Tooth Grinding – Possible Causes & What You Can Do

While most kids outgrow grinding their teeth, intervention may be necessary if they don’t.  Tooth grinding over a prolonged period (especially with permanent teeth) may put them at risk for worn-down teeth, tooth sensitivity, jaw pain, headaches, etc.  There is no one accepted reason as to why it happens, but there are several factors that may be contributing to the problem:

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Tooth Grinding Tips

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DENTAL PROBLEMS

First and foremost, I recommend that you see a dentist to rule out any underlying medical issues that may be the cause of tooth grinding, such as an abnormal bite, misaligned teeth, etc.  A dentist may also recommend a bite guard, especially if the problem only persists at night.
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MEDICATION SIDE EFFECT

Check the medications that your child is on.  Is tooth grinding a side effect?  If so, consult with his doctors to see if there is a suitable alternative.
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Mouth Stuffing & Food Pocketing

How can I keep my son from stuffing his mouth with food, not properly chewing, then getting choked when he swallows?  He is 5 years old and Autistic.  Do you have any idea why he does this?  I assume it has something to do with his oral sensory needs, but I am not sure.
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Yes, you’re right!  It very much has to do with his sensory needs.  Mouth stuffing and food pocketing are common symptoms of oral hyposensitivity, which is just a fancy term for not being fully able to fully feel what’s going on inside your mouth.  Hypersensitive individuals are under-sensitive with limited oral awareness.  As a result, they may stuff their mouths in an attempt to actually feel the food.  Small bites do not provide enough sensory information; it is only with larger bites that they are able to feel food in their cheeks and on their tongues.  And without that input, it’s hard to develop a correct chewing and swallowing pattern.  Imagine not being able to feel food in your mouth – not only is it difficult to manage the food, but it’s also scary!  So you’ll need to to work on increasing oral awareness and normalizing his sensations.
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Also, I wonder if he is eating too fast and needs to be paced.  Take a bite of whatever he is eating and count how many chews it takes you to break down the food.  Then tell him he needs to chew at least __ amount of times for each bite.  Let him swallow, count to three, and then allow him to take another bite.  This should slow him down.  You can create a visual schedule with words or pictures to show him these steps.
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It may also help to show him exactly how big a bite is supposed to be.  You can cut the pieces into the right sizes for him.  Or, you can slide a piece of food through the Right Bite.  This will allow you to present exactly the right portion to him so that he can see how much he is supposed to bite.  Over time, he will get better at visually judging the food.
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As always, it is best to consult a speech-language pathologist and/or occupational therapist trained in sensory issues for a full evaluation in person.
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I hope this helps!  Let me know if you have any other questions,

Debbie
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Tips for Toothbrushing with Oral Defensiveness

Oral defensiveness falls into two main categories: HYPOsensitivity and HYPERsensitivity.  Individuals with hyposensitivities have low oral tone and very little awareness of what’s going on inside their mouths.  This “oral numbness” so to speak can cause anxiety and fear when it comes to toothbrushing.  On the other hand, individuals with hypersensitivities are overly conscious of and sensitive to oral stimulation.  Even the slightest touch can be overwhelming and even painful.  In both cases, it is important to normalize sensation within the oral cavity in order to take care of those pearly whites!
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Gum Massage for Oral Stimulation

Gum massage is a simple yet effective way to provide oral stimulation to a large surface area within the mouth.  This tactile input can:
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•  help decrease oral aversions for hypersensitive individuals
•  help increase oral awareness for hyposensitive individuals
•  help decrease drooling, mouth stuffing, and/or the need the chew
•  be very calming and enjoyable

 

Gum Massage Sensory Input

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For example, I once worked with a child who was mouthing inappropriate objects in the classroom – her hands, pencils, rulers, etc.  So during therapy, I massaged her gums every 10-15 minutes throughout the session.  She completely melted as soon as I started – she enjoyed it so much!  I showed her parents how to do this at home, and eventually along with other sensory strategies, her need to chew subsided.

 

There are many ways to massage the gums, so I’ll describe what is most comfortable for me (right-handed):

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1.  Place your pointer finger just above the upper middle teeth.  Move it across the gums to the back right molars and back to where you began.  Repeat about 3 times.  Then repeat the same motion on the lower gums.
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2.  Use your thumb to repeat the same movement on the other side of the mouth.  Start above the upper middle teeth and move your thumb along the gums to the back left molar area.  Repeat about 3 times.  Then repeat the same motion on the lower gums.
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3.  During each step, notice the child’s response and adjust accordingly.  Is he/she relaxing?  Great!  Is he/she tensing?  Try decreasing the number of repetitions, slowly working up to more over time.  Even just a slight touch is progress.  Make a note of the progress and try to go further in the next session.  Repeat this exercise several times throughout the day, as often as possible.  It MUST be done on a routine basis to have effect.

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Instead of your fingers, you can also use the Z-Vibe with the soft Brush Tip, which has pliable bristles for a gentle massage.  If turned on, the Z-Vibe’s smooth vibration provides additional sensory input and awareness.

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ARK’s GrabbersY-Chews, Krypto-Bite, and/or Brick Stick are another safe way to provide oral stimulation.  These chewies have long extensions that can reach all the way to the back molars for proprioceptive input to the jaw.  The textured versions provide additional sensory feedback, and they come in three color-coded toughness levels for mild to moderate to avid chewing.  To view all of the different options, click here.

 

If you can’t get into the mouth for gum massage, try doing it outside the mouth first (on the cheeks along where the gums are).   And be sure read this article on oral defensiveness.

 

All my best,

Debbie

 

Oral Defensiveness & Aversions with Sensory Processing Disorder (SPD)

Oral defensiveness falls into two main categories: HYPOsensitivity and HYPERsensitivity:
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•  Individuals with hyposensitivities have low oral tone and very little awareness of what’s going on inside their mouths.  This “oral numbness” so to speak can cause significant speech and feeding delays.  For example, the ability to create a food bolus is a critical oral motor skill necessary for swallowing.  But how can I teach this skill to an individual who cannot feel his tongue?  Lack of awareness can also lead to mouth stuffing, leftover food particles in and around the mouth, drooling, etc.  In these cases, it is important to increase oral awareness by providing varied oral input and sensation throughout the oral cavity.  It is at this point, however, that hyposensitive individuals can become orally defensive.  Because they are not used to new feelings and sensations inside theirs mouths, they may be afraid/unsure of the sensations and therefore refuse intervention.

•  On the other hand, individuals with hypersensitivities are overly sensitive to oral stimulation.  Even the slightest touch might be uncomfortable and even painful, which can lead to texture/food aversions, picky eating, and speech and feeding delays.  Let’s say, for instance, that an individual needs to work on tongue lateralization.  To do this, I usually use an oro-Navigator to guide the tongue to one side of the mouth and then to the other.  Or, I’ll place the Probe Tip inside the cheek area and tell the individual to touch it with the tip of his tongue.  But how can we do these exercises if the individual won’t allow anything near his mouth because it hurts?
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Although these two forms of oral defensiveness are different, intervention is quite similar for both – you need to get into the mouth and provide input in order to normalize sensation.  As you proceed with the strategies below, keep in mind that there is no one approach or one answer.  Each individual has different needs that will in turn require a different approach.
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