Introduction

Many parents tell us they are concerned that their children are grinding their teeth at night. Some say the noise is terrifying, others wonder what they can do to stop it.

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Studies showed there was no correlation between TMD symptoms and bruxing in children. No studies demonstrated any correlation of bruxing with sleep apnea in children. The literature did state the etiology of bruxism in children is similar to that of bruxism in adults: life experiences, stress, and anxiety. The literature also stated that children who brux will most likely continue to brux when they become adults. The most interesting finding was no author(s) described a relationship between bruxing in children and damage of permanent teeth!

Diagnosis

At Florman Orthodontics, we recommend early diagnosis of bruxism in children as early as age 6 or at the beginning of the mixed dentition phase. Early diagnosis of bruxism can prevent irreversible damage to permanent anterior teeth, aid in the diagnosis of sleep apnea, which has been associated with bruxing in adults, and help identify children who are dealing with stress.

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When children present with worn down primary or permanent teeth, most parents have no idea their children are bruxing. The most likely reason is that these children are bruxing during the day and/or are not making enough noise at night to alert parents.

Evaluating wear of both the primary and permanent teeth is important. Based on our clinical experience, the majority of children with wear of teeth in the mixed dentition only exhibit wear on primary teeth. Children with wear patters on the primary teeth need to be followed more closely as their permanent incisors begin to erupt. Seldom do we see wear in the 6 year permanent molars. Most damage seen in permanent teeth is in the maxillary and mandibular incisors.

Treatment

After completing a thorough orthodontic examination in the mixed dentition, we determine if early orthodontic treatment is needed. In children that brux, we integrate bruxing appliances into their Phase I orthodontic treatment plan. Children that do not need Phase I treatment receive one of our fixed or removable bruxing appliances.

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If it is suspected that children are bruxing while awake, they must be educated to catch themselves doing it and break the habit. This is the same advice we give adults.