Teeth grinding during sleep, called sleep bruxism, is one of the most common childhood sleep behaviors. It affects somewhere between 6 and 30% of children and adolescents, with rates peaking between ages 10 and 14 before declining into adulthood. Most kids who grind their teeth will stop on their own by around age 6, though some carry the habit into their teens or beyond. The reasons behind it range from simple growing pains to airway problems and stress.
Breathing Problems Are a Major Trigger
One of the most overlooked causes of nighttime teeth grinding in children is difficulty breathing during sleep. When a child’s airway is partially blocked, whether from enlarged tonsils, swollen adenoids, nasal congestion, or allergies, their body may clench and grind the jaw as an unconscious way to reopen the airway. This connection between mouth breathing and bruxism is well documented. Research examining children in mixed dentition (the stage when they have both baby and permanent teeth) found that nasal versus mouth breathing, tongue mobility, and tonsil size were all significant factors in predicting which kids developed sleep bruxism.
If your child snores loudly, breathes through their mouth during sleep, or seems restless at night, those are signs that airway obstruction could be driving the grinding. In these cases, treating the breathing issue, sometimes by removing enlarged tonsils or adenoids, often resolves the bruxism as well.
Stress and Anxiety Play a Real Role
Children process stress differently than adults, and their bodies often express anxiety physically. A new school, a move, conflict at home, test pressure, or even an exciting life change can trigger nighttime grinding. The jaw muscles tense during sleep in much the same way adults might clench their fists or tighten their shoulders under stress. Most researchers agree that high levels of anxiety and stress increase the risk of developing bruxism at any age.
Children with ADHD face a higher risk for a couple of reasons. The condition itself involves impulsivity and hyperactivity that can translate into involuntary jaw clenching. On top of that, some stimulant medications used to manage ADHD are known to cause or worsen teeth grinding. Certain antidepressants and anti-anxiety medications prescribed to children can have the same side effect. If your child started grinding after beginning a new medication, that timing is worth mentioning to their doctor.
Teething, Earaches, and Growing Pains
Younger children, especially toddlers and preschoolers, often grind their teeth in response to physical discomfort. Teething is one of the most common triggers. As new teeth push through the gums, the pressure and irritation can lead a child to clench and rub their teeth together, seemingly to soothe the sensation. Earaches work similarly: the jaw joint sits very close to the ear canal, and pain in that area can prompt grinding as the child unconsciously tries to relieve pressure.
There’s also a developmental component. When new teeth are erupting, children may grind simply because the surfaces feel unfamiliar. Their jaw is adjusting to a changing bite as baby teeth fall out and permanent teeth come in. This type of bruxism is generally harmless and temporary.
How to Tell If Your Child Grinds
The most obvious sign is sound. If you check on your child at night and hear a rhythmic scraping or crunching noise, that’s grinding. A sibling who shares a room may notice it first. But plenty of children grind silently, and in those cases the clues show up during the day.
Watch for complaints of headaches in the morning, especially around the temples. Pain in or around the ears, cheeks, jaw, or neck is also common, particularly after waking up. Your child might say their teeth hurt or that chewing feels uncomfortable. Over time, a dentist may notice wear patterns on the teeth: flattened biting surfaces, small chips, or thinning enamel. Increased tooth sensitivity, especially to cold foods or drinks, can be an early signal.
What Grinding Can Do to Their Teeth
Most childhood bruxism is mild and causes no lasting damage. But in severe or persistent cases, the consequences add up. Enamel, the hard outer layer of the tooth, wears down from the constant friction. Once enamel is gone, it doesn’t grow back. Teeth can become chipped, fractured, or visibly flattened. This damage makes teeth more vulnerable to cavities and sensitivity.
In some children, prolonged grinding puts enough strain on the jaw joint to contribute to temporomandibular joint (TMJ) problems. Symptoms include clicking or popping when opening the mouth, jaw stiffness, and pain that radiates into the face or neck. These issues are uncommon in young children but become more of a concern if grinding persists into the teenage years.
When It Needs Treatment and When It Doesn’t
The International Association of Paediatric Dentistry recommends a case-by-case approach, and the most important takeaway is that many children need no active treatment at all. If your child is grinding but has no pain, no visible tooth damage, and no sleep disruption, the standard approach is to monitor and wait. Most children outgrow it.
When treatment is warranted, the options depend on the underlying cause. If airway obstruction is the issue, addressing that comes first, whether through allergy management, nasal treatments, or surgical removal of enlarged tonsils or adenoids. For stress-related grinding, strategies like a calming bedtime routine, reducing screen time before sleep, and age-appropriate relaxation techniques can help. Cognitive behavioral therapy is an option for older children with significant anxiety.
Occlusal splints (night guards) are sometimes used in children, but less commonly than in adults. A child’s mouth is still growing, and a poorly fitted guard can interfere with dental development. Dentists typically reserve them for kids with permanent teeth who show significant wear. Rapid palatal expansion, a device that widens the upper jaw, is another option when a narrow palate contributes to both breathing issues and bruxism.
What to Watch For Over Time
Keep an ear out at night, and pay attention to what your child reports in the morning. Occasional grinding during a stressful week or while cutting new teeth is normal and expected. Persistent grinding that lasts months, especially if paired with morning jaw pain, headaches, or visible tooth changes, deserves a dental evaluation. Your child’s dentist can check for enamel wear that isn’t visible to the naked eye and help determine whether the grinding is something to treat or simply something to watch.