I can’t tell you how many times a parent’s primary complaint for their child's dental visit is “I hear them grind their teeth while they’re asleep. Is that normal?” This problem is more common than you think. But does common mean normal?
No, unfortunately it doesn’t. The challenge with grinding is that we can’t say with 100% certainty what the underlying cause is, yet there is finally a consensus that has emerged, based on research done in the fields of sleep medicine and airway health, that tells us what to pay attention to. Currently, the most widely accepted theory is that teeth grinding is an attempt to open the airway and breathe better. This theory is certainly the one that makes the most sense to me, based on my experience with my own patients and research on this topic.
Clinicians and researchers (and definitely parents!) have wondered for a long time whether teeth grinding (or bruxism, as it's officially called) is genetic in some way, and now that we know what we know about grinding and other symptoms of Sleep Disordered Breathing, it makes perfect sense that there is a familial pattern. If one or both parents grind their teeth (presumably due to airway problems while asleep), the children, who will anatomically share many features with their parents, will likely share this trait as well.
It’s easy to say “they’ll probably outgrow it” because it makes everyone feel better in the moment and alleviates the worry that there is a problem that may require fixing. I’ve heard it countless times. I feel guilty for all the times in the past that I, like so many of my colleagues, have said this to a parent myself. I always informed parents that it's possible that their child’s teeth grinding may be related to an airway problem, but that’s it. I told them it would be a good idea to bring it up with their pediatrician and possibly see a pediatric ENT, but I personally didn’t really have a solution to help fix the problem by addressing the root cause. And often times, if parents questioned another provider, their concern was brushed off.
Here’s the thing: I’ve learned that most kids do not actually outgrow this issue, if the root causes are not identified and corrected. Sure, some kids will outgrow it because maybe they have enlarged tonsil and adenoid tissue that shrinks a bit with age, or that is surgically removed by an ENT, but what about all the other kids? They will likely continue to grind their teeth well into adulthood, signaling there is still an unresolved problem. And is surgery even the best or only treatment option? Surgery can’t always guarantee complete resolution of the problem, since tonsil and adenoid tissue can regrow, and because many times it’s not the only problem that exists. Many times, the size and shape of the jaws and tongue are incredibly important factors that may be overlooked. If those are not addressed as well, you’ve perhaps partly solved the problem, but the underlying cause has not been fully resolved and the grinding can persist.
Pediatric dentists are uniquely qualified to identify proper growth and development of the teeth and jaws in young children. Every pediatric dentist could tell you, for example, that if there are no spaces between your child’s baby teeth, you’re sure to have crowding and crooked permanent teeth -- it’s almost inevitable, if no one does anything.
On the other hand, not every pediatric dentist will have the advanced training to know how to help, and I can freely admit that I didn’t always know what I know now. This topic is not covered in depth in any dental school curriculum and requires practitioners to seek out continuing education to really get a handle on how to treat this condition.
What can you do if your child grinds their teeth in their sleep? My recommendation is to start by reviewing and thinking about other signs or symptoms of Sleep Disordered Breathing that may exist. There’s a very helpful questionnaire we can provide you, even if you are not a patient at Shady Grove Pediatric Dentistry. Just ask, and we’ll be happy to send you one. Looking at this questionnaire created by HealthyStart™ can help you evaluate if your child's grinding may be part of a bigger underlying problem. Even if it appears to be an isolated issue, you can ask us for help to evaluate if your child would be a good candidate to wear a specialized, patented, FDA-cleared type of retainer to help open their airway.
There is no better way for us to improve the life of a young child than by helping them to breathe better and grow better, which, as a bonus, will eliminate the pesky teeth grinding. For more information on this topic, feel free to set up a visit at Shady Grove Pediatric Dentistry for a HealthyStart consultation. If you'd like to read a related blog article on the closely related topic of snoring, click here. Learn more about Sleep Disordered Breathing, its consequences, and what next step you can take to get your child back on track by calling our office of scheduling an appointment online today!
In Health and Happiness,
Dr. Bana Ball
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