Ask Dr. Marla: Grinding Teeth in a Three-Year-Old

By Dr. Marla Shapiro on April 18, 2011
My three-year-old son grinds his teeth a lot at night. I was told it was a symptom of worms and I should be giving him “worm medicine”. I remember taking it myself as a child, but is it given anymore and is teeth grinding truly a symptom of some kind of disorder?

A. Grinding at night is called nocturnal bruxism. It is not uncommon in children. The cause of grinding is poorly understood. We do know that in both children and adults grinding and or clenching of the teeth and the associated muscles can be stress-related.
That kind of stress can be emotional or physical. In fact, anything that stresses a child, whether it’s an earache, an intestinal infection or even a tooth eruption, can be manifested in nocturnal grinding.
I turned to my dental colleague Dr. Mindy Cash, in the Department or Oral Radiology at the University of Toronto. She reminded me that grinding often goes undetected until its effects are seen by the dentist or physician. In very young children grinding is often reported with the eruption and early contact of the opposing upper and lower teeth. It often disappears on its own, without need for any treatment. In more severe cases, where the condition lasts for long periods of time, it can result in both muscular and tooth-related changes. In these situations, intervention may become necessary.
You ask whether or not this could be a symptom of worms and whether or not you should be giving worm medicine. While the answer is likely not, the correlation has been proposed between the presence of intestinal parasites and the symptom of bruxism. To put closure on this, Dr. Cash searched the dental literature for ParentsCanada.
A study conducted by Diaz-Serrano et al was published in The Journal of Dentistry for Children in September of 2008. It found no relationship between the symptom of nocturnal bruxism and intestinal parasitic infections in children.
If you are concerned about teeth grinding or you are seeing symptoms such as tooth sensitivity, broken restorations, headaches, earache, or tooth or jaw pain, then consultation with a medical or dental practitioner would be advised.

Worm facts

  • Parasitic worms live inside their hosts and feed off them, causing weakness and disease.
  • The most common kind of parasitic worm in North America is the pinworm, estimated to affect one-third of Canadian children between ages five to 10.
  • Symptoms include itchy anus, and in severe cases, weight loss, restlessness and irritability.
  • Pinworm is not a result of poor hygiene, but more likely due to unsanitary living conditions or food preparation.
  • Ringworm is not actually a parasitic worm, it’s a skin infection caused by a fungus.

Published in May, 2011.

Click here to submit your question for consideration by Dr. Marla.


By Dr. Marla Shapiro| April 18, 2011

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