Q: My husband has been travelling a lot lately and my six year-old has been sleeping in my bed at night. I noticed that she frequently grinds her teeth at night. This happens when she is falling asleep and if she stirs during the night. It sounds really loud and painful but she does not wake up during the night. When she wakes up in the morning she is wide awake and happy. When I asked her if her teeth hurt she says no. She hasn’t lost any of her baby teeth yet. What is going on? What do I need to do about this?
A: This is bruxism, or tooth grinding. It sounds awful. We sometimes hear it in the sleep lab. Many kids do it when awake when they are angry. Episodic tooth grinding is fairly common. Seven to 15% of children may be noted to grind their teeth. It’s most common in children before they lose their baby teeth. Multiple disorders have been associated with bruxism:
- Anxiety, stress, and depression
- Malocculsion, or misaligned teeth.
- Attention deficit disorder
- Acid reflux
- Cerebral palsy
- Certain medications (stimulants, selective serotonin reuptake inhibitors (SSRIs)
- Primary sleep disorders (such as obstructive sleep apnea)
Interestingly, bruxism has been shown to disrupt sleep in some children. However, the majority of children grind their teeth once in a while without any ill effects. So, if your child grinds her teeth, there are a few points to consider:
- Mention it to her dentist at her next regularly scheduled tooth cleaning. The dentist can look for signs of tooth wear and prepare a mouth guard if necessary.
- Tooth, jaw pain, or jaw clicking, should prompt a trip to the dentist sooner. Bruxism can be associated with tooth damage or disorders of the temporomandibular joint (TMJ).
- Discuss it with your pediatrician especially if your child suffers from any of the medical conditions noted above, especially if the tooth grinding is associated with signs of sleep disruption such as restless sleep, difficulty getting up in the morning, irritability, or difficulty paying attention during the day. A sleep study may be useful in some cases to determine the extent of the problem.
In the case of the child above, the tooth grinding was intermittent and not associated with any discomfort. She was well rested in the morning implying that her sleep quality was good. Her father’s travel may be a stressor triggering the bruxism, or it may only have been noticed because she was in bed with her mom. In any case, I would only recommend mentioning this at her next dental visit.
NOTE: When I publish these question and answer sessions it is with the permission of the families. This is not a case where I have a doctor patient relationship. Details have been changed to protect privacy.