What is teeth grinding?
Bruxism (teeth grinding) is a condition involving grinding or clenching of the teeth, often during sleep. Bruxism can be mild and occasional or can be so frequent or violent that the teeth are damaged.

What is the cause?
No one knows for certain why some children grind their teeth. Some think that it is because the child's top and bottom teeth do not fit together comfortably. This discomfort causes the child to grind his teeth to make the teeth feel better and later turns into a bad habit. Others believe that children grind their teeth because they feel tense, fearful, or angry. Still others suggest that children could have an allergy or a nutritional problem.

The cause in some cases is abnormal dental occlusion (the way the upper and lower teeth fit together when the person shuts the mouth). More often, the disorder is associated with anxiety, tension, and suppressed anger. Bruxism is usually worse after intake of alcohol.

What are the symptoms?
Teeth grinding, severe or very loud, that occurs during sleep
jaw clenching
Jaw pain or earache (referred pain caused by violent jaw muscle contractions)
Abnormal alignment of teeth
Anxiety, stress, and tension
Personality, suppressing anger

How common is tooth grinding?
Dental examinations of children show that 1 in 6 children have done some tooth grinding. Also, some parents report the behaviour even though their child's teeth appear normal at the dentist. Altogether, 1 in every 3 children grind their teeth at some time in their childhood.

When does tooth grinding usually occur?
Almost all children that grind their teeth do it only at night. The behaviour is most common in children around the ages of 5 and 6; however, it can occur at any age. Grinding the teeth during the daytime should make parents more concerned than if the child is doing it only at night.

How is the diagnosis made?
Examination will rule out other disorders that may cause similar jaw pain or ear pain, including ear disorders such as otitis media, temporomandibular joint (TMJ) dysfunction, and dental disorders. Detailed history may reveal abnormal stress or tension.

What is the treatment?
The goal of treatment is to prevent permanent damage to the teeth and reduce pain.

A night guard or protective dental appliance may be helpful if bruxism is severe enough to cause damage to the teeth or pain to jaw muscles. Orthodontic adjustment of the occlusion or bite pattern may be beneficial for some people.

Psychotherapy or counselling may help the afflicted person to express anger and deal with anxiety or stress. Relaxation or stress management techniques can be beneficial in reducing anxiety or stress. Avoidance of alcohol may be advised for some people.

Will the child's teeth be harmed?
Usually the wear to teeth from grinding does not harm the teeth. The baby teeth (also called primary teeth) can show a lot of wear to their surfaces without causing pain or other problems. If the teeth get very worn down, dental problems, such as tooth infections, can occur.

What can I do to help my child?
If you or your child's dentist sees wear on the tooth surface, it is important to make a special visit to a paediatric dentist. Dentists can polish the teeth to make them fit together more comfortably or make special devices for the mouth that are usually worn at night to keep your child from wearing away the teeth.

It is a good idea to help a child talk about what has caused tension, fear, or anger before going to bed. Do this in the course of the bedtime routine. For example, when your child is telling you about his day, ask some questions about how those events made him feel. While this may or may not help the child with tooth grinding, it does let him know that you care about how he feels. It is probably best not to draw attention to the tooth grinding itself.

Most children will stop tooth grinding on their own without the need for special treatments. Mention tooth grinding to your child's dentist at your child's next regular appointment.

How to prevent it?
Stress reduction and anxiety management may reduce bruxism in persons prone to the condition.

What is the prognosis?
Bruxism is not a dangerous disorder. However, it can cause permanent damage to the teeth and uncomfortable jaw pain or ear pain.

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