Whether due to stress, sleep disorders, or an uneven bite, many people clench and grind their teeth — which is called bruxism. In fact, it’s estimated that 50% of Americans have some degree of bruxism. Since it mostly occurs at night, many don’t even realize they have it, but if you sometimes experience unexplained headaches or wake up with a sore jaw and teeth, you might.
There’s more than one way to address the issue, and it’s all about tailoring your approach to your unique case and its underlying causes. To help, here’s our guide to stopping teeth grinding.
Table of Contents
What Is Bruxism?
Bruxism is the medical term for the unconscious grinding, clenching, and gnashing of your teeth together. It mostly occurs overnight (sleep bruxism) but can also happen during waking hours (awake bruxism). While you’re awake, the habit is still unintentional. You might realize it is happening, though not everyone does.
Bruxism is generally considered a co-occurring disorder, meaning it rarely appears on its own. Instead, it typically comes from underlying conditions, which can include everything from sleep apnea to post-traumatic stress disorder.
Mild and infrequent cases of bruxism rarely require treatment. But more severe and consistent bruxism often does, since it can cause permanent damage and other health disorders. Everyone needs to know the signs of teeth grinding, as most people do not realize they have a problem until the damage is done.
Who Is at Risk?
Anyone can experience bruxism, no matter their age, overall health, or lifestyle. With that said, certain risk factors increase your chances of getting it at some point in your life.
- Family History: Like many medical conditions, you can inherit bruxism from dear old mom and dad. If a close relative has it, you are more likely than the general population to develop it as well.
- Orthodontic Irregularities: If your misalignments make your teeth come together unevenly, you might unconsciously try to correct it by grinding or clenching your teeth. Some jaw misalignments can also cause spasms that lead to grinding.
- Certain Habits: Tobacco products, heavy drinking, and certain drugs are also linked to bruxism. And — bad news coming — so is caffeine. So your jaw pain might stem from your reliance on coffee.
- Stress, Anxiety, and Mental Health Disorders: These can cause both awake and sleep bruxism, but they’re more commonly associated with daytime teeth grinding. Since we all experience stress, it’s a big contributor to the prevalence of bruxism.
- Sleep Disorders: Sleep apnea is the biggest cause here since it blocks the airway, which clenching and grinding can clear. However, any sleep disorder can lead to bruxism.
- Various Medical Conditions: Parkinson’s disease, dementia, gastroesophageal reflux disease, epilepsy, chronic fatigue syndrome, and fibromyalgia can all lead to bruxism.
- Certain Medications: Bruxism is a side effect for some medications, as are spasms and muscle tightness, which can cause it. Antidepressants and other psychiatric medications are more closely linked to these side effects than others.
A bruxism diagnosis starts with an evaluation from your dentist. They will use a visual exam and X-rays to look for signs of clenching and grinding, such as damage to the jaw joints and cracks or erosion in the teeth. If they find any, they’ll likely provide an official diagnosis.
Once they confirm your bruxism, your dentist will work on determining the underlying cause. This will include a discussion about your general health, sleep habits, and stressors, plus a look at your dental alignment.
Sometimes, the dentist can determine and treat the underlying cause. In other cases, they’ll refer you to a specialist. For example, if your answers to their questions about sleep suggest sleep apnea, they might send you to a sleep specialist for diagnosis and treatment. Even if you need to see another doctor for full treatment, your dentist should offer some ways to manage your tooth grinding until you can treat the underlying cause.
Signs You Have Bruxism
We said that a bruxism diagnosis starts with an evaluation, but you’ll probably notice some symptoms before that. If you notice any of the following signs of teeth grinding, make an appointment with your dentist.
- Teeth that appear flatter or smoother on the chewing surfaces
- Muscle pain in the face
- Joint pain in the jaw
- Swelling near the jaw joints
- Clicking noises when eating, speaking, laughing, or yawning
- Daytime fatigue without other explanation
- Unexplained headaches or facial pain
- Tooth pain and sensitivity
- Loose teeth
- Fractured teeth
- Pain when eating
- Jaw locking or slipping out of joint
Underlying Causes of Bruxism
The key to stopping teeth grinding is determining and treating the underlying cause. Some are simple and easy to address; others require a more intensive approach. Below are some of the most common causes of bruxism — and keep in mind that you can have more than one!
This is a big one — especially for people who only occasionally experience bruxism. When we harbor stress, it manifests in various ways, including clenching and grinding. Anyone perpetually in high-stress situations has a greater chance of severe and long-lasting bruxism.
Living with pain isn’t easy, so if you have chronic pain, you’re probably also under constant stress. However, even on its own, pain can lead to teeth clenching. Think about a time you’ve experienced an injury — you probably clenched your teeth or struggled to breathe correctly. People often do the same thing with chronic pain, especially when sleeping.
When the teeth don’t come together as they should, the body might subconsciously try to force it by clenching them together. This won’t correct the misalignment and it will cause damage, but ultimately, it’s the body seeking a solution.
Any problem with the jaw can irritate the body into moving it, often resulting in teeth grinding. These problems can include damage from injuries, uneven jaw growth, and temporomandibular joint disorders.
People with sleep apnea stop breathing periodically while sleeping. For some, this is just a few times a night, while for others, it’s a near-constant disruption. The body will naturally try to keep the airway open by clenching or grinding the teeth.
Stimulants send signals to your brain, and your brain relays those messages to your muscles. Sometimes, this results in spasms and clenching. When that happens in the jaw, it causes bruxism.
Like nicotine, caffeine is a stimulant. While it might give you the energy you need to get through the day, it also overstimulates your muscles, potentially resulting in unwanted clenching and grinding.
Alcohol is a depressant, so it won’t overstimulate your muscles. However, it disrupts sleep patterns. Anything that causes restless sleep will probably create enough of a disturbance that bruxism begins.
Bruxism Treatment Options
If you have bruxism, there’s hope. If your dentist or other doctor can diagnose the underlying condition, they can treat it, eliminating or at least reducing your grinding. If they can’t determine or eliminate the cause, your dentist can offer treatments that manage bruxism without preventing it.
This therapy aims to make you aware of your unconscious habits. The idea is that, if given a stimulus when making an undesired movement — in this case, clenching and grinding your teeth — you will realize what you’re doing and train yourself out of it.
If you are clenching and grinding your teeth because they’re out of alignment, the solution is realigning them. Braces and aligners can both accomplish this, though if you have a severe misalignment, you might need other appliances or even surgery.
Cognitive Behavioral Therapy
Often used in cases of extreme trauma, CBT can also work well at addressing general stress and anxiety — especially if you’re not aware of it. This form of therapy can help some people work through their stressors and let go of the tension causing their bruxism.
These can be specific exercises for the jaw or just exercise in general. Because working out releases endorphins and relaxes the body, it can help you eliminate the tension causing you to clench and grind your teeth.
While it might seem strange to go to physical therapy for your jaw and face, it can make a big difference with bruxism. You might need to search to find a therapist specializing in the face and neck, though.
Changes in Habits
If caffeine, nicotine, or alcohol contribute to your bruxism, reducing your consumption or cutting them out entirely could help to reduce, if not eliminate, your clenching and grinding.
Night guards are an oral appliance you wear while sleeping to prevent the teeth from coming together (preventing grinding) and placing enough space between the two dental arches to take pressure off the jaw (reducing the effects of clenching).
These function similarly to night guards, but their design is slightly different. They’re often thinner, offering greater comfort and more natural speech. They aren’t ideal for nighttime wear, though, because their thinness makes them more fragile.
If your dentist can’t determine an underlying condition, they might use muscle relaxers to treat your bruxism. This is typically a short-term solution based on the idea that, once relaxed, the muscles will stay that way going forward.
If you clench and grind your teeth, there are ways to stop — but the right method will depend on the cause of your bruxism. In some cases, you can’t eliminate it completely, only reduce and manage it. If you’re noticing signs of bruxism, contact your dentist to schedule your evaluation.
Frequently Asked Questions
How do I know if I clench and grind my teeth?
Most people with bruxism clench and grind their teeth while sleeping, so they don’t notice they’re doing it. Unless someone else observes it, you have to rely on your symptoms. Look for signs like facial, neck, jaw, and ear pain or changes to your teeth.
What are the most common reasons for bruxism?
Stress and pain are the two most common reasons, since they are pretty much universal experiences.
Can I unconsciously grind my teeth while awake?
Yes, there are many things we do without thinking all the time, and grinding is one of them. Though you are more likely to realize you’re doing it during the day than when you are asleep.
Can you cure bruxism?
Bruxism is a symptom of other issues. You don’t really cure bruxism, but you can typically cure the cause. Even when you can’t, you can manage the condition, reducing or eliminating any harm.
Are night guards the best treatment for teeth grinding?
Not in every case, but for most people, they are an ideal solution. Just keep in mind that they are management, not a cure. Until you address the underlying issues, your bruxism will remain.
Do night guards make bruxism worse?
Rarely, but they can. Some people respond to having a guard in their mouth by grinding more and clenching harder.
Can any dentist diagnose bruxism?
Yes, all dentists are qualified to diagnose bruxism, but they may send you to a specialist depending on the cause.
How can I know if my cracked tooth is from clenching and grinding?
If you have a cracked molar with no other explanation, it’s likely from bruxism. However, your dentist can look for other signs, such as uneven wearing of the teeth and inflammation in the jaw joints, to confirm.
Are bruxism and TMJ the same thing?
No. TMJ is actually just the jaw joint — it stands for temporomandibular joint. TMD — temporomandibular joint disorders — and bruxism are related, but not the same thing. Bruxism can cause TMD, and TMD can lead to bruxism.
Is bruxism treatment expensive?
Not always. For example, there are at-home night guards you can order online. They’re custom-made based on molds you take but are a fraction of the cost of those from a dentist.