Does Your Child Grind His Teeth At Night? (Bruxism)
Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.
The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.
The good news is most children outgrow bruxism. The grinding gets less between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with us . Because every child is different, we have a wide range of choices to help a child complete needed dental treatment. We will make a recommendation of behavior management methods for your child based upon your child’s health history, special health needs, dental needs, type of treatment required, emotional and intellectual development, and your parental preferences.
The three main goals of behavior management are first to help a child feel relaxed and confident; second to guide a child in coping with dental treatment; and third to complete dental treatment as quickly and safely as possible.
To be a well-informed parent, you should know the choices available to help your child during dental treatment. Working together, we can select the best treatment methods to make your child’s visit as safe and comfortable as possible.
A Menu of Behavior Management Methods
Tell-Show-Do: The pediatric dental team explains the treatment in words just: right for the child’s age and level of understanding, shows the child the treatment in a simplified manner, and then does the treatment.
Positive Reinforcement: The pediatric dental team praises the child for any behavior that helps with treatment. Every child does something right during a dental visit.
Distraction: In this technique, the pediatric dental teams choose their treatment words carefully, pass instruments out of the child’s sight, and occasionally distract the child’s attention away from the treatment with conversation, music, or games.
Voice Control: The pediatric dental team changes voice tone or volume to calm a child or get a child’s attention. Typically, we speak in a soft, controlled tone and repeat messages as necessary. We may occasionally use a loud tone to discourage disruptive behavior or movements that can pose a risk to the child, such as reaching for a sharp instrument. If’ you are not comfortable with the use of voice control with your child, then you should certainly speak to us about the issue.
Local Anesthetics: A topical anesthetic can be applied with a cotton swab to prevent pain on the surface of the mouth. A local anesthetic, such as Novocaine, may be injected in a specific area of a child’s mouth to prevent discomfort during treatment. These local anesthetics cause temporary numbness that may last past the visit. Parents/Guardians must be careful about giving children hot food or liquids until the numbness wears off Parents should also monitor their child after local anesthesia to ensure that they are not injuring themselves.
Nitrous Oxide / Oxygen Analgesia: If a child is worried by the sights, sounds or sensations of dental treatment, they may respond more positively with the use of nitrous oxide / oxygen. Perhaps the safest analgesic in dentistry, nitrous oxide/oxygen can reduce anxiety and gagging in children and make long appointments easier. The child remains fully conscious during treatment. Recovery after treatment is rapid and complete. Nitrous oxide is not effective for children who are congested or will not breathe through their nose.