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
- Autism
- 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.
This is article is incredibly informative discusses an ongoing concern I have about my daughter. In fact, after reading this, I discussed the topic with our dentist and she was in complete agreement. Despite the horrific sounds that I hear during the night, she assured us that this is something children often outgrow after they lose their baby teeth and the wear on her teeth was evident but not a concern at this stage. Since she sleeps soundly, we were told to monitor the grinding in case this changes.
But a follow up question….since that visit, my daughter went for a speech evaluation where she was diagnosed with low tone on her lower jaw/lip. As a result, her jaw slides when she speaks. Given her age (6 yrs), she is aware of the sliding and were told that she “fixes” her jaw when she speaks (kind of locking it in place to counter the movement). Do you think this could be a contributing factor to the grinding at night?
Thanks Dr. C!!!!
I would guess that it likely is related. I suspect that speech therapy will help both the speech and the tooth grinding issues.
Our 8yr old son grinds his teeth. I also do. I heard it can be hereditary. My son is also autistic. My husband just went to find a night guard. Hopefully it works. Really stressful.
It truly is a terrible noise. Also worth getting him checked for sleep apnea as that can be a trigger. Good luck.
I have been very concerned for my son, he is 7 years old and grinds his teeth at night at age 4 he broke one of his molars. His teeth are very tiny and he has started complaining that they hurt at times when he eats. He has not lost any of his baby teeth (minus the molar that had to be removed when it broke) and we tried some mouth gaurds, however he spits his out at night. Not sure where to do.
The first step is to discuss this with your child’s dentist. Good luck.
Thanks for the article on teeth grinding. My 6 year old does it all the time in her sleep. She does have a big under bite. But never did any grinding until recently. She has had some disruption in family life and wondering if that can contribute to teeth grinding also?. Thank you.
I suspect it can as that can lead to sleep disruption, which may trigger tooth grinding.
As a pediatrician, I have been asked about this but often don’t know what to do if it is resulting in disruption. I do go over sleep hygiene, efforts at anxiety reduction, and of course dental consult, but it seems interventions are limited. Especially in the younger kids, a lot of dentists don’t recommend night guards due to rapid jaw growth. Thankfully, as you have said, it is usually temporary!
Theresa great to hear from you! It sounds so unpleasant. When we study kids with bruxism in the lab it is seldom was frequent; this, it is usually pretty benign.