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Bruxism In Children And Adolescents (Grinding)

  1. What is bruxism?
  2. What are the signs and symptoms of bruxism?
  3. What causes bruxism?
  4. How is bruxism managed?
  5. How is the toothwear caused by bruxism treated?

 
1. What is bruxism?

  • Bruxism is the unconscious and involuntary habit of clenching or grinding teeth. This means that a person with bruxism is mostly unaware of, and unable to stop the habit.
    It can take place at night when asleep or during the day.
  • Bruxism is not common in young children but it can affect adolescents.

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2. What are the signs and symptoms of bruxism?

  • This excessive toothwear must be distinguished from normal toothwear.
    • The teeth will be worn down, become shorter and the yellow dentine will be visible.
    • The dental term for this toothwear is attrition.
    • The teeth will also have a tendency to chip.
    • Tenderness in the muscles and jaw joints can be felt on waking in the morning.
    • Pain may be experienced when eating because of restricted jaw movement.
    • Teeth worn down or cracked by grinding may become sensitive.
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Mild toothwear
of upper baby teeth
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Yellow dentine
on baby teeth

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3. What causes bruxism?

  • Bruxism is thought to be stress related.
  • It may also be seen in children with cerebral palsy and in some with learning difficulties.

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4. How is bruxism managed?

  • The treatment of bruxism will be to control the causes, which are usually stress and other medical conditions.
    • These causes are dealt with by psychologists, psychiatrists and medical specialists.
    • Behaviour modification with relaxation training can be used to treat bruxism.
  • The toothwear is corrected by the dentist.
    • Nightguards can help to lessen the effects, and protect the teeth from further damage.
    • They can be made from a soft silicone material or from a hard acrylic. The hard version is called a bite plate.
    • They are designed to cover the biting surfaces of the teeth in one of the jaws, usually the upper.
    • Nightguards prevent the upper and lower teeth from grinding against each other.
    • The acrylic nightguard may also relieve jaw joint ailments caused by bruxism.
Click to enlarge
Nightguard + cast
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Nightguard
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Nightguard in mouth
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Acrylic bite plate

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5. How is the toothwear caused by bruxism treated?

  • Generally bruxism is not treated in children, as they lose their baby teeth anyway.
  • Bruxism in adolescents will be treated in much the same way as in adults:
    • Where bruxism has resulted in severe toothwear, the teeth will need to be restored.
    • The teeth can be fitted with replacement crowns or onlays to restore the worn down teeth.
    • These measures will restore the teeth to their normal size, and the jaws to their normal position when they are closed.
    • The appearance of the teeth and face can be greatly improved.

See Bruxism in the Adult section

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