Children and Bruxism
Bruxism is very common in children. One in 5 children up to the age of 11 are reported to have sleep bruxism, although the real figure is probably higher as parents often are unaware. Children who brux usually begin at 4-8 years of age, the numbers increase between 10‑14 years of age and then start declining after age 14. Many factors associated with children who brux are anxiety, personality, Attention Deficit/Hyperactivity Disorder (ADHD), and other parafunctional habits.4
It is challenging to determine if children have anxiety, although an anxiety state is a prominent factor in the development of bruxing behavior among children. A recent study concluded children with bruxism are more anxiety prone.11
Studies of personality traits in bruxism have been limited, but a conclusion was found that children who brux tend to be more tense than children who do not brux.11 Children with persistent anti-social and aggressive personality traits are diagnosed with having disruptive behavior disorder. Evidence proved anti-social children with persistent behavior problems as they grow older have a range of neurobiological characteristics, including bruxism.12
ADHD is considered to be a developmental disorder, mainly neurologic in nature, affecting 5% of the world’s population. Externalizing behavioral problems such as aggression and hyperactivity was proven as a correlation with anxiety and bruxism. This disorder is prevalent with bruxing and children. Children taking ADHD medication also have a higher occurrence of bruxism.13
Children tend to have a greater intensity, frequency and duration of parafunctional habits; finger and pacifier sucking and nail biting can increase the likelihood of grinding. These particular oral actions cause a motor stimulus to the central nervous system, which reacts with the alteration in the neurotransmission of dopamine–with the final result being clenching and grinding of teeth.4
Teeth grinding often occurs after children develop their first teeth and again after they develop their permanent teeth. The habit usually stops after the adult teeth are fully formed and erupted. The different heights and sizes of teeth in a mixed dentition causes the natural instinct to want to make the bite feel balanced. The body reacts by wanting to even out the taller teeth with the shorter teeth.
Management of bruxism in children can be challenging. As with adults, a night guard could be a treatment option; however, while children are still growing a night guard would not be the best recommendation. Another recommendation is to try relaxation techniques before bedtime to ease anxiety or restlessness. Children who fall asleep watching television or listening to the radio are more prone to bruxing at night. Reading aloud to children right before bedtime and having children sleep alone can decrease sleep bruxism.11