Last Updated on January 15, 2022 by Dr Gustavo Assatourians DDS
Children who grind their teeth
The word grinding or bruxism is more related to the adult stage; however, this health problem that is grinding and clenching the teeth can present in children. In addition, over the years, it is updated to bruxism during childhood.
Bruxism is of great concern to parents because the noise that occurs during teeth grinding is often too loud and occurs repeatedly for a long time. The relationship of muscle pain in the jaw, discomfort, headache, and limited mouth opening is associated with bruxism since it is not only wearing or grinding the child’s teeth.
At present, it is evidenced that the prevalence of bruxism in children varies between 5% and 40% in the world; adding that bruxism is a critical health problem that has a negative impact on the quality of life of children and must have intervention by the dentist to make a correct diagnosis, adequate treatment and proper education of parents to prevent future in children’s oral health.
The concept of bruxism is understood as the day or night motor activity, which tries to clench or grind in an involuntary, non-functional rhythmic way of the teeth when they make contact without functional purposes, with different degrees of intensity and persistence over time.
Bruxism can occur in children, although it is difficult to diagnose because even though the minor is cooperating, different responses can be given; the possibility that parents and/or guardians are not aware of their children’s oral health, either because they do not report or show pain, discomfort, or because they have not been heard grinding their teeth at night.
Over the years, various studies have studied the prevalence of bruxism in children through clinical examinations and surveys. It is reported by the author Morales, that the highest prevalence was between 3 to 5 years and between 6 to 8 years with 36.98%, unlike 9 to 11 with 24.65% and those from 12 to 14 years with a prevalence of 1.36%, the information is handled that as age increases, the aforementioned pathology decreases.
In relation to bruxism and sex, studies have shown differences. However, there are no significant differences between men and women.
Regarding the origin of bruxism in childhood, it is managed that the origin is multifactorial and involves hereditary, psychological, and behavioral factors. Due to the multifactorial nature of bruxism, it is important to establish the diagnosis based on its etiology and the clinical symptoms that the child presents, if there are any exceptions. In this way it will be possible to understand the relationship of the various factors that influence the development and progress in the worsening of the pathology.
Local factors: Associated with the presence of Temporo Mandibular Disorder (TMD), occlusal trauma, premature loss of teeth, muscle tension.
- Psychological factors: Associated with family problems, personality problems, emotional tensions, states of depression, anxiety, and fear.
- Hereditary factors: It is reported that children of parents with bruxism are more likely to suffer from the habit of grinding their teeth.
- Systemic factors: Due to nutritional and vitamin deficiencies, intestinal parasites, and allergies, they have also been associated with systemic and sleep illnesses.
The risk factors that are shown in children with bruxism are that they are exposed to cigarette smoke, neuroticism, sleep disorder. In addition, the presence of snoring, mouth breathing, restless sleep, drooling, and lack of sleep when lying down are factors related to the pathology./span>
DIAGNOSIS FOR CHILDREN WHO GRIND THEIR TEETH
On certain occasions, the signs and symptoms are not noticeable. However, certain characteristics are significant. To be able to identify this parafunctional pathology, leads to stealth and careful observation of specific clinical signs since children are not aware of the pathological habit.
Among the characteristic symptoms, the most evident is the wear patterns at the occlusal and/or incisal level of the tooth, which extends the wear more than normal. Generally, there is discomfort or pain when pressing the muscles of the masticatory system, such as the masseter, temporal, and internal pterygoid these muscles can present fatigue in the morning.
In children, the most reliable clinical method to make a correct diagnosis in patients with bruxism is the grinding of the teeth, being verified by the parents and/or guardians of the child. However, it is limited by the fact that a large part of children worldwide sleep far from their parents. Therefore, it is more difficult to be able to make the correct diagnosis of the pathology above.
Because bruxism is a multifactorial parafunctional activity, a good approach should be taken in identifying the etiological factors, but not only the signs and symptoms that occur in the child. In the beginning, the parents should be educated and informed, from there begin to try relaxation techniques with the child. Currently, there are three types of treatment that are psycho-behavioral, pharmacological, and dental.
- Psycho-behavior: Carried out based on counseling, hypnosis, relaxation exercises, and biofeedback. In addition, the use of electrical devices for muscle relaxation is considered. The child must also be educated to recognize the muscular conditions of tension and relaxation.
- Dental: The use of occlusal splints is common in adults. However, in children, they have not shown clear effectiveness and they could have negative effects on maxillary growth and eruption of permanent teeth. Its use should be limited to only when it is severe and when there is adequate patient-dentist control. Loss of tooth structure due to wear and temporary or permanent restorations are carried out depending on the child’s case.
- Pharmacological: The use of benzodiazepines such as diazepam, muscle relaxants, clonidine, clonazepam, and even botulinum toxin, reduce the frequency of bruxism in adults; therefore, in the child population, the use of hydroxyzine is reported, but such drugs should be used with caution.
In conclusion, it is favorable to carry out a multidisciplinary approach such as the pediatrician, dentist, psychologist, speech pathologist, parents, and the pediatric patient himself, and based on a correct, comprehensive diagnosis. Treatment should be the least invasive possible, starting with the psycho-behavioral treatment, avoiding the use of drugs that will remain for very complex cases.
If you have any oral health-related questions for your family at home, our dentists Channel Island Family Dental Office will be happy to guide you through all your preventive and treatment-related activities. Feel free to call and reserve your appointment today at our dental office in Oxnard, Ventura, Santa Paula, Newbury Park, and Port Hueneme.
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