sensitivity, jaw pain, morning headaches, or grinding noises during the night or during naps. You should also consult a professional healthcare provider if your child is having trouble sleeping or showing signs of sleepiness during the day.
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