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Teeth grinding in children can be surprisingly loud. Many parents first notice it as a harsh scraping sound from their child’s bedroom, or when the dentist mentions that some teeth look more worn than expected. It can be unsettling, especially if you are not sure whether it is simply a phase or a sign that something more serious is going on.
This guide has been written in the context of Melbourne ENT, a specialist ear, nose and throat clinic in St Kilda East, Victoria. It explains what teeth grinding is, why children do it, what you can do at home, and when it may be time to involve your dentist, GP or an ENT specialist.
Throughout the article we will refer to the experience of Dr Stephen Kleid, ENT and Head & Neck Surgeon, and Dr Simon Braham, ENT and Facial Plastic Surgeon. Both care for children and adults with sleep, breathing and ENT problems at Melbourne ENT and at major Melbourne hospitals, including the Royal Melbourne Hospital and the Royal Victorian Eye and Ear Hospital.
Teeth grinding, or bruxism, is when a child clenches, grinds or gnashes their teeth without meaning to. It can happen while they are asleep or awake. During the day, you might notice your child holding their teeth tightly together when they are concentrating or stressed. At night, it often sounds like a scraping, crunching or squeaking noise.
Parents commonly pick it up because:
The important thing to remember is that your child is not choosing to grind. It is an unconscious habit, often related to changes in teeth, sleep patterns or emotions.
Doctors sometimes talk about sleep bruxism and awake bruxism:
Sleep bruxism is more common in children, but it is useful to notice both patterns. They can sometimes have different triggers and might need slightly different strategies.
Teeth grinding is not rare. Many toddlers and primary school children will grind their teeth at some point. In a large number of cases, the grinding eases as:
That said, if grinding is frequent, very loud, or associated with pain, snoring or disturbed sleep, it is sensible to have it properly assessed rather than waiting and worrying.
There is usually more than one reason. Think of teeth grinding as a “perfect storm” of small factors that add up.
When baby teeth come through, and later when permanent teeth erupt, the bite is constantly changing. Children explore new tooth positions without realising it. Grinding can be part of this process. It is especially common:
In many children this is a normal stage. However, if the grinding is intense, or your dentist can see damage, it still deserves attention.
Children in Melbourne often lead very full lives with school, sport, music, tutoring and social activities. Even enjoyable activities can be tiring when there are too many of them. Add in everyday worries about friendships, homework or big life changes, and it is easy to see how stress might creep in.
Some children show stress outwardly with tears or tantrums. Others show it in their bodies, with:
Grinding is never “all in their head”. It is a real physical response and a sign that their system is working hard.
The way the teeth and jaws meet can also influence grinding. If the bite is not comfortable, the jaw muscles may become more active as they try to find a better position. Factors can include:
Your family dentist or paediatric dentist will look at these things during a normal check up. If there are concerns, they may suggest an orthodontic assessment to see whether the bite itself is contributing.
From an ENT perspective, teeth grinding often sits in the same story as snoring and disturbed sleep. Many parents who describe grinding will also say that their child:
These signs suggest a form of sleep disordered breathing, sometimes obstructive sleep apnoea, where the airway is partly blocked. In children, common causes include:
When breathing is not smooth, the brain triggers tiny arousals to keep things going. Grinding can happen around those arousals, almost like the jaw tensing to “fight” through the obstruction. This is one of the reasons Melbourne ENT takes teeth grinding seriously when it appears alongside snoring and mouth breathing.
A smaller group of children grind their teeth in the context of other medical or developmental issues. Grinding can be more frequent in some children with:
If your child has a medical diagnosis or is taking regular medications, it is worth flagging the grinding with your GP or paediatrician so it can be considered as part of the overall plan.
Not every child who grinds needs intensive treatment. The key is to look at the bigger picture: teeth, jaw comfort and sleep quality.
You might notice that:
Keeping a simple diary for a week or two can help you and your health providers see patterns more clearly.
Over time, repeated grinding can leave its mark. The teeth may appear:
The cheeks or tongue may also show signs of accidental biting. Your dentist is in the best position to judge how significant these changes are and whether they are likely to progress.
Grinding becomes more concerning when you notice other sleep related signs. For example, if your child:
then grinding may be one visible part of a deeper sleep and airway issue. These are situations where Dr Stephen Kleid or Dr Simon Braham at Melbourne ENT may be able to help.
You cannot simply tell a child to “stop grinding” and expect it to work. But you can support better sleep, reduce stress and protect their teeth.
Think of bedtime as a gentle landing, not an abrupt stop. A simple routine might include a set bedtime, a warm shower or bath, a quiet story and low lights. Keeping the last hour before bed free from tablets, phones and high-energy games makes it easier for the brain and jaw muscles to wind down. Even small changes, applied consistently, can reduce nighttime restlessness.
Try to give your child space each day to talk about their experiences. A short “highs and lows of the day” chat at dinner, or a few minutes of one-on-one time before bed, can encourage them to share worries before they take them to sleep. If you notice ongoing anxiety, sadness or behaviour changes, your GP can guide you on whether extra support with a psychologist or counsellor might help.
During the day, you can gently coach your child to adopt a relaxed mouth position. A helpful phrase is “lips together, teeth apart”, with the tongue resting lightly on the roof of the mouth. If you notice clenching when they are concentrating, a soft reminder to release the jaw and take a slow breath may help reset the habit over time. Encouraging them to avoid chewing on pens, pencils or nails also reduces strain on the teeth and jaw muscles.
In older children and teenagers, caffeine can sneak in through soft drinks, iced tea and energy drinks. Cutting these down in the afternoon and evening can help stabilise sleep. Aim for regular, not overly heavy, meals and good water intake during the day. This is not about strict or complicated diets, just steady habits that keep the body comfortable at night.
If you notice that your child’s mouth hangs open when they are relaxed, or that they always seem blocked up, it may be harder for them to breathe comfortably at night. Simple allergy management, nasal rinses or prescribed sprays (under guidance from your GP or specialist) can sometimes make a real difference. When nasal blockage is persistent or severe, an ENT review at Melbourne ENT can help identify whether tonsils, adenoids or structural issues are contributing.
The family dentist is usually the first port of call once you notice grinding. A review is particularly important if grinding happens on most nights, or if you or your child have noticed any changes in the teeth. The dentist will examine tooth surfaces, look for chips or cracks, check the bite and assess how the jaw moves. They can then advise whether simple observation is enough or whether protective treatment is needed.
Your GP has a broad view of your child’s health. You should consider making a GP appointment if:
The GP can help determine whether further assessments for anxiety, learning difficulties, reflux or other conditions are appropriate, and can coordinate referrals to paediatricians, psychologists or sleep doctors when needed.
An ENT review becomes especially relevant when teeth grinding and sleep symptoms occur together. You might consider Melbourne ENT if:
At Melbourne ENT, Dr Stephen Kleid (ENT and Head & Neck Surgeon) and Dr Simon Braham (ENT and Facial Plastic Surgeon) can assess the nose, throat, tonsils and adenoids, and discuss whether airway narrowing may be contributing to disturbed sleep and grinding.
Children in Melbourne and regional Victoria are often managed through shared care. A typical pathway might include:
The goal is not to collect more appointments, but to have the right people involved at the right time, with clear communication between them.
Assessment begins with a conversation. You may be asked when you first noticed the grinding, how often it occurs, and whether it seems linked to particular events, illnesses or stresses. Questions about snoring, breathing patterns, restlessness and daytime behaviour help build a picture of your child’s sleep quality. A dental examination looks carefully at tooth surfaces, jaw movement and any tenderness. An ENT examination, if needed, focuses on the nose, throat, tonsils and adenoids.
Not every child with grinding needs a sleep study. However, if there is loud snoring, obvious pauses in breathing, or significant daytime effects, a sleep study can be very useful. It records breathing, oxygen levels, heart rate, movements and, in some cases, jaw muscle activity overnight. The results help determine whether your child has obstructive sleep apnoea or another form of sleep disordered breathing and guide whether treatments such as adenotonsillectomy, CPAP or other interventions should be considered.
One of the benefits of attending a specialist practice such as Melbourne ENT is the emphasis on communication. With your permission, reports are shared with your dentist, GP and any other involved specialists. You are given clear explanations of findings and options, and there is time to ask questions. All treatments have potential risks and benefits, and these are carefully discussed before any decisions are made.
In many younger children, especially those with minimal tooth wear, the safest and most appropriate approach is simply to monitor. This does not mean doing nothing. It involves regular dental check ups, attention to sleep routines and stress, and review of any snoring or breathing changes over time. Many children gradually stop grinding as they grow.
When tooth damage or jaw pain is present, dental treatments may be needed. In older children and teenagers, a custom made night guard or splint can protect the teeth from further wear while they sleep. If bite problems such as crowding or significant overbite are identified, orthodontic treatment may be recommended to improve the way the teeth and jaws fit together. Follow up is important, as children’s mouths change as they grow and appliances often need adjustment.
If grinding is linked to snoring or disturbed breathing, managing the airway becomes a key part of treatment. At Melbourne ENT, options might include medical treatment for nasal allergies, monitoring of mild sleep disordered breathing, or surgery in selected cases. Adenotonsillectomy may be discussed where enlarged tonsils and adenoids are clearly obstructing the airway and causing significant sleep apnoea. In older children and adults with structural nasal problems, nasal or sinus surgery might be considered.
Dr Stephen Kleid and Dr Simon Braham draw on their extensive ENT and head and neck surgery experience, including work at the Royal Melbourne Hospital and Royal Victorian Eye and Ear Hospital, to ensure that any procedure is carefully justified, clearly explained and carried out with a strong focus on safety.
Physical treatments work best when emotional health is also supported. Continuing to use calm bedtime routines, teaching relaxation techniques and addressing school or friendship difficulties all contribute to improved sleep. In some cases, psychological support can help children manage anxiety or stress, which may in turn lessen grinding.
No treatment can guarantee that grinding will stop overnight. The main aims are to:
Some children will stop grinding altogether. Others may continue to grind occasionally but with less impact. At Melbourne ENT, treatment plans are tailored to each child and regularly reviewed.
Most of the time, normal growth and genetics play the biggest role in how a child’s face and jaw develop. Severe, long term grinding may contribute to muscle tension or changes in the way the teeth meet, which is why regular dental reviews are still important, but it is unlikely to dramatically change the overall shape of the face on its own.
If the grinding seems to have settled, that is good news. It is still worth asking your dentist to check for wear, cracks or sensitivity at the next visit. Damage that has already occurred will not undo itself, but it can often be repaired, protected or simply monitored if it is minor and stable.
It is possible, although many children with sleep disordered breathing also snore, mouth breathe or sleep restlessly. If grinding is frequent and you are unsure about their breathing, watching them quietly for a few nights can be very useful. If you notice anything worrying, a discussion with your GP or with an ENT specialist at Melbourne ENT can help decide whether further tests are needed.
If there is no tooth wear or sensitivity, that is reassuring, but it does not completely rule out sleep or breathing issues. The question of an ENT assessment depends more on symptoms such as snoring, pauses in breathing, restless sleep and daytime tiredness. If any of these are present, an airway and sleep review at Melbourne ENT may still be beneficial.
Some research has found higher rates of grinding in children with certain neurodevelopmental conditions. This does not mean grinding causes these conditions, or that every child who grinds has them. If you have concerns about attention, learning or behaviour as well as grinding, it is important to raise this with your GP so a broader assessment can be arranged.
Normal sleep can include occasional snuffles, sleep talking or movement. Grinding has a distinctive scratching or crunching sound. If you hear that sound on many nights, if it sits alongside snoring or gasping, or if your child seems tired or irritable during the day, it is sensible to take the next step and talk with your dentist, GP or an ENT specialist.
A good night guard can shield the teeth from damage, particularly in older children and teenagers. If your child continues to snore, mouth breathe, wake often or seem exhausted despite the guard, that is a sign that their airway and sleep should be checked. In those situations, an appointment with Dr Stephen Kleid or Dr Simon Braham at Melbourne ENT can help determine whether an underlying breathing problem is contributing.
Melbourne ENT is a specialist ENT and head and neck practice in St Kilda East, Victoria. Dr Stephen Kleid, ENT and Head & Neck Surgeon, and Dr Simon Braham, ENT and Facial Plastic Surgeon, are both Fellows of the Royal Australasian College of Surgeons and have many years of experience managing paediatric and adult ENT conditions, including snoring, sleep apnoea and nasal obstruction.
The focus at Melbourne ENT is on safe, evidence based care that aims to improve breathing, sleep and quality of life. Non surgical options are always considered first. When surgery is recommended, the reasons, benefits and possible risks are explained in clear language so families can make informed decisions.
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