Q: My son grinds his teeth in the middle of the night and his front tooth is shorter than the other. What should I do?

Answered by: Dr Kelvin Chee Chun Lin, Paediatrician, Pantai Hospital Cheras (PHC)

Nighttime teeth grinding, or its medical term Sleep-Related Bruxism, is quite common amongst children – one in three children are said to be affected by the time they are six years old. But most of them only occur once in a while and do not cause concern. 

It is believed to be an exaggerated response during the sleep-wake cycle. As a protective mechanism during this cycle, the body displays various involuntary muscle movements. When the chewing muscles are involved in these movements, they manifest as teeth grinding. 

Teeth grinding pattern is unpredictable, and can vary, from night to night, from week to week. Most of the time, it only affects other family members who sleep in the same room, as their sleep is obviously disturbed by the clicking and grating noises. 

In very severe cases, the child may experience aching of these muscles in the morning, due to all the work the muscles had been doing throughout the night. At times, the child’s mouth may suffer self-inflicted bite injuries. Wearing down of the teeth is another possible complication in severe cases, especially when the child does sideways grind. 

In a majority of cases, no specific treatment is needed because they tend to be mild and harmless. But if it occurs on a frequent basis, routine visits to the dentist are advised, to monitor wear and tear of the child’s teeth. Some severe cases may benefit from special mouth devices that protect the teeth. In your child’s case, as the tooth is already worn down, the dentist may need to do restorative procedures.  

It is also important to practice good sleep hygiene and certain behavioural modification can work for older children. Your child’s doctor would be able to help you address this. And sometimes, certain long-term medicines your child is taking, may be the culprit, in which case, dosage adjustment by the doctor would solve the problem.