If you’re the parent or caregiver of someone with Rett syndrome, you already know what it’s like to navigate the unfamiliar. New terms. New symptoms. New patterns that don’t always make sense but are part of the daily rhythm of life.

One of those patterns might be a sharp, grating sound coming from your child’s mouth. At first, you might think it’s just a quirky behavior, or even a phase. But then it happens again. And again. You realize it’s something called bruxism—and you’re not alone.

So, What Is Bruxism?

Bruxism is the medical term for the involuntary grinding, clenching, or gnashing of the teeth. It can happen during the day (awake bruxism) or during sleep (sleep bruxism), and it affects people of all ages—including children with Rett syndrome.

In the general population, bruxism can be caused by stress, anxiety, or dental misalignment. But in people with neurodevelopmental conditions like Rett, it often has different causes—and different consequences.

How Bruxism Shows Up in Rett Syndrome

Bruxism is one of the most common symptoms of Rett syndrome. Studies estimate that over 80% of children with Rett will experience it at some point.

It’s not just a behavioral tic. It’s often linked to neurological changes and motor control difficulties caused by mutations in the MECP2 gene, which affects brain development.

Common signs of bruxism in Rett syndrome:

• Loud grinding or clenching noises, especially during the day

• Visible wear on teeth (flattened, chipped, or cracked)

• Difficulty chewing or biting down

• Facial pain, jaw discomfort, or frequent rubbing of the jaw

• Interrupted sleep (in cases of night bruxism)

• Tension or tightness in the mouth, especially during sensory overload

Many parents describe it as one of the first noticeable symptoms—often appearing before regression or speech loss.

Why It Happens: The Neurological Connection

In Rett syndrome, bruxism isn’t usually caused by emotional stress (though it can be made worse by it). Instead, it’s often the result of disrupted signals between the brain and the muscles, particularly those involved in motor control.

Here’s what may contribute to bruxism in Rett:

• Autonomic nervous system dysregulation – leading to repetitive or involuntary motor actions

• Sensory processing issues – grinding may offer calming or organizing input to the nervous system

• Motor apraxia – difficulty planning or coordinating movements, which can include chewing and jaw movement

• Communication frustration – for nonverbal children, clenching or grinding may be a response to overstimulation or unmet needs

Every child is different. For some, it’s occasional and manageable. For others, it’s frequent and concerning—especially if it causes pain or dental problems.

What You Can Do: Gentle Strategies for Caregivers

Bruxism can be distressing, especially when you feel powerless to stop it. But there are steps you can take to ease the discomfort and protect your loved one’s teeth and well-being.

1. Talk to a dentist with neurodiversity experience

• Find a pediatric dentist or special needs dental provider who understands Rett and can monitor tooth wear.

• Ask about custom mouth guards (though not all children with Rett will tolerate them).

• Discuss options for treating sensitivity or enamel damage at an early stage.

2. Work with a neurologist or developmental pediatrician

• Let your medical team know how often and how intensely the bruxism is happening.

• Medications like gabapentin or clonidine are sometimes used for sleep bruxism or severe muscle tension—but only under close supervision.

• In some cases, reducing other symptoms (like anxiety, sensory overload, or seizures) can reduce bruxism too.

3. Explore occupational therapy (OT) and sensory supports

Many children grind as a way to self-regulate. An OT can help with:

• Chewy necklaces or oral motor tools
• Weighted blankets or compression gear
• Calm-down strategies tailored to their sensory profile

4. Care for your own emotional health, too

• Bruxism can be loud, stressful, and difficult to witness on a daily basis.

• If it’s wearing on your nerves or your heart, that’s okay—and you’re not weak for feeling that way.

• Try taking sensory breaks and connecting with other caregivers who get it.

Is It Dangerous?

Not usually—but it can cause dental damage, jaw pain, and sleep disruption over time. The key is monitoring and managing, not necessarily stopping it completely. Your child’s comfort, safety, and communication matter more than eliminating a behavior altogether.

In many cases, bruxism lessens with age or shifts into more manageable patterns as your child develops.

A Symptom That Deserves Understanding

Bruxism may seem like a small piece of the larger Rett syndrome puzzle—but for many families, it’s one of the most noticeable and persistent challenges. It’s loud. It’s hard to ignore. And it can make you feel helpless as a parent or caregiver.

But here’s what’s true: Your child is not doing this on purpose. And you’re not failing because you haven’t found the perfect solution. This is just one more part of the story—one more thing you’re meeting with love, resilience, and adaptability.

You are not alone in this. And there are people—dentists, therapists, researchers, and fellow families—working to understand it better and support you every step of the way.