Bruxism In Children

Bruxism in Children

And recognizing the “Allergic Child”

A frequent question that I get asked by parents is “why my child is grinding”?

I am dedicating this to the late Dr. James F. Garry, a pioneering pediatric and TMJD dentist, the co-inventor of the “Nuk Sager Nipple”. And teacher and mentor to many dentists and doctors, including my self and my mentor Dr. Clayton Chan.

Studies have shown that 20% of non-allergic children were grinding teeth in comparison to 60% of children who were allergic. Dentists commonly believe that the cause of grinding is a “mind thing” due to local irritants, systemic factors, occupational factors, or a combination of these. Allergies as a factor have been ignored by many.

Listed are frequently seen facts that lead to bruxing:

• Mouth breathing – causing dry mouth and lessened flow of saliva, thus diminishing the need for swallowing
• Allergic itching or thickening of the palate and ears – bruxing relieves those symptoms
• Negative pressure build up in the middle ear cavity with auditory tubule dysfunction causing swelling of the mucosa in the Eustachian tube
• Eruption of secondary dentition and exfoliation of the primary and the attempt to establish contact of greater number of teeth

It is imperative to know that in a growing child that is hypersensitive like an allergic child, metabolic changes in the affected areas interfere with normal growth and development. The most common dental manifestation is malocclusion caused by chronic mouth breathing as a result of upper respiratory tract edema. This will lead to, if untreated, to a neuromuscular imbalance between the lower jaw and the upper jaw. The patient may accommodate for many years as he/she are growing, then suddenly develop myofacial pain dysfunction and TMJD.

Recognizing the allergic child: “Listen and Observe”!

  

Most allergic children can be recognized by the following:

• Allergic shiners bellow the eyes (dark lines)
• Intermittent hearing difficulties
• Complaint of stuffy ears, full ears, popping ears, fullness of head, vertigo
• Loss of smell and taste
• Sounds of an allergic child: nasal speech, constantly clearing throat, wheezing, frequent gulping
• Open mouth syndrome
• Forward head posture
• Shoulders are hanging and rolled forward
• Body seems bend and collapsed
• Adenoidal facial expression
• Teeth of the upper jaw are forward and retrognathic lower jaw
• Lower lips dry and rolled
• Bed wetting
• Snoring
• Sleep apnea
• Growth failure

In children, growth failure and short stature are the major manifestations of Growth Hormone deficiency, where the most intense period of growth hormone release is shortly after the onset of deep sleep. An allergic child that is a mouth breather has insufficient deep sleep stages.

As always, a primary diagnosis should come from your physician and, or pediatrician. A dentist’s role should aid in primary recognition and making the parent aware of these problems and recommend appropriate medical evaluation of the child.