Why Kids Clench Teeth at Night: Hidden Airway Connection

If your child clenches or grinds their teeth during sleep, it may seem like just an odd or annoying habit. But nighttime teeth clenching (bruxism) is not normal, especially in children. At TMJ Sleep and Breathe Center, Dr. Gary Adams and our team understand that this behavior is often a red flag—signaling a deeper problem with your child’s airway and breathing during sleep.

In this post, we’ll explore:

• Why kids clench their teeth at night
• The airway-sleep connection most parents and doctors miss
• How a small jaw, tongue tie, or poor tongue posture contributes to the problem
• Why traditional approaches often fail
• How we treat the root cause using palatal expanders, tongue/lip tie release, and myofunctional therapy

What Is Nighttime Teeth Clenching in Kids?

Teeth clenching or grinding during sleep—also known as sleep bruxism—involves involuntary, forceful jaw movements that can wear down teeth, cause headaches, disturb sleep, and even lead to TMJ disorders. While some pediatricians may reassure you that it’s “normal” or your child will outgrow it, frequent or intense clenching is a symptom of airway obstruction and requires treatment. Many kids with night time bruxism have pediatric sleep apnea. Explore the signs of sleep apnea in kids.

The Real Cause: Nighttime Airway Obstruction

Children do not clench their teeth for no reason. Bruxism is often the body’s defense mechanism—a built-in alarm to deal with disrupted breathing during sleep. Airway dentists call this sleep disordered breathing. When the tongue falls back into the throat and blocks airflow, the body goes into panic mode. In response, the jaw muscles contract, triggering a clench or grind that can help:

• Partially open the airway
• Stimulate the tongue to move forward
• Shift the body out of deep sleep into lighter stages, reducing the risk of oxygen deprivation

This protective mechanism can occur multiple times per night, leading to fragmented sleep and a cascade of developmental issues.

Why Does the Tongue Obstruct the Airway at Night?

1. Small or Narrow Palate

A narrow upper jaw doesn’t allow the tongue to rest comfortably against the palate. Instead, the tongue drops down and back, increasing the risk of airway blockage.

2. Tongue Tie or Lip Tie

 

When a child has a tongue tie (ankyloglossia), the tongue is physically tethered to the floor of the mouth. This prevents it from achieving proper posture—lightly suctioned to the roof of the mouth. As a result, it tends to collapse back into the throat during sleep and block the airway.

3. Low Tongue Posture

Even without a tie, many children develop poor oral posture from habits like mouth breathing or thumb sucking. If the tongue doesn’t habitually rest on the palate, it’s more likely to fall back when the muscles relax during deep sleep.

4. Mouth Breathing

Mouth breathing, especially during sleep, worsens everything. It lowers tongue posture, dries out the mouth, and often leads to enlarged tonsils and adenoids—further narrowing the airway. Explore ways to stop kids from mouth breathing.

Why This Matters: Consequences of Untreated Bruxism

Ignoring nighttime teeth clenching can result in:

• Tooth wear and enamel erosion
• TMJ dysfunction or jaw pain
• Headaches and facial muscle tension
• Sleep fragmentation and poor sleep quality
• Daytime fatigue or hyperactivity
• Developmental delays or behavioral issues

More importantly, chronic sleep-disordered breathing during a child’s developmental years can alter the way their face grows, how their brain develops, and how their immune system functions.

Traditional Treatments Miss the Root Cause

Pediatricians and even some dentists may recommend:

• “Monitoring” the behavior
• Nightguards or splints
• Anxiety reduction techniques

But these solutions are like putting a bandage on a fire. They do nothing to address why the child is clenching in the first place. In fact, giving a child a nightguard may mask the symptom and delay proper treatment for an underlying airway disorder.

How We Treat the Root Cause at TMJ Sleep and Breathe Center

At our practice, we focus on correcting the anatomical and functional problems that lead to airway obstruction in the first place. Here’s how we do it:

1. Comprehensive Evaluation

We begin with a full evaluation of your child’s airway, tongue posture, jaw development, and sleep patterns. This often includes:

• A clinical exam
• CBCT imaging
• Myofunctional assessment

We look beyond the teeth to understand the full picture of your child’s airway and facial development.

2. Palatal Expansion

We use a Slow Palatal Expansion to gently and biologically widen the upper jaw. Our most popular kids expanders are the Schwarz expander, Myobrace and and ALF appliance. Expanding the palate creates:

• More room for the tongue
• A more open nasal airway
• Improved facial symmetry and bite balance

Unlike rapid expanders that can cause discomfort, dental trauma and cranial imbalances, our slow protocol respects the biology of the cranial bones and ensures long-term, stable results. We also have adult palatal expanders such as the Homeoblock and MARPE combined with clear aligners/Invisalign protocol.

 

 

3. Clear Aligner Therapy (if needed)

Clear aligners such as Invisalign help guide the teeth into better positions and improve the bite without bulky metal braces or any heavy mechanical forces.

4. Tongue and Lip Tie Releases

If your child has a tongue tie or lip tie, we may perform a laser frenectomy using the LightScalpel CO2 laser. This procedure is:

• Quick and precise
• Minimally invasive
• Effective in improving tongue mobility, posture, and function

Releasing a tongue tie allows the tongue to stay properly positioned during sleep—where it belongs: on the palate, not in the throat.

5. Myofunctional Therapy

This is like physical therapy for the mouth and face. We refer to trusted myofunctional therapists who help children:

• Retrain the tongue to rest on the palate
• Improve nasal breathing
• Strengthen lip seal and orofacial muscles
• Break long-standing mouth breathing habits

Myofunctional therapy is essential for reinforcing the structural corrections we make.

6. Ongoing Monitoring and Support

Our approach is collaborative. We work closely with ENTs, sleep specialists, and therapists to ensure your child gets comprehensive care. We also guide parents on supporting breathing-friendly habits at home.

Signs Your Child’s Teeth Clenching Is Airway-Related

Consider an airway-focused evaluation if your child:

• Grinds or clenches teeth during sleep
• Snores or breathes through the mouth at night
• Wakes frequently or seems restless in bed
• Has dark circles under the eyes
• Complains of morning headaches or sore jaw
• Shows signs of hyperactivity or poor focus
• Has a history of enlarged tonsils/adenoids or allergies

These are not isolated issues—they’re often symptoms of a poorly functioning airway.

The Bottom Line: Clenching Is a Symptom, Not a Disorder

At TMJ Sleep and Breathe Center, we don’t treat clenching—we treat the reason your child is clenching. Through a combination of airway expansion, tongue tie release, and functional retraining, we help children:

• Sleep deeply
• Breathe properly
• Grow into healthy, balanced faces

If you’re concerned about your child’s nighttime teeth clenching, don’t wait. Early intervention can prevent years of dental problems, poor sleep, and developmental challenges.

Schedule a Consultation

We invite you to schedule a comprehensive airway evaluation at TMJ Sleep and Breathe Center with Dr. Gary Adams. Together, we can uncover the root cause of your child’s clenching and create a custom treatment plan that supports lifelong health and breathing.