For anyone suffering from head pain, ear or jaw pain upon awakening from sleep could be suffering from bruxism. Specialist Pediatric Dentist Dr. Anukriti Pathak explains more about this problem and what can be done to help it.
Bruxism is the medical term for the grinding of teeth or the clenching of jaws. It refers to movements of the teeth and jaws that are not necessary for functional activity; for example: chewing, speaking, or swallowing. In healthy infants, sleep bruxism typically starts at about one year of age, soon after the front teeth come into the mouth. In young children, teeth grinding may be due to the immaturity of the neuromuscular system that controls chewing. In older teens, other than psychological factors, smoking, illicit drug use, as well as medications, trauma, and disease can cause bruxism. Teeth grinding, or “bruxism,” is a fairly common habit among children, particularly those under the age of 11.
Many cases of bruxism go undetected with no ill-effects, while others may cause headaches or earaches. Usually though, it's more bothersome to other family members because of the grinding sound. In some circumstances, nighttime grinding and clenching can wear down tooth enamel, chip teeth, increase temperature sensitivity, and cause severe facial pain and jaw problems.
Bruxism is a condition of multifactorial etiology, determined by an association of psychological, local(dental), and systemic factors. Local factors include occlusal interferences (mobile teeth,
cuspal interferences, high restorations, premature contacts or occlusal disharmony), malocclusion, and temporomandibular dysfunction.
Systemic factors implicated in bruxism include intestinal parasites, subclinical nutritional deficiencies, allergies, and endocrine disorders.
The Role of stress
Stress and anxiety may be directly related to bruxism. There is a close association between bruxism and underlying personality problems. Stress, usually nervous tension or anger, can be the cause. For instance, a child might worry about a test at school or a change in routine (a new sibling or a new teacher). Even arguing with parents and siblings can cause enough stress to prompt teeth grinding or jaw clenching.
Bruxism is found in those who suffer from post-traumatic stress disorder, further suggesting that psychological factors may be involved. Counseling and other forms of relieving psychological stress, such as muscle relaxation, have been shown to reduce teeth grinding in children.
Hyperactivity and other medical conditions
Hyperactivity is also associated with bruxism as are the amphetamines used for managing attention deficit hyperactivity disorder (ADHD). Sometimes kids with other medical conditions (such as
cerebral palsy, Down syndrome, and epilepsy) or who take certain medicines can develop bruxism.
Bruxism is prevalent in children who snore and/or breathe through their mouths. A link has also been made between teeth grinding and enlarged tonsils, which in turn is strongly correlated to upper airway obstruction. Removing the tonsils and adenoids has been shown to lessen teeth grinding in some children. Asthma and respiratory airway infections may also be factors in bruxism.
In some cases, kids may grind because the top and bottom teeth aren't aligned properly. Others do it as a response to pain, such as from an earache or teething. Kids might grind their teeth as a way to ease the pain, just as they might rub a sore muscle. Many kids outgrow these fairly common causes for grinding.
Effects of bruxism
In some circumstances, grinding and clenching can wear down tooth enamel and chip teeth. Other trauma to the dentition and supporting tissues include thermal hypersensitivity, tooth hypermobility, injury to the periodontal ligament and periodontium, hypercementosis, fractured cusps and pulpitis, and pulpal necrosis. Continued bruxism can cause severe facial pain and jaw
problems, such as temporomandibular joint disease (TMJ).
• Most kids outgrow bruxism, but a combination of parental observation and dental visits can help keep the problem in check until they do.
• In cases where the grinding and clenching make a child's face and jaw sore or damage the teeth, a pediatric dentist or general dentist may prescribe a special night guard. Molded to a child's
teeth, the night guard is similar to the protective mouthpieces worn by athletes.
• Children with upper airway obstruction are sent to an ENT specialist for further evaluation. Kids with severe psychological problems are referred for therapy. Children or adolescents who are
taking medications that may cause bruxism are discussed with the child's primary care provider including whether it's possible to switch medications.
Tips to help a child with bruxism
1. Whether the cause is physical or psychological, kids might be able to control bruxism by relaxing before bedtime. For example, by taking a warm bath or shower, listening to a few minutes of soothing music, or reading a book.
2. It is recommended that children in preschool get between 11 to 13 hours of nightly sleep.
3. Try massage and stretching exercises to relax the muscles.
4. For bruxism that's caused by stress, ask about what's upsetting your child and find a way to help. For example, a child who is worried about being away from home, reassure him/her that mom or dad will be nearby if needed. If the issue is more complicated, discuss your child's/teen’s concerns and try to ease any fears.
5. Taking kids for routine dental visits can help find and treat bruxism.
(Credit: Specialist Pediatric
Dentist Dr. Anukriti Pathak)