Night grinding (nocturnal bruxism)* is a very common occurrence in children. It is possible that it could be caused by the stresses of everyday life which is new to a child. Some theories include attempting to open up the middle ear to equalize the pressure. Regardless of the cause, most childhood grinding does not need to be treated. A majority of the cases tend to clear up as the child gets older. I have seen many cases where a child has ground their baby teeth down to little numbs only to end up with a fully healthy set of permanent teeth. The first line of defense for night grinding in an adult is the construction of a nightguard. However, a child is actively growing and wearing a nightguard can stunt the growth of the roof of the mouth, causing more problems in the future than there would have been with no treatment. So if you go into your child’s room at night and hear sounds of gnashing teeth reverberating off the walls, don’t be too concerned.
There is no need to worry about your child’s thumb-sucking habit during their pre-school years, however, if they have not stopped by the time that the permanent teeth come in, then life long damage can occur. Many times, peer pressure in school alone can cause a child to stop the habit. However, an occasional child will still persist, especially at night while sleeping. Many methods have been proposed and tried to break the habit. No one technique works for every child. There are positive and negative ways. Using positive reinforcement can be very effective but requires a lot of work. You can get a calendar and stick a star on for everyday that the child doesn’t suck their thumb. So many days in a row can earn a reward. This requires lots of parental participation and is difficult to break nighttime sucking. Other methods include wrapping the thumb in tape or gauze or placing a sock over it while sleeping.
By not stopping a thumb-sucking habit by the time that the permanent teeth erupt, the child will not swallow properly. This causes a dreadful muscle imbalance which affects the direction and growth of the jaw bones and the final placement of the teeth. The upper arch tends to be long and narrow since the tongue tends to thrust forward with each swallow. The lower jaw will tend to be smaller because the tongue will usually be swallowing forward. Once the thumb-sucking habit is stopped, the orthodontic problems persist since the muscles are in imbalance. When orthodontic treatment is done, the muscle imbalance and swallowing issues must be addressed or else rapid relapse can occur. Things such as myofunctional therapy or tongue exercises are best instituted before any orthodontics is started. This will allow for a much more stable result.
Thumb-sucking is a natural reflex for babies. The habit can continue for the first few years of childhood without any permanent damage being done. However, if the habit is not discontinued by the time that the permanent teeth erupt, then the mouth can become permanently deformed. The classic look of a chronic thumbsucker is tiny prominent upper central incisors (or buck teeth) along with a receded chin. It’s possible that there can be a speech impediment also. It’s not really the pressure of the thumb physically pulling the teeth forward that causes the deformity. When the thumb is present when the child swallows, it redirects the tongue downwards away from its natural position in the roof of the mouth. When the thumb is not present, the tongue will continue to thrust forward causing the upper teeth to shift forward and the pressure from the cheeks will collapse the arches inward.