Ask a Therapist: Teeth Grinding

Posted by Deborah Grauzam on

My child has no problems with eating or drinking, but grinds his teeth until I want to grind mine! His dentist says it's common in kids with Down syndrome. I saw your teeth grinding items and wondered if they might help? He is 5 years old, does not speak much – he imitates sounds, growls and whale noises from his favorite movies, but has no interest in forming words. He is in speech therapy through school.

Teeth grinding is generally used to help children with special needs to organize their bodies or to calm down; they are seeking stimulation to the temporomandibular joint (TMJ). This joint is where the upper jaw and lower jaw meet right below the ears. Babies suckle their thumbs or suckle on a pacifier to get the same needed stimulation. As your dentist noted, teeth grinding is common in children with the diagnosis of Down syndrome, but there are reasons and a treatment protocol. Because your son is not talking, I suspect he has weakness in the masseter muscles (muscles of the jaw) as related to his diagnosis, he too may need that additional stimulation to the TMJ.

This is such a huge issue that I have written a book on the subject called, Assessment and Treatment of the Jaw.

There is a whole chapter on why kids grind their teeth or have other habits that provide direct stimulation to the TMJ. I encourage you to read the book before you invest in any therapy tools, as it will help you identify what tools and activities would most benefit your son.

In addition, if there is a gap between what your son understands and what he can say, then his jaw weakness may be a primary factor in keeping him from using oral language. You may want to look into having him evaluated by an SLP in your area who is familiar with Oral Placement Therapy. Many SLPs have taken our introduction classes and would be able to work with your son if there are muscle-based deficits related to his difficulty in learning to talk. 

Sara Rosenfeld-Johnson

Ask a Therapist Jaw pacifier Speech Therapy Teeth Grinding TMJ

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Comments


  • My two year old son has Down syndrome and not talking yet. He chatters his teeth constantly and grinds periodically. I have asked all his doctors for help and advice with no answers. Even his OT has little answers. It started a couple months ago around the same time we brought home his baby brother. Just reading the above has shed little light. I need your book, please help. Where can I purchase it? Even used on amazon it’s $75 dollars. Which is more than we can afford. All I want are answers with a solution. Please feel free to email me back. Sincerely a desperate mother. Thank you.

    Melanie on
  • Thank you very much, Sara. I will do what you’ve suggested. My son has speech therapy tomorrow and I’ll speak with his S/L Path about what you’ve suggested. What do you think about things like ARKS grabbers and ZVibes and chews?
    Oh – I have the book on hold from the library. So until I can buy my own, at least I’ll be able to begin reading it! Thank you so much for your help.

    Moriah on
  • Hi Moriah,
    It is not uncommon for children with jaw weakness or jaw instability to teeth grind, stop and then renew the habit when they are under stress. Surgery can certainly be considered a stressful situation. As I had mentioned above and reiterate in my book, “Assessment and Treatment of the Jaw: Sensory, Feeding and Speech” available through TalkTools at: www.talktools.com, the TMJ (temporomandibular joint) is the site of organization within the human body. What your son is telling you, without using the words, is that he wants stimulation in that joint to calm himself down (to satisfy a need). Once teeth grinding begins and the dentition becomes uneven the habit may continue after the stress has left. The grinding continues to even out the biting surface of the teeth for chewing or may continue just because the child learns the grinding “feels good.” In either case, we know the grinding is detrimental to your son’s teeth and we need to find a way to help him to stop doing it.

    You asked for specific suggestions and here is what I would like you to do. Since your son has the diagnosis of Down syndrome it is likely that he also has jaw weakness. The activities taught in the book, “Assessment and Treatment of the Jaw: Sensory, Feeding and Speech” are used as an alternative to the teeth grinding while addressing the root cause. The activities will improve jaw symmetry, stability and grading. Each of these jaw goals will also improve his feeding skills and his speech clarity. If possible I would ask you to find a Speech-Language Pathologist in your area who has been trained in the TalkTools approach to muscle-based feeding and speech deficits. She or he would be able to direct you through the two primary activities: “Jaw Grading Bite Blocks” and the “Bite-Tube Hierarchy.” Used together these should reduce and hopefully eliminate the teeth grinding. Additional activities in the book include: teaching him to chew gum without swallowing the gum, chewing on his back molars and a variety of other activities to address the identified jaw muscle needs.

    As in all cases it is best to read the entire book first to identify your son’s specific needs and then to choose the activities that he enjoys. An ideal time to practice each activity would be when he is teeth grinding. In this way you will give him an alternative that will help him while acknowledging the fact that he needs stimulation to the TMJ.
    I hope this helps-

    Sara

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