Treatment for Teeth Clenching and Grinding in Children

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

Bruxism can cause problems such as abrasions and flattening of teeth, fractures in fillings and teeth, sensitivity in teeth, itching in the gums, loose teeth, pain in muscles and joints, limitation in jaw movements, noise coming from the joints, 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, and sleep disorders increase bruxism.

Causes of Bruxism in Children

Among the causes of bruxism in children, there may be many local and systemic causes as well as emotional and psychological stress.

Psychological Causes of Teeth Clenching and Grinding

The most important cause of bruxism is increased stress and anxiety, as in adults. Especially having a new sibling, starting school, and 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 teeth, improper filling and tooth contact, and joint disorders.

The most important of these and the situation we encounter frequently is that there are different contacts during the teeth change period and the child tries to get used to this. Milk teeth change and permanent teeth start to appear in their place, teeth clenching and grinding problems can be seen due to different contacts until the teeth reach the desired position.

Another reason is the presence of elevations or protrusions, which we call premature contact, in the restorations or fillings that have been made. In such cases, all restorations must be checked, contact points must be determined and premature contacts must be eliminated.

Systemic Causes of Teeth Grinding

Systemic causes of bruxism include reflux, allergies and respiratory disorders, nutritional deficiencies, intestinal parasites, some endocrine and neurological disorders, adenoids and large tonsils.

In cases where children clench and grind their teeth at night and also have salivation during their sleep, it should not be overlooked that they may have intestinal parasites.

Respiratory disorders and teeth grinding due to allergies are more common in children under 5 years of age.

Some studies suggest that teeth grinding can be passed down genetically from parents to children; however, it should not be forgotten that teeth clenching and grinding can occur in all family members due to stress due to family problems. It should also be kept in mind that children may imitate behaviors they see in their families, and especially in children who clench and grind their teeth while awake during the day, they may be imitating someone else.

Treatment

The aim of bruxism treatment is to eliminate the main factor. Therefore, dentists and physicians need to work together.

In children, teeth grinding and clenching usually disappear on their own after the permanent teeth have fully erupted (approximately age 12). For younger children, possible systemic problems should be evaluated and the cause should be identified and treated first.

In cases of teeth clenching and grinding that occur as a result of emotional and psychological stress and anxiety, methods should be applied to relax the child and reduce stress before sleep (such as playing a game he/she likes, reading a book he/she likes, listening to relaxing music). If these do not work, psychological support should be considered.

In adult patients, night guards can be comforting in terms of preventing tooth wear, but it should not be forgotten that bruxism is a multifactorial disorder and all possible factors should be considered. Joints and muscles should be examined together and appropriate appliances should be prepared by experts.

In children, night guards are generally not applied unless there is serious wear on the teeth because their growth development is not yet complete. In special cases where there is serious wear on the teeth and all factors are eliminated, appliances can be prepared by experts, but they are generally not preferred in order not to affect growth and development.

Pediatric Dentist Cansu Uzun Önalan