“Why does my child grind their teeth at night?”

During the course of an initial orthodontic consult, we discuss whether parents notice if their children grind their teeth at night. Surprisingly, a large percentage of parents report that they can actually hear their kids grinding, which can often be alarmingly loud. I remember being able to hear my daughter grinding her teeth from outside her room when she was 8-9 years old! It is normal to wonder if this is something to be concerned with, and if it will do any short or long term damage.

Bruxism, or bruxing, is the medical term for grinding teeth, and sleep bruxism is grinding teeth at night. Ginding at night is considered a sleep-related movement disorder, and although a large percentage of the population grinds their teeth at night, the frequency and severity varies from mild to severe. Signs and symptoms of bruxing include teeth with enamel wear or chipped edges, sore jaw muscles, headaches or what may feel like an earache, and tooth sensitivity. Sometimes their are no symptoms, and other household members just hear the grinding! There is not a well established link between bruxing and long term TMJ disorders, but it certainly can be a contributing factor.

The causes of bruxing are not completely understood, but the following may be causes or triggers: Emotionalcauses such as stress, anxiety and anger; A response to pain such as headaches or teeth erupting; Abnormal alignment of the teeth such as severe crossbites; genetic causes and related sleep disorders such as sleep apnea and snoring; sometimes there is no apparent cause at all. Bruxing is most common in young children, and most kids will outgrow it as they age. However,if you feel that the grinding is excessive and is becoming a concern, options include:

• Informing your dental professional at your next visit. I check for signs of tooth wear, sore “chewing” muscles, and a history of headaches in the early morning upon waking.
• Identifying causes of stress and anxiety. Addressing these issues can often reduce the frequency and intensity of grinding.
• For adults, try reducing caffeine, smoking and alcohol intake.
• In severe cases, we can make a splint, or night guard, to protect your teeth. Wearing a night guard before all the permanent teeth have erupted is often difficult, as kids go through stages of loosing and gaining new teeth. This makes fitting a night guard that will fit securely in their mouth difficult to impossible depending on their dental development.
• If a bruxer is currently in braces or orthodontic treatment, teeth are actively moving and they often have to wait until the braces are removed to get a night guard that will stay secure long-term. Once the braces are removed, I will review special retainer options for my patients who are bruxers. Night guards can be incorporated into retainers quite nicely!
• Orthodontic treatment itself may not always reduce the amount of grinding, but it certainly can help reduce wear on teeth that are wearing or chipping. I will determine if any teeth are wearing excessively or disproportionately (patients can often see uneven wear on their front teeth before starting treatment), and I will make a plan to move teeth to minimize wear. You may hear me checking for “canine guidance” and “interferences”… I will let you know that that means if you are interested!

Dr. Dan Rejman is an orthodontic specialist in Castle Rock, Colorado. He is the owner of Meadows Orthodontics, and has been Board Certified by the American Board of Orthodontics since 2007.