Clenching and Grinding Treatment in Children

Bruxism, also known as Bruxism, is defined as the friction of the teeth against each other as a result of involuntary clenching or grinding. It is named in two different ways according to daytime (diurnal) and nighttime (nocturnal) clenching. Nocturnal bruxism, which is called nocturnal bruxism and occurs during sleep at night, is more common.

Bruxism can cause problems such as abrasions on the teeth, flattening, fractures in fillings and teeth, sensitivity in the teeth, itching sensation in the gums, shaking in the teeth, pain in the muscles and joints, limitation in jaw movements, noise from the joint, jaw pain, head, ear and facial pain.

The main cause of bruxism is thought to be stress and anxiety. Apart from these, it is known that conditions such as medications (antidepressants), neurological diseases such as Parkinson’s, alcohol and addictive substances, sleep disorders increase bruxism.

Causes of Bruxism in Children

Bruxism is seen in 7-15% of children and the incidence decreases after the age of 12. Generally, parents state that their children grind their teeth during sleep and that they notice it because of the sound.

The causes of bruxism in children may include emotional and psychological stress, as well as many local and systemic causes.

Psychological Causes of Teeth Grinding and Grinding

The most important cause of bruxism is increased stress and anxiety as in adults. Especially having a new sibling, starting school, family problems are situations that increase stress in children. Apart from these, teeth clenching and grinding can also be seen in children with hyperactive and aggressive personalities.

Local Causes of Teeth Grinding

Local causes of bruxism are improper closure of the teeth, improper filling and tooth contact and joint disorders.

The most important and frequently encountered situation is that there are different contacts during the change of teeth and the child tries to get used to it. Milk teeth change and permanent teeth begin to erupt in their place, and until the teeth are in the position they should be, teeth clenching and teeth grinding problems can be seen due to different contacts.

Another reason is the presence of heights or overflows in the restorations or fillings, which we call premature contact. In such cases, all restorations should be checked, contact points should be detected and premature contacts should be eliminated.

Systemic Causes of Teeth Grinding

Systemic causes of bruxism include reflux, allergy and respiratory disorders, malnutrition, intestinal parasites, some endocrine and neurological disorders, adenoid and large tonsils.

It should not be overlooked that children may have intestinal parasites in cases where there is saliva flow as well as teeth clenching and grinding during night sleep.

Teeth clenching and grinding due to respiratory disorders and allergies are more common in children younger than 5 years of age.

Some studies suggest that teeth grinding may be genetically transmitted from parents to children; however, it should not be forgotten that all family members may have teeth clenching and teeth grinding due to stress caused by family problems. At the same time, it should be kept in mind that children can imitate the behaviors they see from their parents and that they may be imitating someone, especially in children who clench and grind their teeth while awake during the day.

Treatment

The aim of bruxism treatment is to eliminate the main factor. Therefore, dentists and medical doctors should work together.

In children, teeth clenching and teeth grinding usually disappear spontaneously after the permanent teeth erupt completely (approximately 12 years of age). For younger children, it is necessary to evaluate possible systemic problems and first identify and treat the cause.

In cases of teeth clenching and grinding that occur as a result of emotional and psychological stress and anxiety, methods aimed at relaxing the child and reducing stress should be applied before sleep (such as playing a favorite game, reading a favorite book, listening to relaxing music). In cases where these do not work, psychological support should be considered.

In adult patients, night protective trays can be comforting in terms of preventing tooth wear, but it should be remembered that bruxism is a multifactorial disorder and all factors that may cause it should be considered. Joints and muscles should be examined together and appropriate appliances should be prepared by specialists.

In children, night protective trays are generally not applied unless there is serious wear on the teeth because their growth is not yet complete. In special cases where there is severe abrasion on the teeth and continues despite the elimination of all factors, braces can be prepared by specialists, but are generally not preferred in order not to affect growth and development.