No really…this IS about pulling and grinding teeth. It’s just one of the sensory seeking signs of proprioceptive dysfunction. Recall that the proprioceptive sense deals with” input from the muscles and joints about body position, weight, pressure, stretch, movement, and changes in position in space.” See http://www.sensory-processing-disorder.com/sensory-processing-disorder-checklist.html. Proprioceptive stuff is crazy, wild, and awesome – for more information, see:
Day #8 – Making Sense of Proprioception
Day #48 – Over and Under
Day #55 – Field Testing Proprioception
Day #56 – Elephant on the Stairs
Day #113 – The Greatest Treasure? Knowledge.
Day #115 – What’s the Point?
Day #147 – You Wanna Brush My What?
It’s about to get a bit crazy up in here.
Yes, teeth grinding – it’s real, and it’s exacerbated by the spectrum. Severe teeth grinding is also called bruxism. Tucker has had to have all but three baby teeth pulled by the dentist. In fact, he still has two baby teeth hanging on for dear life. We have to have our dentist help us with these teeth. Why?
Because this is what is left of them.
They have been ground down to nearly nothing. So, what does grinding teeth have to do with the spectrum? Actually…quite a bit.
- It could be a form of stimming. Stimming is that self-regulatory behavior that folks on the spectrum use to help calm themselves. You know stimming as children who may rock or clap their hands repeatedly. Well…grinding teeth often manifests as a stimming behavior. It’s something the child has little control over. It’s something they can do with rhythm and repetitive motion. This means it’s calming and able to be self-regulated. Another reason? Your teeth are always there – so stimming by grinding is ‘handy.’
- Oral Hyposensitivity. Remember the over/under discussions? Same thing here – some may have little awareness so they need oral input. They may chew on their shirts, hands, pencils…or even…grind their teeth!!!
- Global Sensitivity. From http://www.arktherapeutic.com/post/1051: Tooth grinding could also be a symptom of global hyposensitivity, not just oral hyposensitivity. For instance, when children have low muscle tone or awareness throughout the body, they sometimes have difficulty turning on just one muscle group. They could engage their jaw muscles while they are trying to stabilize their trunk to sit upright, and therefore grind their teeth.
So, what can you do?
- If it’s stimming – not much. HOWEVER, stimming is an indicator that a melt-down is about to occur – so the sooner you can figure out what is bothering your child (hunger, thirst, temperature, noise, visual stimuli, etc.) the sooner you can avert the stimming. Stimming is the mechanism used to calm the nervous system. So consider this grinding and clenching of the jaw a ‘warning’ of sorts.
- If it’s oral hyposensitivity a speech therapist or OT can help with intervention strategies for controlling the need for input. Some of these ideas include: oral chew toys or gum massages. Here is a great website that lists 10 products you could choose from: http://www.friendshipcircle.org/blog/2013/10/07/10-sensory-chew-toys-for-children-with-autism-other-special-needs/
- You can include more ‘crunchy’ foods in a child’s diet. We use apples – no kidding, at least two apples EVERY DAY and sometimes up to five. Yes, that can get pricey – but if it stops him from chewing on paper or his t-shirt, I’ll take it!
- If it’s global sensitivity a physical and/or occupational therapist will be able to help. The PT/OT will help your child manage and develop other muscle groups in their body so they stop relying on the oral stimulation.
- Talk to your dentist about using mouth guards, especially at night.
- The Center for Autism and Related Disorders conducted a research student that found, ‘the combination of vocal and physical cueing can effectively treat teeth grinding in young children with autism.’ A great summary of that study can be found at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790940/
One of the answers we have discovered is having a great relationship with our dentist. Our dentist is patient and kind and really works at getting Tucker. He spends time explaining what is happening at every step along the way.
However, this is complicated by the fact that the Dentist Office is a tough place – smells, sounds, noises. Tomorrow’s post will touch on this – how a ‘regular’ trip to the dentist office doesn’t just ‘happen’ in our family. Stay tuned…