Bruxism, defined as repetitive jaw-muscle activity characterized by clenching or grinding of the teeth, presents differently in children and adults. Understanding these distinctions is essential for appropriate diagnosis and treatment.
📌 Recommended Article :
Video 🔽 Can children suffer from bruxism? ... Bruxism is an involuntary and parafunctional activity, it is characterized by the grinding and clenching of teeth, and it is usually at bedtime. It occurs with some frequency in children up to about 5 years old.While pediatric bruxism is often self-limiting, adult bruxism is usually multifactorial and chronic, demanding targeted intervention.
Advertisement
✅ Bruxism in Children: Characteristics and Causes
Pediatric bruxism is commonly sleep-related and may occur during tooth eruption, mild airway disturbances, stress, or parasomnias. In most cases, it decreases spontaneously with age.
Key features
▪️ Frequent in children aged 4–12
▪️ Often physiological and self-limiting
▪️ Less associated with chronic pain
▪️ May correlate with occlusal changes, ADHD, sleep-disordered breathing, or anxiety
📌 Recommended Article :
Dental Article 🔽 Occlusal Splints: Types, Benefits, and Who Needs Them ... Occlusal splints, also known as bite guards, night guards, or dental orthotics, are removable dental devices that cover the occlusal (biting) surfaces of teeth.✅ Bruxism in Adults: Characteristics and Causes
Adult bruxism often involves both awake bruxism (AB) and sleep bruxism (SB) with stronger association to stress, anxiety, sleep apnea, substance use (caffeine, alcohol), or medications (SSRIs).
Key features
▪️ More likely to cause muscle pain, TMJ disorders, and tooth wear
▪️ Strong stress-related component
▪️ Associated with sleep fragmentation
▪️ Typically chronic unless underlying cause is treated
📌 Recommended Article :
PDF 🔽 Hall Technique Procedure Manual: Advantages, Disadvantages, Step-by-Step Procedure ... The Hall technique is a safe and effective procedure that prevents the advance of dental caries in primary teeth. One of its great advantages is its low cost and little prior preparation.✅ Clinical Differences: Children vs. Adults
▪️ Etiology: Children—parasomnias and development; Adults—stress, medications, airway issues.
▪️ Symptoms: Adults experience greater pain and damage due to stronger bite forces.
▪️ Progression: Children often improve with age; adults tend to worsen without intervention.
📌 Recommended Article :
PDF 🔽 Alternative for the rehabilitation of pediatric patients with early childhood caries ... Rehabilitation in pediatric dentistry is a challenge since the treatment must be immediate to avoid problems in the child's cooperation. There are several methods to rehabilitate and replace prematurely lost teeth.✅ Evidence-Based Treatments for Children
1. Behavioral and Preventive Approaches
▪️ Sleep hygiene
▪️ Stress reduction strategies
▪️ Management of airway issues (ENT evaluation when needed)
2. Occlusal Splints in Children
Used cautiously and usually short-term to avoid affecting jaw growth. Soft splints may reduce wear in severe cases.
3. Dental Monitoring
Regular evaluation of wear, mobility, restorations, and TMJ health.
📌 Recommended Article :
Video 🔽 Dental trauma in children: What can we do? ... Dental trauma occurs in a higher percentage in children and adolescents. The causes are falls and injuries related to games and sports.✅ Evidence-Based Treatments for Adults
1. Occlusal Splints (Hard Acrylic Night Guards)
Most effective non-invasive treatment to reduce tooth wear and protect restorations.
Types: Full-arch stabilization splints, Michigan splints, and mandibular advancement devices (when sleep apnea is involved).
2. Physiotherapy and Muscle Rehabilitation
Exercises, manual therapy, and thermal therapies help reduce myofascial pain.
3. Stress & Behavioral Management
CBT, relaxation therapy, biofeedback devices.
4. Pharmacologic Therapy (Selective Cases)
Low-dose muscle relaxants or clonazepam for severe sleep bruxism—but not recommended long-term.
5. Botulinum Toxin (BTX-A)
Used in chronic or refractory cases to reduce masseter hyperactivity.
📊 Comparative Table: Consequences of Bruxism (Children vs. Adults)
| Aspect | Advantages | Limitations |
|---|---|---|
| Tooth Wear (Adults) | Early detection allows restorative planning | Severe enamel and dentin loss, fractures |
| Tooth Wear (Children) | Helps identify parafunctions early | May affect eruption patterns and vertical dimension |
| TMJ Disorders (Adults) | Indicates need for physiotherapy or splints | Chronic pain, clicking, limited mouth opening |
| TMJ Symptoms (Children) | Allows monitoring of joint development | Less common but may cause headaches or jaw fatigue |
| Muscle Hypertrophy | Useful diagnostic marker | Facial asymmetry, masseter hypertrophy |
| Dental Hypersensitivity | Encourages preventive remineralization therapy | Can affect eating and oral hygiene behaviors |
| Restoration Failure | Detects weak areas early | Chipping, crown failure, implant overload |
| Sleep Disturbances | Early identification supports sleep evaluation | Fragmented sleep, fatigue, behavioral issues in children |
| Headaches | Prompts differential diagnosis | Can become chronic migraines or morning headaches |
| Behavioral Consequences (Children) | Supports early psychological or pediatric referral | May be associated with anxiety, ADHD, or stress disorders |
| Gingival Trauma | Indicates maladaptive bite forces | Recession or soft tissue abrasion |
| Cracked Tooth Syndrome (Adults) | Early diagnosis improves prognosis | Pain on chewing, restoration loss, complex treatment needs |
💬 Discussion
Although bruxism appears in both children and adults, the pathophysiology, severity, and management differ significantly. Children generally need monitoring and minimal intervention, whereas adults require multimodal, long-term management to prevent complications.
Emerging evidence links bruxism, especially sleep bruxism, to neurophysiological arousal and sleep disturbances, highlighting the need for interdisciplinary evaluation.
✍️ Conclusion
Bruxism in children is usually temporary, whereas adult bruxism is commonly chronic and more destructive. Early identification, individualized management, and preventive strategies are essential for reducing long-term consequences. Dentists should tailor treatment based on age, etiology, and symptom severity, integrating behavioral, dental, and medical approaches.
🔎 Recommendations
▪️ Evaluate for airway issues in children with bruxism.
▪️ Use occlusal splints only when necessary in children.
▪️ For adults, prioritize night guards, stress management, and physiotherapy.
▪️ Refer to sleep specialists when sleep apnea is suspected.
▪️ Monitor tooth wear regularly and consider minimally invasive restorative approaches.
📚 References
✔ Lobbezoo, F., Ahlberg, J., Raphael, K. G., Wetselaar, P., Glaros, A. G., Kato, T., ... & Manfredini, D. (2018). International consensus on the assessment of bruxism. Journal of Oral Rehabilitation, 45(11), 837–844. https://doi.org/10.1111/joor.12663
✔ Manfredini, D., Winocur, E., Guarda-Nardini, L., Paesani, D., & Lobbezoo, F. (2013). Epidemiology of bruxism in adults: A systematic review. Journal of Orofacial Pain, 27(2), 99–110.
✔ Ramos-Jorge, J., Ferreira, M. C., Rodrigues, C. N., et al. (2011). Association between bruxism and behavioral problems in children. Journal of Oral Rehabilitation, 38(11), 859–864. https://doi.org/10.1111/j.1365-2842.2011.02212.x
✔ Okeson, J. P. (2019). Management of Temporomandibular Disorders and Occlusion (8th ed.). Mosby.
📌 More Recommended Items
► Dental Splinting (Ferulization) in Primary and Young Permanent Teeth: Indications and Materials
► What are the consequences of bruxism?
► Is Bruxism a Medical or Dental Problem? Causes, Risks, and Treatments
