What It Means When Toddlers Grind Their Teeth

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If you have noticed your toddler grinding their teeth, you may be wondering if the behavior is normal. The unpleasant sound can cause concern, but usually, it's safe. Only in some cases do you have to step in.

Learn why toddlers grind their teeth and when you need to take action for your little one.

Why toddlers grind their teeth
Verywell / Brianna Gilmartin

What Is Teeth Grinding?

Teeth grinding is known as bruxism by doctors and is very common in children. It occurs when a person presses their upper or lower jaw down on each other, moving the teeth against one another. Tooth grinding is not considered a disease, but certain other disorders may make it worse.

Grinding During Sleep

Tooth grinding during sleep is referred to as sleep-related bruxism.

According to the American Academy of Pediatrics (AAP), teeth grinding is especially common in children while they sleep, since during sleep the muscles of the jaw contract.

If those jaw contractions are too strong, it can cause grinding. It can be so loud that you can hear it, but most of the time, if it is happening during sleep, it is involuntary, meaning your child is not even aware that they are doing it.

Baby teeth grinding tends to occur most often during REM sleep, the second stage of sleep. Most of the time, a child who is grinding their teeth will not wake up during the grinding episode. However, some studies have shown that there are signs of disturbed sleep during grinding, such as an increased heart rate, called "micro-arousals." That means that the child shows signs of stirring awake, although they do not fully awaken.

Doctors aren't totally sure if the tooth grinding is a result of the arousal, or if the arousal happens because of the tooth grinding, so a lot of nighttime tooth grinding is still a mystery.

Severity

The severity of tooth grinding varies widely. Some children will experience minor episodes, with only a few instances of teeth grinding throughout the night, while others will experience severe bruxism and have hundreds of occurrences throughout the night.

As you can imagine, the more severe the tooth grinding and the more frequent the episodes occur, the higher the risk of damage to the teeth. Prolonged episodes of tooth grinding can cause dental damage as a result of the teeth wearing down.

Prevalence

The AAP notes that tooth grinding occurs in about 14% to 17% of children, and it can start very early in childhood, as soon as the upper and lower teeth have erupted through the gums.

Although the majority of children who grind their teeth tend to grow out of bruxism by around the age of six, around one-third of children will still continue the tooth grinding into adulthood. It's estimated that around 18% of adults between the ages of 18 and 29 experience bruxism and less than 6% experience it past the age of 60.

There doesn't seem to be any noticeable difference in teeth grinding among boys or girls and studies have shown conflicting results, but they do confirm that teeth grinding happens in both male and female children.

Signs

In most cases, parents will know that their toddler is grinding their teeth only by observing the child do it or by hearing it. The child, many times, is not even aware that they are doing it.

In some cases, a child will grind their teeth while awake too, and the parent or caregiver can help to redirect the child's attention from the behavior.

There is a diagnostic tool called Bitestrip that can be used at home to help identify if sleep bruxism is occurring, but most of the time, that device is only used in adults or in severe cases.

Causes

Doctors aren't entirely sure what causes tooth grinding. It's likely that there are many factors that play into a child grinding their teeth.

The Dental Press Journal of Orthodontics explains that experts think that central nervous systems, the mouth, the sleep-wake cycle, genetics, and environment are all involved in tooth grinding.

In some cases, there is also a link between sleep disorders and teeth grinding, such as sleep apnea, although that's more common in adults.

In cases where a toddler's tooth grinding is occurring at night or during sleep, there may be no cause at all. For some children, however, tooth grinding can be caused by periods of stress or anxiety, such as a major life event or trauma.

Tooth grinding could also be the result of your child experiencing pain. For instance, if they are teething or have an ear infection, your baby may resort to grinding their teeth as a way to relieve the pain. Some children may also grind their teeth as a result of misalignment of their teeth.

Effects on Health

In most cases, teeth grinding is not dangerous. Because tooth grinding occurs in children under the age of six and tends to disappear as they get older, it will not cause any permanent damage because they don't yet have their adult teeth.

Every child is different and if you have any concerns or notice any breakdown in your child's teeth, you should speak to their doctor or dentist.

If your child has passed the age of six and is still showing signs of tooth grinding, you will also want to speak with a doctor or dentist to see what kind of options you have for preventing any long-term damage to their teeth and to figure out what (if anything) may be causing the tooth grinding.

Behavioral Effects

Some parents may be concerned about their children's tooth grinding habits based on limited reports that teeth grinding is associated with negative behavior in children. For example, in 2008, the American Academy of Sleep Medicine (AASM) issued a release explaining that there is a link between teeth grinding in toddlers and problems with adjustment in school, as well as social withdrawal behaviors.

The parents reported in their surveys that the same children who exhibited teeth grinding at night also displayed problems adjusting to preschool, engaged less with their peers, and were more withdrawn in social settings. In the study, parents reported that 36.8% of pre-schoolers grinding their teeth one or more times per week, while 6.7% did it four or more times per week.

The AASM's findings were based on 1,956 preschoolers and discovered after the low-income parents in the study filled out a survey about their toddlers' behaviors, school performances, social abilities, and teeth grinding patterns.

Ultimately, however, the study did not find a cause-and-effect relationship between the teeth grinding and negative behavior—only that a relationship exists. The study also showed that the more teeth grinding that the parents reported, the higher incidence of the negative social behavior they reported as well, which means that there could be other factors involved.

A further 2006 study in Sleep found that tooth grinding was not associated with lower intelligence levels in children or any sign of acid reflux, but that teeth grinding did appear to have a link in some children with behavioral problems.

Specifically, 40% of the children in their study also had elevated scores on the Achenbach Child Behavior Checklist. Higher scores on the checklist are associated with attention and behavior problems, and the more the teeth grinding seemed to wake up the children, the higher the risk for attention and behavior problems seemed to be.

A study review by a dental journal also found that nighttime tooth grinding in children, under the age of 12 and most commonly around age 4, was also associated with some behavior irregularities, including hyperactivity, bad temper, and poor academic performance. Physically, children who had nighttime tooth grinding were also more likely to have chronic medical conditions such as allergies, asthma, and upper respiratory tract infections.

As you may have guessed, many sleep studies that have examined bruxism have theorized that excessive teeth grinding in children who are preschool age may be interfering with quality sleep, which could be linked to the negative behaviors and social withdrawal. Toddlers and preschoolers require 13 to 14 hours of quality sleep per night.

If teeth grinding is interfering with sleep, work with a doctor to figure out what is causing the grinding.

In some instances, a sleep study might be warranted to see if a sleep disorder is causing the teeth grinding.

Usually, however, teeth grinding does not fully wake a child up or interfere with their sleep, so it is rare that it will disturb their sleep. However, if you are a family that co-sleeps, or if your toddler shares a sleeping environment with another adult or sibling, it's worth noting that teeth grinding may be loud enough that it disrupts other peoples' sleep, so don't forget that your sleep matters too!

If your toddler's teeth grinding is keeping you from getting the rest you need, you may want to consider temporarily moving your child into another room, using white noise or a fan to help drown out the sound, or adjusting your sleep routines so you are able to rest through the noise.

When to Get Help

Most cases of tooth grinding are harmless in children and will eventually disappear on their own. But, in rare cases, the tooth grinding may either be caused by another condition that needs to be addressed or lead to additional problems for your toddler.

If your toddler is experiencing teeth grinding, the Dental Press Journal of Orthodontics advises parents to keep an eye out for the following:

  • If your child appears to have pain or discomfort in their face upon waking up
  • If frequent headaches are occurring
  • If your toddler has tooth sensitivity to hot or cold food
  • If there are any signs of trauma to the teeth or gums, such as redness, swelling, or bleeding

Bring the issue to a doctor in all of these cases.

A Word From Verywell

Teeth grinding among toddlers and young children is common and in most cases occurs during sleep at naptime and bedtime. Most children will grow out of it by the age of six.

Because most cases of tooth grinding occur before the child has their adult teeth, it usually does not cause any long-term damage. The majority of the time, there is no real cause for tooth grinding in children and your child will not even realize that they are doing it.

However, if the teeth grinding is interfering with your child's sleep, growth, or development, or your child seems to be having any other symptoms, such as fever or pain, be sure to speak with a doctor to rule out any underlying causes. You should also consult with a doctor and possibly a dentist if your child has not outgrown tooth grinding past the age of six.

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Article Sources
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  2. Machado E, Dal-Fabbro C, Cunali PA, Kaizer OB. Prevalence of sleep bruxism in children: a systematic reviewDental Press J Orthod. 2014;19(6):54-61. doi:10.1590/2176-9451.19.6.054-061.oar

  3. Children who grind their teeth are more likely to have problems in school, be withdrawn from others. American Academy of Sleep Medicine. Published online, June 2008.

  4. Salvatore I, Gozal D, McNeil, D, Montgomery-Downs, H. Indirect effect of tooth grinding on preschool performance. Sleep. 2008;13:A69-A69.

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