Bruxism (Grinding)

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, in rare cases, the parent may notice wear (teeth getting shorter). The cause of grinding often remains unknown. One thing we do know is that it is VERY common. Bruxism is often noticed around the time the PRIMARY molars are erupting, and continues until the last PERMANENT tooth has erupted. One theory suggests that all children grind; some are just louder than others. It is a way for the primary teeth to send signals to the adult teeth to continue their development, and begin to erupt. A second 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. Finally, a third 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, this may explain why children that are prone to frequent ear infections, may have a tendency to grind more or louder than others.

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 good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. If your child grinds their teeth, discuss the issue with Dr. Anokhi. She can advise you whether treatment is necessary for your child.

Thumb / Finger Sucking

Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects (blankets, stuffed animals etc) on which to suck. It may make them feel comfortable, or provide a sense of security at difficult periods. Since thumb / finger sucking is relaxing, it may induce sleep.

Thumb / finger sucking that continues after the eruption of the permanent teeth can cause problems with the proper growth of the mouth and dental alignment. The intensity with which a child sucks on fingers or thumbs will determine whether or not dental or skeletal problems will occur.

Children should discontinue thumb / finger sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.

Dr. Anokhi recommends the use of positive reinforcement starting around age 3 to try to discontinue a finger or thumb habit. Instead of scolding your child for sucking their thumb / fingers, praise them when they are not. Older children often suck their thumb / fingers when they are feeling insecure, tired, or hungry. Focus on correcting the cause rather than the habit itself. Reward children when they refrain from sucking.

If all of these methods have not helped to decrease the habit by age 4 or 5, try putting a sock, or mitten on the hand at night. DO NOT put bandages, Band-Aids, or tape on the fingers or thumb (a common practice by some parents). ALL of those items can be choking hazards to a young child.

If these approaches don't work, Dr. Anokhi may recommend the use of fixed appliance therapy, such as a bluegrass appliance or a thumb crib / fence to be used as an aid in discontinuing the habit.

Pacifiers

Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit.

Dr Anokhi recommends discontinuing pacifier use on or around your child's third birthday. Prior to the age of 3, discuss discontinuing pacifier use with your child. Begin by limiting pacifier use to nap time and bed time only using positive reinforcement and praise. Once this has been adopted as the new routine, begin limiting its use to bed time only; and subsequently discontinuing its use all together. If all else fails, you can always throw away all pacifiers and have a few "sleepless nights." Your child will soon forget that they ever relied on a pacifier at all.