What To Do About A Child Who Grinds Their Teeth and Snores?

Why Do Children Grind Their Teeth?

In years past, it was thought that children who ground their teeth and snored would grow out of it eventually. And the conventional wisdom was in some small way right. After a certain age, a good number of these kids did seem to stop these behaviors (we’ll get to why in just a bit). What many doctors didn’t realize is that in the intervening time, there could be some significant health issues that developed as a result of what is known as sleep disordered breathing (SDB).

What we are starting to learn now is that children who grind their teeth and snore often have sleep disordered breathing. This is a condition in which their body isn’t getting enough oxygen as they sleep during the night. In order to get more oxygen, their body wakes them up to take a breath. They are back asleep almost immediately, never remembering all these awakenings. This can happen dozens of times an hour, all night long.

You might be thinking, “That only happens in overweight, middle aged men, right?”. That is what everyone used to think too. We are finding out that sleep disordered breathing is a problem for a lot of people, not just overweight middle aged men. It affects everyone from very young children, to skinny young mothers, to the very elderly.

Back to the grinding part. We believe that the grinding is a result of the sleep disordered breathing. The grinding may help them wake up enough to breath correctly. It is no longer thought that stress or anxiety leads to nighttime grinding in children. It may possibly lead to daytime grinding, but not nighttime.

What Causes Snoring In Kids?

Snoring itself is a result of air moving through tissues that aren’t quite large enough causing loud vibrations. It can be loud enough to wake up people asleep several rooms away. Yes, even in kids it can be loud enough to wake the dead. Even if it isn’t loud, it can still mean that there is an issue.

There are a lot of different areas that the snoring can originate from in children. These include the nose, tongue, palate, or tonsils. Knowing what area/s the snoring is originating from can help to know how to treat it.

Snoring can be chronic (happening consistently) or acute (limited duration). Chronic snoring is usually a result of over-enlarged tissues (especially tonsils and adenoids). Being overweight is a major risk factor for chronic snoring in children. Acute snoring is more often related to allergies and colds and will often go away once the source is removed.

As we discussed just a bit ago, a lot of kids do grow out of snoring. Many times as they grow, their tonsils and adenoids shrink in size as compared to the airway. This shrinking can be enough to open their airway to a healthy level. So if this is the case, why do we need to treat children for sleep snoring. It’ll just go away with time right? The major problem is what happens in the meantime by not treating it. What we are finding out now is that it can cause some major behavioral and mood disorders and possibly affect their overall growth.

If your child is snoring often enough that you notice, I highly recommend you have an evaluation done by your dentist and ENT for some of the risk factors we’ll go over in just a bit.

What Are The Dangers of Disordered Sleep in Children?

Sleep disordered breathing has been linked to a variety of different developmental issues with children. These include:

• Mood disorders. How grumpy and unhappy would you be if you got poor sleep every night?
• Behavior disorders, with a particular emphasis on disorders similar to ADHD
• Poor academic performance
• Poor growth
• Higher incidence of poor jaw development (leading to the need for braces later on)

In adults with sleep disordered breathing, such as obstructive sleep apnea, we know that they develop major health issues such as high blood pressure, diabetes, heart disease, stroke, and mental deterioration at a much higher rate than the regular population. Their lifespan is reduced by 5-10 years, easily.

If this is what happens to adults with sleep disordered breathing, what do you think it does to children as they developing? Unfortunately, we don’t have the answers to this yet, but we do know that it has been correlated with poor outcomes for certain measures of behavior and development.

What Are Some of the Warning Signs For A Sleep Disorder?

• Snoring
• Grinding teeth at night
• Excessive daytime sleepiness
• Large tonsils
• Overweight for their age
• Overactive behavior (inadequate sleep can cause a paradoxical effect where the child exhibits even more overactive behavior)
• Mouth Breathing (open mouth at rest, sleeping with their mouth open) – Your dentist will also notice very specific dental symptoms related to mouth breathing. The gum tissues in a person who breathes through their mouth tend to be extremely red and irritated on the top, front teeth.
• Unusual stress or anxiety
• Consistent bed-wetting

How Do We Treat Sleep Disordered Breathing In Children?

As opposed to adults, treating sleep disordered breathing in children is pretty straightforward. In most children, removing the tonsils and adenoids opens up the airway enough to allow proper air flow.

For children who have a narrow palate structure, they may also need early intervention by a qualified orthodontist. In most of these cases the orthodontist will place a palatal expander, which is a device that is fixed in place and slowly widens their upper arch of teeth. This treatment must be done early on, while the child is still growing, usually around age 7-9, in order to achieve the best effects.

Some children who are overweight, may also need help in losing the additional weight to fully treat their issues with sleep disordered breathing. Being overweight makes it so that their is additional tissue in the airway, blocking adequate airflow.

If your child suffers from frequent colds or allergies, it may be helpful to start on maintenance medications to keep them from becoming an issue. These include medications such as antihistamines for allergies (Claritin, Zyrtec, etc).

Why I Care About This Subject

I’m passionate about this subject, not only because I’m a dentist, but because I have four kids of my own. At the time of this writing, one of my children had his tonsils and adenoids out just months ago. He had many of the classic symptoms of sleep disordered breathing. His twin brother was constantly up because of his brother’s snoring. The snoring has stopped and he appears to get far better sleep than he used to. My only regret is that we didn’t have the surgery done sooner.