BEDTIME

Bruxism (Teeth Grinding or Clenching)

When you look in on your sleeping child, you want to hear the sounds of sweet dreams: easy breathing and perhaps an occasional sigh. But some parents hear the harsher sounds of gnashing and grinding teeth, called bruxism, which is common in kids.

About Bruxism

Bruxism is the medical term for the grinding of teeth or the clenching of jaws.
Bruxism often occurs during deep sleep or while under stress. Two to three out of
every 10 kids will grind or clench, experts say, but most outgrow it.  

Causes of Bruxism

Though studies have been done, no one knows why bruxism happens. But in some cases, kids may grind because the top and bottom teeth aren't aligned properly. Others do it as a response to pain, such as an earache or teething. Kids might grind their teeth as a way to ease the pain, just as they might rub a sore muscle. Many kids outgrow these fairly common causes for grinding. 
Stress — usually nervous tension or anger — is another cause. For instance, a child might worry about a test at school or a change in routine (a new sibling or a new teacher). Even arguing with parents and siblings can cause enough stress to prompt teeth grinding or jaw clenching.Some kids who are hyperactive also experience bruxism. And sometimes kids with other medical conditions (such as cerebral palsy) or on certain medications can develop bruxism.
Effects of Bruxism

Many cases of bruxism go undetected with no adverse effects, while others cause headaches or earaches. Usually, though, it's more bothersome to other family members because of the grinding sound.

In some circumstances, nighttime grinding and clenching can wear down tooth enamel, chip teeth, increase temperature sensitivity, and cause severe facial pain and jaw problems, such as temporomandibular joint disease (TMJ). Most kids who grind, however, do not have TMJ problems unless their grinding and clenching is chronic. 

Diagnosing Bruxism

Lots of kids who grind their teeth aren't even aware of it, so it's often siblings or parents who identify the problem.


Some signs to watch for:

    * grinding noises when your child is sleeping
    * complaints of a sore jaw or face in the morning
    * pain with chewing

If you think your child is grinding his or her teeth, visit the dentist, who will examine the teeth for chipped enamel and unusual wear and tear, and spray air and water on the teeth to check for unusual sensitivity.

If damage is detected, the dentist may ask your child a few questions, such as:

    * How do you feel before bed?
    * Are you worried about anything at home or school?
    * Are you angry with someone?
    * What do you do before bed?

The exam will help the dentist determine whether the grinding is caused by anatomical (misaligned teeth) or psychological (stress) factors and come up with an effective treatment plan.
Treating Bruxism

Most kids outgrow bruxism, but a combination of parental observation and dental visits can help keep the problem in check until they do.

In cases where the grinding and clenching make a child's face and jaw sore or damage the teeth, dentists may prescribe a special night guard. Molded to a child's teeth, the night guard is similar to the protective mouthpieces worn by football players. Though a mouthpiece may take some getting used to, positive results happen quickly.

Helping Kids With Bruxism

Whether the cause is physical or psychological, kids might be able to                   
control bruxism by relaxing before bedtime — for example, by taking a
warm bath or shower, listening to a few minutes of soothing music, or
reading a book.

For bruxism that's caused by stress, ask about what's upsetting your child and
find a way to help. For example, a kid who is worried about being away from home
for a first camping trip might need reassurance that mom or dad will be nearby if anything happens.

If the issue is more complicated, such as moving to a new town, discuss your child's concerns and try to ease any fears. If you're concerned, talk to your doctor.

In rare cases, basic stress relievers aren't enough to stop bruxism. If your child has trouble sleeping or is acting differently than usual, your dentist or doctor may suggest further evaluation. This can help determine the cause of the stress and an appropriate course of treatment.

How Long Does Bruxism Last?

Childhood bruxism is usually outgrown by adolescence. Most kids stop grinding when they lose their baby teeth. However, a few kids do continue to grind into adolescence. And if the bruxism is caused by stress, it will continue until the stress is relieved.

Preventing Bruxism

Because some bruxism is a child's natural reaction to growth and development, most cases can't be prevented. Stress-induced bruxism can be avoided, however, by talking with kids regularly about their feelings and helping them deal with stress. Take your child for routine dental visits to find and, if needed, treat bruxism.

TRAINING ur KIDS using POTTY

Many parents are unsure about when to start toilet teaching or "potty training." Not all kids are ready at the same age, so it's important to watch your child for signs of readiness, such as stopping an activity for a few seconds or clutching his or her diaper.

Most children begin to show these signs between 18 and 24 months, although some may be ready earlier or later than that. And boys often start later and take longer to learn to use the potty than girls.

Instead of using age as a readiness indicator, look for other signs that your child may be ready to start heading for the potty, such as the ability to:

    * follow simple instructions
    * understand words about the toileting process
    * control the muscles responsible for elimination
    * express a need to go verbally
    * keep a diaper dry for 2 hours or more
    * get to the potty, sit on it, and then get off the potty
    * pull down diapers, disposable training pants, or underpants
    * show an interest in using the potty or wearing underpants

About Timing

There are some stressful or difficult times when you may want to put off starting the toilet-teaching process — when traveling, around the birth of a sibling, changing from the crib to the bed, moving to a new house, or when your child is sick (especially if diarrhea is a factor). It may be better to postpone it until your child's environment is stable and secure.

Also, some experts may recommend starting the process during summer because kids wear less clothing, but it is not a good idea to wait if your child is ready.

How Long Does It Take?

Of course, teaching a toddler to use the potty isn't an overnight experience. The process often takes between 3 and 6 months, although it may take more or less time for some children.

And although some little ones can learn to both make it through the night without wetting or soiling themselves (or the bed) and use the potty around the same time, it may take an additional months to even years to master staying dry at night.

Potty types

   1. a standalone, toddler-size potty chair with a bowl that can be emptied into the toilet
   2. a toddler-size seat that can be placed on top of your toilet seat that will let your child
       feel more secure and not fear falling in

If you opt for the modified toilet seat, consider getting a stepping stool so that your child can reach the seat comfortably. Stools can also help kids learn to push with their legs when having a bowel movement.

It's usually best for boys to first learn to use the toilet sitting down before learning to pee standing up. For boys who feel awkward — or scared — about standing on a
stool to pee in the toilet, a potty chair may be a better option.

Buy a training potty or seat for every bathroom in your house. You may even want to keep a potty in the trunk of your car for emergencies. When traveling long distances, be sure to take a potty seat with you and stop every 1 to 2 hours. Otherwise, it can take more time than your child may have to find a discreet location or restroom.

About Training Pants

Experts sometimes disagree about whether to use disposable training pants.
Some think that they're just bigger diapers and might make kids think it's OK to
use them like diapers, thus slowing the toilet-teaching process.

Others feel that training pants are a helpful step between diapers and underwear. Because kids' nighttime bladder and bowel control often lags behind their daytime control, some parents like using training pants at night. Others prefer that their child use training pants when they’re out and about. Once the training pants remain dry for a few days, kids can make the switch to wearing underwear.

Ask your doctor if your child would benefit from using disposable training pants as a transitional step.

Common Problems

It's common for a previously toilet-taught child to have some trouble using the potty during times of stress. For example, a 2- or 3-year-old dealing with a new sibling may regress (return to a previous level of development).
But if your child was previously potty trained and is having problems, talk with your doctor just to be on the safe side and to rule out things like an infection.

If your child is 3 years or older and is not yet potty trained, talk to the doctor, who can help determine the problem and offer advice to make the process easier.

Tips for Toilet Teaching

Even before your child is ready to try the potty, you can prepare your little one by teaching about the process:

    * Use words to express the act of using the toilet ("pee," "poop," and "potty").
    * Ask your child to let you know when a diaper is wet or soiled.
    * Identify behaviors ("Are you going poop?") so that your child can learn to
       recognize peeing and pooping.
    * Get a potty chair your child can practice sitting on. At first, your child can sit
       on it clothed. Then, he or she can sit on the chair with a diaper. And when
       ready, your child can go bare-bottomed.

If you've decided that your child is ready to start learning how to use the potty, these tips may help:

    * Set aside some time to devote to the potty-training process.
    * Don't make your child sit on the toilet against his or her will.
    * Show your child how you sit on the toilet and explain what you're
       doing (because your child learns by watching you). You can also
       have your child sit on the potty seat and watch while you — or one 
       of his or  her siblings — use the toilet.
    * Establish a routine. For example, you may want to begin toilet 
       teaching by having your child sit on the potty after waking with a 
       dry diaper, or 45 minutes to an hour after drinking lots of fluid. You
       may be able to catch your child peeing. Only put your child on the   
       potty for a few minutes a couple of times a day, and let your child get up if he
       or she wants to.
    * Try catching your child in the act of pooping. Children often give clear cues
       that they need to use the bathroom — their faces turn red, and they may 
       grunt or squat. And many kids are regular as to the time of day they tend to
       have a bowel movement.
    * Have your child sit on the potty within 15 to 30 minutes after meals to take
       advantage of the body's natural tendency to have a bowel movement after
       eating (this is called the gastro-colic reflex).
    * Remove a bowel movement (poop) from your child's diaper, put it in the
       toilet,and tell your child that poop goes in the potty.
    * Make sure your child's wardrobe is adaptable to potty training. In other words,
       avoid overalls and shirts that snap in the crotch. Simple clothes are a must at this
       stage and kids who are potty training need to be able to undress themselves.
    * Some parents like to let their child have some time during the day without a diaper.
       If he or she urinates without wearing a diaper, your child may be more likely to feel
       what's happening and express discomfort.
       (But if you opt to keep your child's bottom bare for a little while, you'll probably
       need to keep the potty close by, protect your rugs and carpet, and be willing
       to clean up.)
    * When your son is ready to start peeing standing up, have "target practice."
       Show him how to stand so that he can aim his urine stream into the toilet. Some
       parents use things like cereal pieces as a sort of bull's-eye for their little guys to
       try aiming at.
    * Offer your child small rewards, such as stickers or time reading with Mommy,
       every time your child goes in the potty. Keep a chart to track of successes.
       Once your little one appears to be mastering the use of the toilet, let him or
       her pick out a few new pairs of big-kid underwear to wear.
    * Make sure all of your child's caregivers — including babysitters, grandparents,
       and childcare workers follow the same routine and use the same names for
       body parts and bathroom acts. Let them know how you're handling the issue
       and ask that they use the same approaches so your child won't become
       confused.

Above all, be sure to praise all attempts to use the toilet, even if nothing happens. And remember that accidents will happen. It's important not to punish potty-training children or show disappointment when they wet or soil themselves or the bed. Instead, tell your child that it was an accident and offer your support. Reassure your child that he or she is well on the way to using the potty like a big kid.

   And if you're torn about when to start the toilet-teaching   process altogether, let your child be your guide. Don't feel pressured by others (your parents, in-laws, friends, siblings, co-workers,etc.) to begin. Many parents of past generations started potty training much sooner than many parents do today. And it all depends on the child. Kids will let parents know when they're
ready.

Learning to Play

WHAT WE HOPEFULLY LEARN IN KINDERGARTEN

I hope that lessons at the train table and on the playground will help Ayeesha get along with others. Sometimes I want her to work things out for herself and then sometimes I know I have to intervene.

There are times when we can't just walk away. When Ayeesha has hurt another child, for example, we always work together to console the child she's wronged and I ask Ayeesha to look directly at the child's face. "You made him feel SAD," I say. "That is not okay. What can you do to help him feel better?"

When Ayeesha has been seriously hurt by another child I first make sure she's okay and then I figure out how to bring up the issue with the child, the child's caregiver, or both. Usually these conflicts are resolved as quickly as they started and I think Ayeesha learns quite a bit from listening to what the adults are saying to each other.

I am occasionally shocked, however, to find that it's the ADULTS on the playground (or around the train table) who have a hard time communicating and getting along. I've heard parents rationalize harmful behavior or deal with the situation by accusing other people's children -- trying to transfer the blame. I think back to the basic lesson we were all supposed to learn years ago in kindergarten: Play well with others. Only four words -- so simple yet so complex -- and definitely worth remembering.

 PRETEND "NO!" PLAY

Ayeesha won't be in kindergarten for a while, but she has a school of sorts evolving at home. Some of her biggest arguments have been with Baby, her stuffed doll, and Bonkers, her stuffed dog.

A few months ago, she started handing toys to Baby and Bonkers and then quickly pulling them away saying, "No!" I realized she was doing what she wasn't allowed to do with other kids.

I pretended I was Baby with a dramatically sad voice, "Oh no. That makes me so sad. Please share your toy with me. Please?" After a couple of weeks, Ayeesha started acting out the whole thing by herself. She'd hand something to Baby, then pull it away, saying "Sad" in a very sad voice, then hand the object back to the baby, take it away again and say, "Sad" in an even more pitiful voice and so on.

Now Ayeesha does the whole routine with a new ending. After she takes the toy away once and says, "So sad," she leaves the toy with Baby or Bonkers, gives them a turn and says "So HAPPY."

I guess Ayeesha has been working through her real-life conflicts in the safety of her pretend play at home. Luckily, Baby and Bonkers don't seem to mind. 

"CLIMB" SCENE INVESTIGATION

The issues that come up around the train table seem magnified on the playground. The added element of outdoor physical play and playground equipment means that in addition to the issues of whose turn it is, there are also safety concerns. I find myself making split second assessments of what happened when and to whom; and I feel like we adults instantly become the detectives, the attorneys, the judges, and the jury. 

Who was there first? But who has been there too long? Who didn't say excuse me, but rather shoved by promptly knocking another child onto her bottom? Who is climbing up the slide so no one else can take a turn going down? Who had the first turn driving the jungle gym car? 

One lawyer in my head says, "That little terror, who is older and should know better, just bumped into Ayeesha, knocked her over and stole her car!" And the defense attorney in my head says, "Yes, but please note that it's just a plastic wheel attached to a jungle gym and it is for all kids to play with" and the prosecuting attorney counters with, "It's still illegal. The action obviously breaks unwritten, but clearly accepted playground rules AND Ayeesha looks really upset AND she'd only been driving for 30 seconds!" And then the judge in my head says, "They're kids. Get over it," and the jury says, "Yeah, we're cold. Let's go drink hot chocolate." 

Ultimately, we find another wheel to steer or decide to try the slide or the swing. We play happily with kids who aren't being rough and then we head home for a tasty lunch or a cup of warm "hot" chocolate. I chalk it up as good experience for both Ayeesha and me -- a lesson in patience, forgiveness and the ability to walk away.

TODDLER RESOLUTIONS

Toddlers don't generally come up with their own New Years resolutions so I have a couple in mind for my daughter Ayeesha. These are only suggestions, of course, but they are really good ideas.

I think Ayeesha should resolve to consistently share, take turns and generally work on being more patient with others while also maintaining a strong sense of self. A simple list for a 21-month-old, right? You think this is too much to ask. Hmmmmm. Well, maybe, but a mom can dream!

One place I've been helping Ayeesha work on these goals (a.k.a Mommy's resolutions for Ayeesha) is at our local bookstore. This store has a train set in the kids' reading area and Ayeesha loves that train. As it turns out, ALL kids adore the train and they especially love the engine.

The engine is the prized temporary possession of every child who stands eagerly around the periphery of the rectangular table and gazes at the tracks winding across bridges and through tunnels. Kids reach out in a sea of tiny arms; clutching helicopters, airplanes, and colorful train cars. Eventually two or more kids reach for the engine. This is when the real games begin.

Conflicts over the single engine seem inevitable, but their resolutions are completely dependent on the personalities of the kids AND the adults involved. It's as if every one of us becomes a coach leaning in over the edge of a hypothetical boxing ring, except not one of the coaches REALLY knows what to do next. The situation changes every visit and so do the players. Every new strategy is an experiment and we just hope and pray to our own god or goddess of train engines that something works with as few tears as possible. It would be kind of hysterical except that I'm not just an observer. I have to play as well!

 

I usually stand near Ayeesha, but not right on top of her; or I sit in one of the chairs a couple of feet away, but I listen to everything. When it seems like a big disagreement is evolving, I'm there by Ayeesha's side to coach her through the discussions about who had what first or who needs the next turn. Sometimes I and the other adults who are "playing along" just look at each other and smile. Maybe we're all amazed at how frustrated our children can get over a tiny engine or rights to pass through a small wooden tunnel first. I try to stop and put myself in Ayeesha's shoes and I notice how passionate she and her peers are. It becomes obvious how much they are learning about themselves and others through their play. Then I understand -- in that particular moment, one small engine making it through one small wooden bridge means everything to a child.