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Good Morning.

Most of us were taught to think of pediatric bruxism as a habit, a phase, or at worst something to “watch and wait.”

But sometimes, grinding isn’t a dental problem at all.
It’s the nervous system talking.

In today’s edition of More Than Teeth, we take a closer look at why pediatric bruxism may be one of the earliest and most visible signs of nighttime physiologic stress, and how, in one young patient, it became a clue that helped explain far more than tooth wear.

5-minute read👇

The Case (Briefly Revisited)

This is the same 5-year-old boy we discussed last week, the child diagnosed at age three with idiopathic intracranial hypertension (IIH) after an extensive neurologic, endocrine, and genetic workup.

Among the many symptoms his mother noticed early on:

• Loud, frequent teeth grinding

• Restless sleep

• Chronic congestion

• Poor growth

• Headaches and mood dysregulation

What stood out to us was not any single symptom, but how well they all fit together once the airway and nervous system were considered as part of the same story.

Bruxism Is Not Random. It’s Organized.

During sleep, the body is supposed to downshift.

Heart rate slows.
Cortisol drops.
Growth hormone rises.
The parasympathetic nervous system takes the wheel.

But when airflow is restricted, especially through the nose, the brainstem doesn’t interpret that as “sleep.”

It interprets it as a threat.

Research has consistently shown that sleep-disordered breathing increases sympathetic nervous system activity, even in children. The result is repeated micro-arousals, elevated nighttime stress hormones, and an inability to fully settle into restorative sleep stages.¹ ²

In that environment, bruxism begins to make sense.

Why the Jaw Gets Involved

Grinding is not a random movement. It is neurologically coordinated.

The trigeminal nerve, one of the most powerful sensory nerves in the body, has direct connections to:

• Brainstem respiratory centers

• Autonomic regulation

• Arousal pathways

When breathing becomes unstable during sleep, the jaw often responds with:

• Mandibular advancement attempts

• Increased muscle tone

• Rhythmic clenching or grinding

Multiple studies have shown a strong association between sleep bruxism and sleep-disordered breathing, particularly in children.³ ⁴

In other words, the jaw may be trying to help stabilize the airway when the airway cannot do so on its own.

Bruxism as a Marker of Sympathetic Overdrive

This is where things get interesting.

Chronic sympathetic activation doesn’t just affect sleep; it affects everything downstream:

• Growth hormone suppression⁵

• Poor appetite and digestion

• Impaired emotional regulation

• Increased inflammatory signaling

• Venous congestion and impaired cranial drainage

Seen through this lens, bruxism isn’t an isolated dental finding.
It’s a visible marker of an autonomic system that never fully powers down.

And importantly:
This is not pathology. It’s an adaptation.

What Changed When the Airway Changed

In this case, the treatment first aimed to help with nasal breathing and make breathing easier. Then, gentle support was provided to help develop the teeth. As nighttime breathing improved, several positive changes occurred without directly addressing teeth grinding: Grinding decreased, sleep became deeper and more restful, mood improved, headaches occurred less often, growth became more normal, and the jaw didn’t need to fight anymore because the airway stopped asking it to.

A Simple Reframe for Clinicians

Instead of asking, "How do we stop the grinding?" try asking, "What stress is this child dealing with at night?" This question changes how we see teeth grinding, when we take action, and who we work with. It also highlights the role of dentistry in observing overall body health.

Cathy’s Corner

(A Functional Nutrition Lens for Parents)

Nutrition Basics for Kids Who Grind Their Teeth

Teeth grinding is a sign that the nervous system is working overtime. Food should calm the system, not stress it.

Focus on:

• Simple, whole foods that are easy to digest

• Soft fruits, cooked vegetables, eggs, yogurt

• Soups, stews, rice, oats, potatoes

Limit (especially at night):

• Processed snacks and sugary foods

• Acidic drinks and frequent grazing

• Very hard or sticky foods

Support relaxation:

• Nutrients like magnesium, iron, B-vitamins, and zinc matter

• Food first; supplements only if needed

Bottom line: calm digestion helps calm sleep, and calmer sleep means less grinding.

Selected References with Links

1. O’Brien LM, Gozal D. Autonomic dysfunction in children with sleep-disordered breathing. Sleep. 2005;28(6):747–752.

2. Walter LM, et al. Autonomic dysfunction in children with sleep-disordered breathing. Sleep. 2013.

3. Manfredini D, et al. Sleep bruxism and obstructive sleep apnea: a systematic review. J Oral Rehabil. 2015.

4. Huynh N, et al. Sleep bruxism is associated with arousals and breathing disturbances. Sleep. 2006.

5. Van Cauter E, et al. Sleep and growth hormone regulation. Endocrine Reviews. 2000.

6. Guilleminault C, et al. Abnormal blood pressure in prepubertal children with sleep-disordered breathing. Pediatric Research. 2004.

7. Sugita Y, et al. Sleep apnea and intracranial pressure. Chest. 1985.

Final Thought

Pediatric bruxism deserves more respect—not because it damages teeth, but because it often tells the truth long before anything else does.

Sometimes, the mouth isn’t the problem.
It’s the messenger.

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Until next week,
Dr. Michael & Cathy Bennett
More Than Teeth | A Mission for Generational Health