Parents hear their child grinding their teeth at night. The noise can be striking—almost worrying. The next question is almost always the same: is it serious, should we consult?
It’s one of the most common reasons for consultation in pediatric dentistry. My answer is based on an important clinical fact, often unknown to parents: bruxism in children is mostly physiological, unlike adult bruxism, which is pathological.
Here is how I approach this question at Dental Swiss Clinics in Montreux.
Child bruxism is not the same as adult bruxism
This is the fundamental distinction to make from the outset.
In adults, bruxism is a pathological phenomenon. It wears down teeth, reduces the vertical dimension, and sets the stage for long-term aesthetic and functional complications. Managing it is a serious clinical decision.
In children, the situation is different. As long as the dentition is not stable—meaning throughout the primary dentition period and then the mixed dentition period—bruxism is most often a physiological manifestation linked to dental development, maturation of the neuromuscular system, and the natural occlusal instability of this stage.
It does not lead to lasting complications. It usually decreases and disappears once stable permanent dentition is established.
What the literature says
Epidemiological studies confirm this clinical interpretation. The prevalence of bruxism is significantly higher in children (up to 40% in some studies, with an average around 15% in 5–6-year-olds) than in adults (around 5%).
This spontaneous decrease with age is consistent with the hypothesis of a phenomenon linked to maturation of the nervous system and the establishment of a stable occlusion. Research has not confirmed a significant causal link between occlusal discrepancies and bruxism, which rules out purely mechanical explanations.
The critical age is between 7 and 10 years, which corresponds to mixed dentition. Frequency naturally decreases as the first permanent molars and incisors come in.
What objectively reassures parents
Three concrete points can be shared with worried parents.
First, child bruxism is common. About one in five to one in ten children grind their teeth at some point during childhood. It’s not a rare individual abnormality; it’s a common developmental variation.
Second, it decreases naturally. Longitudinal studies confirm that prevalence drops sharply between childhood and adulthood. The vast majority of children who grind their teeth will not become adults who grind their teeth.
Third, wear on primary teeth is physiological. The occlusal surfaces of baby teeth naturally wear down with use. Some visible wear is not necessarily a sign of a problem; it can be a normal progression.
Another common reason for consultation
It’s worth mentioning a related clinical situation that also brings many parents in for a consultation: the eruption of permanent incisors behind baby teeth.
When the lower permanent incisors start to come in, they sometimes appear behind the primary teeth that are still present. Parents then discover a “double row” that worries them. This is a temporary, generally benign situation. Baby teeth gradually fall out, and the permanent incisors naturally move into place.
It’s not bruxism, but it’s an equivalent source of parental concern, and it deserves the same approach: reassure, explain, monitor.
When a clinical assessment is needed
Physiological bruxism in children does not require intervention. However, certain situations justify a more careful clinical assessment.
Jaw or joint pain
If the child complains of jaw pain on waking, facial tension, or difficulty opening their mouth, an assessment is indicated. These symptoms may signal temporomandibular dysfunction.
Severe wear or fractures
Marked wear that goes beyond simple physiological attrition, or dental fractures, warrant an assessment. This is rare in children, but possible in some cases of intense bruxism associated with other factors.
Persistence with stable permanent dentition
If bruxism persists after permanent dentition is fully established (generally from age 12–13), the situation changes. It moves beyond physiological and becomes closer to pathological, and management may become relevant.
Anxiety or significant stress
Bruxism can be exacerbated by significant stress, school anxiety, or family difficulties. In these cases, management is not dental but global, sometimes with the help of a child psychologist.
What I don’t recommend
In children with primary or mixed dentition, I do not recommend a bruxism splint. Three reasons.
First, the appliance would be poorly tolerated and rarely worn.
Second, it would disrupt the natural development of the dentition.
Third, there is no proven clinical benefit for a situation that will resolve spontaneously.
This position may seem passive. In reality, it is based on current scientific evidence: in primary bruxism in children, the consensus trend is observation, not intervention.
My clinical approach in summary
When faced with bruxism in a child, my approach is structured.
First, listen to the parents and take their concern seriously. It is legitimate, even if the phenomenon is benign.
Then, examine the child clinically. Look for signs of wear, assess the joint, and check that there is no pain or complication.
Then explain clearly. Bruxism is common, usually physiological, and decreases with age. The dentition is not yet stable; it will stabilise once permanent dentition is established.
Finally, plan follow-up. Check progress in a few months, make sure the situation remains benign, and reassure again if needed.
It’s this combination of listening, examination, explanation and follow-up that best addresses parental concern, without imposing unnecessary treatment on a child.
Frequently Asked Questions
My child grinds their teeth at night— is it serious?
No, in the vast majority of cases. Bruxism in children is common (15% to 40% depending on the studies) and most often physiological. It decreases naturally with age and with the establishment of stable permanent dentition.
From what age should I worry?
If bruxism persists after permanent dentition is fully in place (generally 12–13 years), the situation warrants an assessment. Before that, in the vast majority of cases, observation is enough.
Should my child who grinds their teeth wear a splint?
No, it is not recommended in children with primary or mixed dentition. The splint is poorly tolerated, disrupts natural dental development, and provides no proven benefit for a phenomenon that resolves spontaneously.
Can stress cause bruxism in my child?
Yes, significant stress or school anxiety can exacerbate bruxism. In these cases, a global approach is helpful, sometimes with the support of a child psychologist. The solution is not dental.
When should I consult about my child’s bruxism?
Consult if the child complains of jaw pain, if tooth wear seems excessive, or simply to be reassured. A clinical assessment helps confirm the benign nature of the situation and plan follow-up.
For an assessment for your child, contact Dental Swiss Clinics in Montreux, Monday to Friday from 8am to 8pm.