Bruxism is the involuntary clenching, grinding, and gnashing of the teeth. About half of the population does it from time to time. Around 5% of the population are regular, forceful tooth grinders. Often it happens during sleep, but some people grind their teeth when they are awake.
Usually, a person doesn’t realize that they grind their teeth in their sleep. The partner who shares their bed (and hears the grinding noises at night) is often the first to notice the problem. Parents may also hear it in their sleeping children. Teeth grinding can be a result of stress. For example, some people grind their teeth when they are angry, concentrating, or feeling anxious.
Sleep bruxism is considered a sleep-related movement disorder. People who clench or grind their teeth (brux) during sleep are more likely to have other sleep disorders, such as snoring and pauses in breathing (sleep apnea).
Mild bruxism may not require treatment. However, in some people, bruxism can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth, and other problems.
Because you may have sleep bruxism and be unaware of it until complications develop, it's important to know the signs and symptoms of bruxism and to seek regular dental care.
Signs and symptoms of bruxism may include:
- Teeth grinding or clenching, which may be loud enough to wake up your sleep partner
- Teeth that are flattened, fractured, chipped, or loose
- Worn tooth enamel, exposing deeper layers of your tooth
- Increased tooth pain or sensitivity
- Tired or tight jaw muscles, or a locked jaw that won't open or close completely
- Jaw, neck, or face pain or soreness
- Pain that feels like an earache, though it's not a problem with your ear
- Dull headache starting in the temples
- Damage from chewing on the inside of your cheek
- Sleep disruption
When to see a doctor
See your dentist or doctor if you have any of the symptoms listed above or have other concerns about your teeth or jaw.
If you notice that your child is grinding his or her teeth — or has other signs or symptoms of bruxism — be sure to mention it at your child's next dental appointment.
Doctors don't completely understand what causes bruxism, but it may be due to a combination of physical, psychological, and genetic factors.
- Awake bruxism may be due to emotions such as anxiety, stress, anger, frustration, or tension. Or it may be a coping strategy or a habit during deep concentration.
- Sleep bruxism may be a sleep-related chewing activity associated with arousals during sleep.
These factors increase your risk of bruxism:
- Stress. Increased anxiety or stress can lead to teeth grinding. So can anger and frustration.
- Age. Bruxism is common in young children, but it usually goes away by adulthood.
- Personality type. Having a personality type that's aggressive, competitive, or hyperactive can increase your risk of bruxism.
- Medications and other substances. Bruxism may be an uncommon side effect of some psychiatric medications, such as certain antidepressants. Smoking tobacco, drinking caffeinated beverages or alcohol, or using recreational drugs may increase the risk of bruxism.
- Family members with bruxism. Sleep bruxism tends to occur in families. If you have bruxism, other members of your family also may have bruxism or a history of it.
- Other disorders. Bruxism can be associated with some mental health and medical disorders, such as Parkinson's disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, night terrors, sleep-related disorders such as sleep apnea, and attention-deficit/hyperactivity disorder (ADHD).
In most cases, bruxism doesn't cause serious complications. But severe bruxism may lead to:
- Damage to your teeth, restorations, crowns, or jaw
- Tension-type headaches
- Severe facial or jaw pain
- Disorders that occur in the temporomandibular joints (TMJs), located just in front of your ears, which may sound like clicking when you open and close your mouth
Treatment for teeth grinding
If you think you grind your teeth, speak with your dentist or other oral health professional. They will look at your teeth and talk about possible treatment options that may include:
- repair of tooth damage
- rule out other types of tooth wear such as erosion
- assessment of risk factors including sleep-disordered breathing
- a special mouthguard (‘bite splint’) to wear at night so that the guard is worn down instead of your teeth. In most cases, a bite splint will only help with the symptoms and will not stop you from grinding altogether.
Management of bruxism can include:
- stress management therapy
- relaxation techniques
- cognitive behavior therapy
- good sleep hygiene
- regular exercise