The sound of a child grinding their teeth at night can be startling, sometimes loud enough to hear from the next room. Most of the time it is not a cause for alarm. A few patterns are worth acting on, though, and some of them are a question for your pediatrician rather than for us.
How common it is
Nobody has a reliable single number. A 2014 systematic review found that studies put the share of children who grind in their sleep anywhere from 5.9% to 49.6%, a spread the authors linked mainly to the different ways studies defined and detected it. What the sources agree on is that it is common. The American Academy of Pediatrics notes on its HealthyChildren site that grinding is common in toddlers and preschoolers and can begin before a child's first birthday.
Most children grow out of it
The American Academy of Pediatric Dentistry states that the evidence indicates grinding in children is self-limiting and does not persist into adulthood. HealthyChildren says that in most cases it disappears by about age 6, although some children continue into their teens. Research reviews describe it becoming less common from around age 9 or 10. In other words, time alone resolves it for many children, which is why the first step is usually watching rather than treating.
What can set it off
The exact cause in children has not been pinned down, but HealthyChildren lists several contributors. Stress and worry about school, family or friends is a common one. So are teeth that do not line up properly, irritation inside the mouth, pain from teething or an earache, and allergies that affect breathing during sleep. Sleep disorders, conditions such as autism or cerebral palsy, and some medicines, including stimulant medicines for ADHD, can play a part. Research also links secondhand smoke to grinding.
If you think a medicine may be involved, do not stop it on your own. Raise it with the doctor who prescribed it.
Snoring, tonsils and breathing at night
This is the part most worth knowing. In children, grinding sometimes goes along with sleep-disordered breathing. Large tonsils and adenoids can partly block a child's airway during sleep, which leads to snoring and frequent waking. In one study of 140 children aged 4 to 12 who had breathing symptoms from enlarged tonsils and adenoids, parents reported grinding in about a quarter of them before surgery to remove those tissues and in about 7% afterward. That is a single study relying on questionnaires, but it fits the wider picture.
HealthyChildren lists the signs of sleep apnea in children as frequent snoring, problems breathing during the night, sleepiness during the day, difficulty paying attention and behavior problems. The National Heart, Lung, and Blood Institute adds overactivity and bedwetting. If you notice these, tell your pediatrician promptly. Sleep apnea in children is diagnosed and treated by physicians, not dentists. For a child who grinds loudly and never seems rested, HealthyChildren notes that a sleep study may be the next step.
Why we are cautious with night guards
For adults, a custom night guard is the usual first step. Children are different, because their jaws are still growing and their teeth are changing. A 2021 literature review on grinding in children noted that there is only limited data on guards for baby teeth or a mix of baby and adult teeth. It also raised the concern that such a guard could interfere with growth of the bone that holds the teeth, although guards may reduce muscle activity and discomfort.
That does not mean a guard is never right. HealthyChildren notes that dentists often recommend one when they see worrying damage, and a custom guard made from a mold of the child's teeth is more comfortable and effective than a store-bought one. We decide case by case, usually for an older child with real wear or pain. We also plan for the fact that a growing mouth outgrows a guard.
When to see the pediatrician or the dentist
HealthyChildren suggests talking with your child's dentist and doctor if a toddler or preschooler grinds loudly and has ongoing face, ear or jaw pain, if your child grinds loudly and does not seem to get enough rest, or if an older child has chipped, cracked or worn teeth. Snoring, pauses in breathing and daytime sleepiness go to the pediatrician first.
Otherwise, regular checkups are where we track wear over time, alongside the routine care in our guide to preventing cavities in children. If a tooth is chipped or broken in a fall or at sports, that is a different situation. See our advice on emergency dental care for kids. For adult grinding, start with our teeth grinding treatment page or the article on grinding and sleep apnea.
Frequently Asked Questions
Frequently Asked Questions
Frequently Asked Questions
Frequently Asked Questions
Is it normal for my child to grind their teeth at night?+
It is common, especially in toddlers and preschoolers, and most children grow out of it. It is worth mentioning at checkups so we can watch for wear, and worth raising with your pediatrician if your child also snores or seems tired during the day.
Does my child need a night guard?+
Usually not at first. Because a child's jaws are still growing, we use guards cautiously and case by case, most often for an older child with real tooth wear or pain. A custom guard also needs replacing as the mouth grows.
Can teeth grinding be a sign of sleep apnea in children?+
It can go along with it. Enlarged tonsils and adenoids can block a child's airway during sleep, and in one study grinding became much less common after those tissues were removed. Snoring, pauses in breathing, daytime sleepiness or attention problems are reasons to see your pediatrician.
When should I call the dentist about my child's grinding?+
Call if your child has chipped, cracked or worn teeth, or ongoing face, ear or jaw pain. Otherwise, mention it at the next checkup so we can compare wear over time.
Cavities develop gradually, not overnight. Bacteria in your mouth feed on sugars and starches, producing acids that pull minerals from your enamel. Saliva repairs some damage, but frequent acid attacks overwhelm it, and plaque lets bacteria attack the tooth directly. Left unchecked, decay progresses from the enamel into the dentin, pulp, and eventually an abscess. Good hygiene, diet, and regular dental visits keep cavities preventable.