By Kelley Yost Abrams, PhD

About the Author: Dr. Yost Abrams received her PhD from the University of California, Berkeley, and is a fellow with ZERO TO THREE. She is a parenting expert and early childhood researcher. Dr. Abrams specializes in parent-child attachment relationships, social-emotional development, and infant mental health.

Autism and Teeth Grinding: How to Help Your Child Cope

Autism is a developmental condition known for creating significant challenges in how people interact and communicate. Children with autism often face various medical and behavioral issues, which can make regular dental care more complex. One common problem they experience during sleep is bruxism, where they grind their teeth forcefully.

When children with autism have teeth-grinding issues, communication and behavioral difficulties can make it challenging for dentists to help. However, with careful planning and lots of patience, effective treatment can still lead to positive results. Here, we explain bruxism (teeth grinding) and share tips to manage it in children with autism, providing options for parents and caregivers to explore.

Understanding Bruxism (Teeth Grinding) in Children with Autism

Bruxism is a term used to describe the habit of forcefully grinding or gnashing teeth without a purpose. It's not uncommon, affecting about 10-20% of people. Interestingly, it's more common among children who have special needs. When bruxism happens, it can cause problems like wearing down the teeth too much, pain in the jaw joints, teeth needing to be pulled out, and other dental issues. 

Teeth grinding is a common behavior seen in many children, especially those with autism. Autism is a complex condition, and the reasons behind teeth grinding in kids with ASD can be quite varied.

Let's explore some possible reasons:

Sensory Sensitivities 

Children with autism might have difficulties processing sensory information, including their oral sensations. They may grind their teeth as a way to stimulate their senses or relieve discomfort in their mouths. Sometimes, certain textures or tastes can trigger this behavior. It can be hard for parents to understand these sensory issues fully, but we can think of it as the child finding comfort in this action.

Coping with Stress

The major reason for teeth grinding in autistic children is stress, which can take various forms—physical, mental, or emotional. The challenges that an autistic child might face such as changes in routine or new environments, can lead to anxiety and stress. When confronted with these stressful situations, your child might grind their teeth, much like how someone might twirl their hair when feeling anxious. Teeth grinding, therefore, can be a form of stimming—a self-regulatory behavior used by individuals on the spectrum to find calmness. 

Teeth Grinding as a Communication Tool

Children with ASD often struggle with verbal communication. Teeth grinding might serve as a nonverbal way for them to express discomfort or frustration, much like how some autistic children make unusual noises to communicate.

Medical and Dental Factors in Teeth Grinding

Although less common, medical or dental issues can also contribute to teeth grinding in children with autism. It could be related to conditions like gastroesophageal reflux disease (GERD), ear infections, or teething.

Understanding the reasons behind teeth grinding in autistic children can help parents provide the necessary support and care for their child's unique needs.

Why It's Crucial to Prevent Your Child from Teeth Grinding

Although some children with autism may develop the habit of grinding or clenching their teeth, these actions can lead to cracked teeth, damage, and a higher risk of cavities. Additionally, these habits can increase the likelihood of temporomandibular joint disorder (TMJ), a painful condition known for causing jaw pain, swelling, bite problems, and frequent headaches. Therefore, it's essential for parents and caregivers to assist their child in coping with teeth grinding to prevent these potential issues and ensure their oral health and overall well-being.

Helping Your Child With Autism Cope With Teeth Grinding

Unfortunately, when it comes to treating bruxism in children with autism, there are some challenges. This is because they may have trouble understanding and communicating well, making it harder to use treatments like mouthguards or behavior-changing techniques.

Here are six suggestions for addressing teeth grinding (bruxism) in children with autism:

Early Identification of Stressors

If your child's teeth grinding is a form of stimming, it's like a warning sign for an upcoming meltdown. Quickly identifying and addressing what's bothering them, such as hunger, thirst, noise, or other stimuli, can help prevent stimming and its associated teeth grinding. Remember, stimming is their way of calming themselves down.

Oral Hyposensitivity Support

Hyposensitive children may grind their teeth as they seek extra oral stimulation due to reduced mouth awareness, leading to activities like shirt chewing, pencil gnawing, or tooth grinding. If oral hyposensitivity is the issue, consider consulting a speech therapist or occupational therapist (OT). They can offer strategies to manage the need for sensory input, like using oral chew toys or gum massages.

Include Crunchy Foods

Incorporate crunchy foods into your child's diet, like apples. This daily habit can help satisfy their need for oral stimulation, reducing the urge to chew on non-food items like paper or clothing.

Global Hyposensitivity Support

Global hyposensitivity in children refers to challenges in controlling certain muscles due to reduced muscle tone and body awareness. Teeth grinding can occur when their jaw muscles are inadvertently activated while they try to stabilize their bodies, such as when sitting upright. A physical or occupational therapist can assist if your child's teeth grinding relates to global hyposensitivity. These therapists will help your child develop and manage muscle groups throughout their body, reducing their reliance on oral stimulation.

Consult a Dentist

Another important step is consulting with a dentist to explore potential underlying medical factors contributing to teeth grinding, such as an abnormal bite or misaligned teeth. Speak with your dentist about using mouthguards, especially at night, to protect your child's teeth from damage due to grinding.

Find a dentist experienced with autistic children who welcomes them. Ask how they'll make your child comfortable, possibly through:

  • Office tours or pre-appointments
  • Early appointments to reduce waiting stress
  • Quick dental work
  • Planning for uncooperative moments
  • Consistent staff
  • Your presence during appointments
  • Sedation information

A positive experience ensures proper care and future visits. Choose a dentist focused on comfort for effective results.

Combined Cueing Approach

Consider a combined cueing approach, combining vocal and physical cues, which has been found effective in treating teeth grinding in young children with autism. You can learn more about this approach in a research summary here conducted by the Center for Autism and Related Disorders.

These strategies aim to address and manage teeth grinding in children with autism, providing various options for parents and caregivers to explore.

Caring for Your Child: Steps Forward

This article aims to provide useful insights into why some children with autism grind their teeth. It also offers practical advice for parents and caregivers to assist their children. For a deeper understanding of what to expect during an autism evaluation for your child, we encourage you to explore this informative resource.

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Monroy PG, da Fonseca MA. The use of botulinum toxin in the

treatment of severe bruxism in a patient with autism. Spec Care

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Additional Resources