Many parents come to our office concerned that their children grind their teeth at night. For this reason, we want to dig deeper into this problem on this problem, explaining everything you need to know about bruxism in children.
What is bruxism?
Bruxism is an involuntary habit of clenching or rubbing teeth against each other without a functional objective and with variable intensity. This phenomenon is considered to be regulated by the central nervous system and influenced by peripheral factors. There are two types of bruxism (nocturnal and daytime), but it can also be classified according to its origin as:
- Primary or idiopathic when it is not related to any medical entity.
- Secondary or iatrogenic when it is related to medical illnesses caused by certain medications.
Does it affect children a lot?
Regarding the prevalence of the disease, studies speak from 4-40% of the child population. The critical age for this disease is between 7 and 10 years, which corresponds to the period of mixed dentition, and tends to decrease as age increases as more stable occlusion patterns are established when the first molars and incisors erupt permanent.
What are the symptoms?
The most characteristic and common symptom is the noise produced by teeth grinding at night. It is a fairly intense noise, which occurs repeatedly over time and is usually accompanied by wear on the dental surfaces.
In principle, this symptom is an indication that the patient is bruxing since he still does not have stable occlusal patterns (which occur between 5-10 years) and is considered normal as long as it is not accompanied by functional problems such as limited opening, or orofacial pain.
Other symptoms that we can observe in patients with bruxism are: affectation of the gums, affectation of the cervico-cranial muscles and the temporomandibular joint, headaches, and even sleep disorders.
What is the origin of bruxism?
The conclusion is that the cause of childhood bruxism depends on multiple factors:
- Malocclusions: the bad position of the teeth can create occlusal interferences that, together with stress, constitute the fundamental etiological factors for the development of the habit of bruxism.
- Sleep-disordered breathing.
- Sleep quality: there is an association between the number of hours of sleep and bruxism, indicating that children who sleep less than 8 hours are more predisposed to suffer from it.
- Psychosocial disorders: stress level and personality types are risk factors for the development of bruxism in children.
- Postural problems: some studies also link some body postures and bad oral habits with a higher rate of bruxism.
- Genetic disorders: a higher incidence of this disease has been observed in patients with Down syndrome, cerebral palsy or autism.
How to treat childhood bruxism?
Before establishing a treatment plan, the most important thing is to make a good diagnosis, since, as we have commented, the causes of bruxism can be due to neurological, psychological, and anatomical factors, and all of them must be taken into account when planning the most appropriate treatment for the child.
Regarding primary bruxism in children, there is controversy about what is the ideal treatment. In general, in these cases there is a tendency towards observational rather than interventional therapy. It is normal for there to be some wear or physiological dental attrition on the temporal teeth due to use and the need for the jaws to develop. In addition, as the permanent teeth erupt and the child grows, there is a decrease in its prevalence.
It is different, in case the child patient presents any symptom indicative of temporomandibular disorder such as pain or limited opening. In this type of situation, the necessary therapeutic measures must be taken to alleviate the symptoms. The treatments proposed to treat the different types of bruxism depending on their origin are:
- Occlusal appliances during sleep: their use in children with deciduous and mixed dentition is controversial due to growth and development at these ages.
- Orthopedics: it has been seen that in cases that bring it together by expanding the maxilla, bruxism is improved or eliminated.
- Psychological therapy: helps reduce stress and establish healthy lifestyle guidelines.
- Surgical treatment: in cases in which the cause is due to respiratory obstructions.
- Physiotherapy: for postural correction.
Definitely, the most important thing is to find out the origin of bruxism in order to treat it correctly. In most cases, observation through periodic dental check-ups is sufficient. However, if along with sleep bruxism the patient presents other symptoms such as headaches or temporomandibular problems, it is recommended to treat the patient in a multidisciplinary way to ensure correct management.
