What possible stress can a four year old have? Many adults grind their teeth, also referred to as “bruxism”, because of emotional stress in their lives. College students may grind their teeth during finals; Married people may grind their teeth when they have financial stresses; Other people may grind their teeth while they are driving in stressful road conditions…but what stress can a young child possibly have that causes them to grind so loud during their sleep that their parents can hear the screetching sounds from down the hallway?
Before completing my fellowship training at LVI (Las Vegas Institute for Advanced Dental Studies) I used to just tell parents, “a lot of kids grind their teeth but they will grow out of it, do not to worry about it”. Now after extensive post doctoral training at LVI, I have a very clear understanding that bruxism in children is most often a result of allergy symptoms.
The incidence of bruxism in allergic children is three times that of non-allergic children. The cause is obstruction of the eustacian tube (ear tube) by enlarged adenoidal tissue. Bruxing, or movement of the jaw from side to side while in contact with the teeth, relieves pressure by activation of a muscle near the opening of the ear tube (the medical pterygoid). This little muscle is attached to the lower jaw and enlarges the eustacian tube opening. As the child moves their jaw from side to side, the little muscle pulls on the ear tube opening, allowing pressure release (sort of like SCUBA divers wiggling their jaw when they dive down below the surface to “equalize” the pressure from the inside of the ear to the outside environment.
Alot of parents ask if teeth grinding will be harmful to their child. With what I now know, most definitely, if a child has allergy symptoms, a whole cascade of airway and dental issues could possibly develop. How does this happen? Allergies are the most common cause of chronic rhinitis (inflammation of the nasal lining) leading to inflammation, nasal congestion, runny nose, and nasal obstruction.
The tonsils and adenoids are lympohid tissues that become hyper-responsive to such irritations from nasal inflammation. In a healthy child, tonsils and adenoids begin to atrophy or disappear at the approximate age of 5 and by puberty, are barely evident. However, in the allergic child with chronic runny nose, the tonsils and adenoids often become enlarged from overuse to fight off the inflammation.
So how do enlarged tonsils and adenoids cause serious dental issues for your child? The tonsils and adenoids are located in the back of the throat in close proximity to the tongue. As the tonsils and adenoids enlarge, they may touch the back of the tongue which causes a proprioceptive response of the tongue to move or “thrust” forward in order to allow more room in the back of the throat for air to pass down the wind pipe. This is also known as “airway obstruction”. If the tonsils and adenoids are filling the air space, something has to get out of the way to allow your child to get enough air to breathe, expecially at night when they are laying down and the tongue falls back. Your child probably has a protective response to push their tongue forward.
So still Dr. Hughes, Cosmetic Dentist Boulder, you ask…what does this all have to do with possible dental problems?
(This is a photo of my daughter, Cami, when I picked her up from school this Monday. She was suffering from a debilitating headache just at the age of 7. I have scheduled an appointment with an Ear, Nose and Throat doctor to evaluate her upper airway. I have noticed she places her tongue forward between her front teeth when she sleeps…she is trying to get air while sleeping.)
With the tongue being out of it’s proper position between the dental arches, the teeth and dental arches shift into an undesireable position as they develop during childhood/adolescence. This causes a bad bite which causes the muscles in a persons head and neck to be out of equilibrium and eventually causing a lifetime of headache/neck/TMJ pain.
Have your child’s teeth grinding evaluated early by a Neruomuscular Dentist and/or an Otolaryngologist (an ear, nose and throat specialist). Dr. Hughes is one of approximately 850 dentists in the US and Canada who have completed this training at LVI. If someone tells you “don’t worry about it, she’ll grow out of it” get a second opinion. It could save your child from a lifetime of unecessary pain and suffering.
For more information on how a bad bite causes headaches, refer to my previous blog from last week, Headaches and Your Bite?.
Dr. Tracey Hughes, Implant dentist Denver