Why Do Children Grind Their Teeth?
Children grind their teeth for different reasons than adults. In many cases, the grinding is a normal part of dental development and resolves without any treatment. Understanding the possible causes helps parents decide whether to seek evaluation.
Tooth Eruption and Jaw Development
Teeth coming in is one common reason young children grind. [2] As baby teeth erupt and later as permanent teeth replace them, some children grind as they adjust to the new sensation in their mouth. Grinding tied to teething often fades as the teeth settle into position.
Misaligned teeth are also listed as a possible cause of grinding in children. [2] [7]
Stress and Anxiety
Just like adults, children can grind their teeth in response to stress. A new school, family changes, test anxiety, or social pressure may all show up as nighttime teeth grinding. [1] [4] Children may not express stress verbally, and stress can show up in other ways.
If grinding starts suddenly or increases during a stressful period, the timing can be a helpful clue. Addressing the underlying stress may help reduce the grinding.
Bite Misalignment (Malocclusion)
Misaligned teeth are one possible contributor to grinding. [2] A pediatric dentist can assess the bite and refer to an orthodontist if alignment correction is needed.
Enlarged Adenoids and Sleep-Related Breathing Problems
Research has found a connection between teeth grinding in children and sleep-disordered breathing, including obstructive sleep apnea. [4] Enlarged adenoids or tonsils can partially block the airway and lead to mouth breathing and snoring. Why grinding and breathing problems often occur together is not fully understood.
Children who snore loudly, breathe through their mouth at night, or have restless sleep alongside grinding should be evaluated for sleep-disordered breathing. Loud snoring or pauses in breathing can signal sleep apnea and should be checked by a physician. [6] Learn more about bruxism and sleep apnea. For children with sleep apnea and enlarged tonsils or adenoids, the American Academy of Pediatrics recommends adenotonsillectomy as first-line treatment. [6] Whether treating the airway problem also stops the grinding has not been firmly established.
When Is Teeth Grinding in Children a Concern?
Most teeth grinding in children is mild and causes no damage. However, certain signs indicate that the grinding is more than a passing phase and deserves professional attention. [2]
Signs That Grinding Needs Evaluation
- Visible wear or flattening on the tops of the teeth
- Tooth sensitivity to hot, cold, or sweet foods that was not present before
- Jaw pain or stiffness, especially in the morning
- Frequent headaches, particularly upon waking
- Grinding loud enough to wake a sibling or parent in another room
- Chipped, cracked, or loosened teeth
- The child complains of ear pain with no ear infection present
Grinding and Sleep Quality
Children who grind heavily may not sleep well, even if they do not fully wake up. Children who seem tired during the day, have difficulty concentrating, or show behavior changes alongside nighttime grinding should be checked by a dentist and a doctor. [2]
In some cases, a pediatrician may refer the child for an overnight sleep study. Obstructive sleep apnea is diagnosed by a physician, not by a dentist. [6]
How Is Teeth Grinding in Children Treated?
Treatment for a child who grinds their teeth depends on the cause, the severity, and the child's age. Many children need no treatment at all. When treatment is recommended, the goal is to protect the teeth and address the underlying trigger.
Custom Night Guards
For children with significant tooth wear or jaw pain, a pediatric dentist may recommend a custom-fitted night guard. This appliance fits over the teeth and is meant to protect them from grinding during sleep. A custom guard made from a mold of the child's teeth is more comfortable and effective than an over-the-counter one. [2] Evidence for night guards in children is limited, so they are usually reserved for concerning tooth damage or pain. [4]
Over-the-counter night guards are generally not recommended for children because they often do not fit well as a child's mouth changes. [2]
Addressing the Underlying Cause
When stress is the likely trigger, relaxation techniques before bed can help. A calm bedtime routine, reduced screen time in the evening, and gentle conversation about any worries can lower nighttime tension. Some pediatric dentists also recommend behavioral strategies such as relaxation. [4]
If bite misalignment is contributing to grinding, an orthodontic consultation may be the next step.
For children with enlarged adenoids, chronic snoring, or signs of sleep-disordered breathing, a referral to an ENT specialist or pediatric sleep medicine doctor is often part of the plan. [6]
Do Children Outgrow Teeth Grinding?
Many children do outgrow teeth grinding. Grinding becomes less common as children get older, with one review noting a drop from around ages 9 to 10. [3] [4] The American Academy of Pediatric Dentistry describes childhood bruxism as self-limiting. [1] Grinding tied to tooth eruption usually fades on its own.
However, not every child outgrows it, and some keep grinding into their teen and adult years. [2] A professional evaluation is valuable when grinding is persistent or causing symptoms.
Regular dental checkups allow a pediatric dentist to monitor tooth wear over time. Even when no immediate treatment is needed, tracking the pattern helps determine whether the grinding is stable or getting worse.
Cost of Evaluation and Treatment
An initial evaluation with a pediatric dentist for teeth grinding typically falls within the range of a standard dental exam. Costs vary by location, provider, and case complexity. If X-rays or additional diagnostic tests are needed, the total may be higher.
Costs for a child's custom night guard vary widely by the type of guard, the dental practice, and your location. Many dental insurance plans cover a portion of night guard costs when they are prescribed for bruxism. Check with your insurance provider for details on your specific plan.
If the grinding leads to a referral for orthodontic evaluation or sleep study, those costs are separate and vary widely. Your pediatric dentist can help you understand what is covered and what to expect before you proceed.
When to See a Pediatric Dentist About Teeth Grinding
A pediatric dentist is the right specialist to evaluate a child who grinds their teeth. Pediatric dentists complete residency training beyond dental school focused on treating children, including evaluating developing bites and habits like bruxism. [1]
You should schedule an evaluation if your child grinds most nights, if you notice tooth wear or chips, if your child complains of jaw pain or headaches, or if grinding is accompanied by snoring or mouth breathing. You do not need a referral to see a pediatric dentist in most cases.
Even if the grinding turns out to be harmless, the evaluation provides peace of mind and establishes a baseline. If the grinding worsens later, having that baseline makes it easier to track changes and decide on treatment.
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