Question:

I am a school-based OT working with a teenager with significant mental retardation, who grinds his teeth incessantly. In two days, he has chewed through all of the oral-motor chew tools that I ordered through various catalogs. Do you have any other ideas?

Answer:

This type of teeth grinding doesn’t often respond to sensory input. One of two things may be going on. Either (1) it isn’t a sensory issue at all or (2) it may be a sensory issue, but his high-intensity need cannot be met with any oral motor tools. Here are a few things to think about:

  • Does he have low oral-motor tone? A lot of kids with Down Syndrome do a lot of teeth grinding in an attempt to elicit oral tone. Maybe this child is doing it for the same reason. If so, use strategies to improve tone such as vestibular input, muscle tapping, oral-motor strengthening, etc. While these strategies may be helpful, since it is a teenager, you may not see a huge reduction in the behavior.
  • Does he have TMJ disorder? This can cause severe discomfort in the jaw and kids often grind their teeth in an attempt to override the pain. A good dentist or orthodontist would be needed to assess the jaw. Sometimes the entire disc in the jaw joint has disintegrated and causes massive discomfort.
  • Are there any triggers for the teeth grinding or anything that seems to increase the intensity? Certain times of day? Certain environments? Task demands? Chaos in the classroom? Bright lights/loud noises, etc.? This may be an attempt to self-calm. If that is the case, adapt and accommodate as much as possible to reduce environmental stress.
  • If nothing else helps, he probably should get a good tooth guard at a minimum to prevent dental issues and further jaw damage.

I’m sorry! I wish I could be of more help, but I haven’t had wild success addressing this issue in the past. Please let me know if you find anything that helps this student!

Best Wishes,
Gwen