why does my child grind their teeth at night

The sound is alarming: a loud, gritty scraping from the next pillow at 2 AM. Many parents are surprised to learn how common it is. Grinding or clenching during sleep, called bruxism, is seen in a large share of young children, especially between about three and ten years old, while milk teeth are being replaced by adult teeth.

The usual causes

• A bite in transition. As teeth loosen, fall out and new ones erupt, the way the top and bottom teeth meet keeps changing. Grinding may be part of the jaw finding its way. This is the most common and least worrying reason.
• Sleep and breathing. Enlarged tonsils or adenoids, a blocked nose from allergies (very common in the Pune monsoon and winter), and mouth breathing are linked with grinding. If your child also snores loudly, gasps or pauses in breathing, sleeps restlessly or starts wetting the bed after being dry, mention it to your paediatrician, because these can be signs of disturbed breathing during sleep.
• Stress and routine. Exams, a new school, a new sibling, or screens right up to bedtime can show up as clenching at night.
• Medicines and conditions. Some medicines, including some used for attention difficulties, and certain neurological conditions are associated with grinding. Tell the dentist about every medicine your child takes.

Many families have heard that grinding means worms in the stomach. That link is not well supported by evidence. Deworming should be done as your paediatrician advises, not as a cure for grinding.

Is it doing damage?

In most children, the wear stays on the milk teeth, which are going to be replaced anyway. A dentist will look for:

• flattened or chipped biting edges, especially on the milk canines and molars
• wear that has gone through the enamel into the yellower dentine (the layer under the enamel), which can cause sensitivity
• wear appearing on the new adult teeth, which deserves closer attention
• jaw muscle soreness, clicking, or morning headaches

What can be done

For most children, the answer is simply to watch and review at routine check-ups. A calm bedtime routine, no screens for the last hour, and treating a blocked nose can help.

A night guard (a soft plastic shield worn over the teeth) is rarely made for young children, because their jaws and teeth change so quickly that it would need frequent replacing and could interfere with growth. It may be considered for an older child with adult teeth and significant wear. If a breathing problem is suspected, the right first step is usually a paediatrician or ENT specialist, not a dental appliance.

When to book a check

Book a dental visit if the grinding continues once most adult teeth are in, if teeth look visibly shorter, chipped or sensitive, or if your child complains of jaw pain. For children under 10, a paediatric dental specialist is the right person to assess it. You can read more about grinding in general on our teeth grinding page, and about breathing during sleep on our sleep apnoea page.