Why Do Kids Grind Their Teeth?

Author：Dr. Ni Ronghua

As the saying goes, "grinding your teeth at night, worms crawl in your stomach" is not always true. Let's talk about the prevention and treatment of sleep-related bruxism.

What's up with grinding teeth?

The main clinical manifestations of teeth grinding are rhythmic and intermittent contraction of temporomandibular muscles, prolonged muscle clenching or mandibular grinding, often accompanied by teeth clenching or grinding, and loud sound.

There are 3 types: grinding (producing the typical rubbing sound), clenching of the teeth, the light clasping of the teeth, or tightening of the jaw.

Bruxism, the essence of which is the stereotyped tooth-grinding movement during sleep. Sleep bruxism is mainly seen in stage 1 and 2 sleep and REM sleep. The incidence was higher in children and adolescents, with no significant gender differences. Mental retardation, children with cerebral palsy, and adults with obvious psychological stress have a higher incidence. The incidence of molars gradually decreases with age, and most of them heal themselves when they grow up.

Bruxism is a common and frequently-occurring disease in stomatology. Night bruxism can produce huge occlusal force, far exceeding the force of conscious occlusion. Grinding can cause abnormal tooth wear, high sensitivity to hot and cold stimuli, tooth loosening, periodontal tissue damage, cementum hyperplasia, cusp fracture, pulp necrosis, etc. As a result of overexertion, bruxism patients often present with masticatory muscle fatigue, tenderness, dysfunction, and muscle tension pain. It can even lead to serious consequences such as temporomandibular joint disorders.

Grinding sounds are often noticed by bed mates as an unpleasant experience.

What is the cause of bruxism?

It's not entirely clear yet.

Obstructive sleep apnea, severe snorers, moderate daytime sleepiness, heavy alcoholism, caffeine consumption, smokers, highly stressful life events, and anxiety are at higher risk for sleep grinding. Others such as sleep talking, violent or harmful behavior during sleep, sleep paralysis, and hypnotic hallucinations are also associated with sleep grinding.

The pathogenic factors found so far include mental factors, occlusal factors, neuromuscular dysfunction of the masticatory muscle system, and other factors such as endocrine disorders, genetics, etc. Most scholars believe that pathogenesis is caused by multiple factors.

In children, jaw incongruity is thought to be one of the main factors in bruxism. Children are in the period of mixed teeth, misaligned teeth, missing teeth, missing or too long teeth, unilateral chewing, chronic gingivitis or problems with chewing muscles, etc.

The wearing of removable restorations in childhood, poor shape recovery of fillings, poor orthodontic plan design, and improper force can also cause bruxism, and may even cause skeletal deviation of craniofacial development.

Some scholars have also proposed gastrointestinal disorders related to molars and parasites, nutritional deficiencies in children, zinc deficiency, endocrine disorders such as hyperthyroidism, blood sugar changes, blood pressure fluctuations, allergies, and histamine and some histamine-like substances in the body's stress process. In addition, it may cause nocturnal teeth grinding.

Some scholars believe that bruxism in children has nothing to do with intestinal parasitic infection, and there is a lack of strictly controlled experiments and epidemiological survey data.

Some cases show genetic factors.

What needs to be done to check?

1. Clinical examination

The stomatologist needs to check whether there is non-functional wear and tear of the teeth in the patient's mouth, whether there is jaw interference, whether there is periodontal damage, whether the masticatory muscles are tense and sore, and whether the temporomandibular joint area is painful or uncomfortable.

2. Auxiliary inspection

The intraoral device, maxillofacial electromyography, polysomnography, plain X-ray, CT, magnetic resonance imaging (MRI), etc.

How is Bruxism Diagnosed?

The diagnosis can be made by asking about the history of bruxism and the general clinical manifestations. Typical manifestations include night grinding during sleep or clenching during the day, wear of the maxillofacial and adjacent surfaces of the teeth, or associated with periodontal tissue damage, masticatory muscle pain, and temporal Mandibular joint dysfunction symptoms. In addition, auxiliary oral examinations can assist in diagnosis.

How is bruxism treated?

Due to the complex etiology and pathogenic mechanism of bruxism, there is currently no recognized effective treatment method.

The current treatment is to relieve the symptoms of grinding teeth and protect the oral and jaw system. The treatment methods mainly include psychological and behavioral therapy, occlusal therapy, and drug therapy.

Other treatments:

Bruxism patients with periodontal inflammation can undergo periodontal treatment; treatment for sleep ventilation disorders, smoking, coffee addiction, and other causes can also relieve bruxism.

How does bruxism affect your life?

Mild bruxism has little impact on life. In severe cases, symptoms such as tooth sensitivity, maxillofacial muscle soreness, and temporomandibular joint disorders may occur, and most of them have a good prognosis after treatment. Bruxism patients generally do not affect their natural life span.

What should we pay attention to on diet?

Bruxism patients, especially those with discomfort in the preauricular joint area, should pay attention to eating less hard and chewy food as much as possible, not a partial eclipse, but can eat more foods rich in vitamins and have a balanced diet.

How to care for a child with bruxism?

Children and adolescents are in the developmental period. They should develop a good diet and lifestyle, pay attention to relaxation, release pressure in time, adjust poor sleeping posture, improve their sleep environment, and maintain good oral hygiene.

Actively treat abnormal occlusal relationships, relax, don’t be picky eaters, have a balanced diet, and use the occlusal plate with caution to avoid affecting growth and development.