|
Many parents first realize that their child grinds his
teeth when they hear loud "tooth gnashing" sounds coming
from the youngster's bedroom during sleep. Other times, parents
initially encounter nighttime grinding while on a vacation trip when
children and parents often share a hotel bedroom.
While nocturnal grinding can be very loud and
disturbing to others, the child is usually unaware of his potentially
harmful chewing habit.
There is a professional controversy that surrounds the
cause of grinding or bruxing, whether treatment is required and, if
so, what is the best course to pursue.
All grinding does not harm the teeth, especially in
very young children if the grinding is only of a sporadic nature. For
example, episodic grinding often accompanies periods of nasal
congestion, sinus infections, earaches or seasonal allergies. When
these conditions are resolved, the grinding frequently spontaneously
ceases as well. There are those instances, however, when the grinding
becomes an unconscious habit and continues long after the original
associated medical problem disappears.
The harmful effects that can occur from chronic
bruxing can be avoided or reduced if the grinding is recognized early.
Continued grinding can become pathologic and, in time, destroy healthy
tooth enamel and result in the need for dental restoration to the
involved teeth, and even rehabilitation of the entire bite pattern.
While it is beneficial to determine the cause of
grinding in order to get proper medical attention and-or medication,
in cases of a neurological or psychological stress component the
dental treatment is usually the same.
Bruxing that continues into the mixed dentition
period, that is, during the time that children have a combination of
both primary and permanent teeth, can often be seen as small visual
"wear" spots on the chewing surfaces of the teeth. However,
due to the significant thickness of enamel on primary teeth, wear is
often not noticed until the late teens or early 20's.
Educating patients about tooth destruction caused by
harmful grinding habits, along with the fabrication of a bite guard
appliance, is the most common approach to treatment.
A good bite guard, sometimes referred to as an
occlusal splint, is a custom-made mouth guard type of appliance. It is
usually fabricated in a plastic material and can be made to fit either
the upper or lower teeth. The appliance must be made thick enough so
as not to be chewed through too quickly. Properly maintained bite
guards protect the teeth from harmful wear, have an average life
expectancy of 2-8 years and usually are worn every night for sleep,
but can also be worn during the day in times of psychological or
emotional stress.
Dr. Eric Lebowitz, a Pinecrest resident for over 20
years, is a pediatric dentist specializing in dental and orthodontic
care for infants, children and teens. He is in private practice at
Tooth Fairy-Land, located near Baptist Hospital.
|
