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Tooth Troubles
Tooth grinding and clenching, often heard at night. This page explains what it is and what the AAPD says about it — including something reassuring that many parents have not been told.
The clinical term is bruxism. The AAPD defines it as repetitive jaw movements characterised by tooth clenching and grinding, occurring with variable intensity and frequency during sleep and while awake. Sleep bruxism is classified as a sleep-related muscle activity.
The cause is not single. The AAPD describes the origin as multifactorial and reports emotional stress, traumatic brain injury, neurologic disabilities and sleep disturbances among the factors that have been associated with it.
Some people’s teeth do a grinding thing while they are asleep, and they never know they are doing it. It is quite common. Your dentist will check your teeth are alright.
The most useful thing on this page for most parents: the AAPD states that evidence indicates juvenile bruxism is self-limiting and does not persist into adulthood. That does not mean it should be ignored — it means the usual worry, that a child who grinds becomes an adult who grinds, is not what the evidence shows.
Four statements, all from its guidance on the developing dentition:
That third point is why grinding is not simply noted and dismissed. Worn teeth have more than one possible explanation and telling them apart matters.
Three things worth knowing.
The AAPD states evidence indicates juvenile bruxism is self-limiting and does not persist in adults. Worth knowing before spending a night listening to it.
The AAPD describes the spectrum of management as running from parent and patient education, through occlusal splints and behavioural strategies, to psychological techniques and medication. Which end applies is a clinical judgement.
The AAPD is explicit that wear from grinding needs distinguishing from erosion caused by diet, reflux or eating disorders. If your child’s teeth look worn, that distinction is part of what the examination is for.
Looking at the teeth for wear, and asking questions about sleep, stress and general health, since the AAPD describes the aetiology as multifactorial.
Raise it at a routine checkup if your child grinds but has no pain and their teeth look normal to you. Ring sooner if there is jaw or facial pain, headaches, teeth that look visibly worn or chipped, or if your child is waking because of it.
Where grinding sits alongside a wider sleep concern — snoring, pauses in breathing, unrefreshing sleep — mention that to your child’s doctor as well as your dentist.
The noise at night is alarming — should we be worried? It is a common reason parents raise this, and the AAPD’s position is reassuring: evidence indicates juvenile bruxism is self-limiting and does not persist in adults. That is not a reason to skip mentioning it, because the wear it can cause needs distinguishing from other causes. But it is a reason not to lose sleep over the sleep.
The AAPD states evidence indicates juvenile bruxism is self-limiting and does not persist in adults. That is a statement about the evidence generally rather than a prediction about your child, but it is the direction the guidance points.
Emotional stress is one of several factors the AAPD reports as associated, alongside sleep disturbances and some medical conditions. It describes the cause as multifactorial, so grinding is not by itself evidence of stress.
Occlusal splints appear in the AAPD’s described range of management, which also includes education, behavioural strategies and medication. Whether a splint is appropriate for a growing child is a clinical decision. Ask your dentist rather than buying one.
It may be, and the AAPD is explicit that wear from grinding must be differentiated from other forms of enamel loss, naming dietary erosion, reflux and eating disorders. That distinction needs an examination.
Mention it to both your dentist and your child’s doctor. The AAPD lists obstructive sleep apnoea among oral habits and conditions considered in the developing dentition, and sleep concerns are worth raising properly rather than in passing.
Every clinical statement on this page comes from the American Academy of Pediatric Dentistry documents below.
This website is for education only and does not replace care from your dentist, physician, or emergency services.