Teeth Grinding: What You Need to Know About Your Child's Tooth Damaging Habit



Excessive teeth grinding (Bruxism) can lead to tooth loss.

Illustration: Tessa Phongsavath

 

Have you ever tiptoed into your children's bedroom to make sure they're tucked in for the night, only to have your ears assaulted by an awful, grating noise?

If so, you quite likely stumbled into an episode of teeth grinding, which is known in the health care world as bruxism. Parents may become more aware of this when they share hotel rooms with their kids during summer vacations.

"Grinding is really common in kids," said Dr. Abbie McKnight, a Leawood-based dentist. "Parents will say, 'my kids don't complain, but when I open the door I hear this horrible sound coming from their bedroom.'"

Dr. Jill Jenkins, a dentist who practices in Johnson and Wyandotte counties, said many of her patients grind their teeth and their parents frequently ask her about it.

"In kids that are under age six, it's very normal for children to grind and grit their teeth and move their jaws around," Jenkins said. "It's actually a way to help grow more teeth. So, with the primary teeth before age six, we usually don't worry much about grinding."

While some teeth grinding in children can be harmless if it continues as permanent teeth come in, flattening can occur.

 

But McKnight said grinding could become problematic for young children if they grind their baby teeth so much that they burn through the enamel and break into the dentin, which is the portion of the tooth that surrounds the pulp. Dentin is harder and denser than bone, but softer than enamel.

Teeth grinding in kids usually begins to wane by the time permanent teeth come through, McKnight said. "The problem is, it's not that uncommon for a first molar that comes in to get flattened off (from grinding), and it's a tooth they have their whole life. That's when we really start to get concerned — when they start to damage permanent teeth."

Jenkins said teeth grinding after age six usually causes more problems. "A lot of times we'll see grinding in that age group because they have some discrepancies in their bites, like crossbite or underbite. We can usually remedy that during the growth stage by working with an orthodontist who straightens out the bite. That will usually eliminate a lot of the grinding."

Frequent teeth grinding becomes a more significant concern if it's still occurring when kids reach 16 and 17, Jenkins said. "Then we worry about structure loss on the toothand the tooth becoming shorter and affecting the jaw joint area."

Jenkins said teens are more willing that young children to wear a bite guard that can prevent grinding, "especially after they've done some orthodontics and worn retainers. They're more amenable to tolerating devices."  

McKnight said excessive teeth grinding can be caused by anxiety and too much stimulation. "I think our kids have a ton of screen time, I feel like it's harder for them to settle down and fall into deep sleep. I think they're over stimulated."

Jenkins said teeth grinding frequently goes along with kids not sleeping well. She and McKnight agreed that parents should take steps to help their kids settle down at night before bedtime, such as limiting screen time.

In addition to limiting before-bed screen time, the American Academy of Sleep Medicine recommends that parents establish a consistent bedtime routine that includes a relaxing setting and interacting with their child.  

McKnight said medications for depression also could contribute to teeth grinding but said she would never recommend a change in such medicines because of grinding issues. Rather, she said, awareness of grinding "might lead to a willingness to wear a bite guard."

Jenkins said she seldom recommends mouth devices to prevent grinding in younger kids because she doesn't want to restrict the growth of their teeth. "If I've got some special situation, we have to come up with some inventive ways to protect the teeth while not hindering their growth potential," she said.

For example, Jenkins said many of her patients who have autism and Down syndrome grind their teeth excessively. "Sometimes we will use material to build up the surface of their molars to keep their bite open, so they're not able to do tooth-on-tooth grinding.  I have kids that I'll see every six months and rebuild composite beads on their teeth so they're not wearing down the enamel, because they're unable to tolerate a mouthpiece."

And while teeth grinding is not always a serious issue, Jenkins said parents shouldn't hesitate to bring it to the attention of their kid's dentist. "There's no stupid question when it comes to your kids. If you hear them grinding one time, it's always worth a conversation with a dentist."