Bruxism (Teeth Grinding)

What is bruxism?

Bruxism is when you clench, grind or gnash your teeth. It usually occurs subconsciously, and it can happen when you’re awake or asleep.

Many people grind their teeth every now and then, especially during stressful times. But if you do it a lot, it can put extra strain on your teeth and jaws, leading to dental damage, headaches, jaw pain and other issues.

Anyone can develop bruxism, but it’s most common during childhood, adolescence and young adulthood. It’s difficult to know exactly how many people grind their teeth because it often happens during sleep.

Bruxism symptoms

If you grind your teeth a lot, you might develop symptoms like:

• Headaches or facial pain, especially in the morning.
• Earaches.
• Sore jaw muscles.
• Tinnitus (ringing in your ears).
• Pain when eating.
• Difficulty opening and closing your mouth.

Types of bruxism

Bruxism can happen when you’re awake or asleep. The grinding action is the same, but awake and asleep bruxism are two separate conditions:

• Awake bruxism: If you only brux (grind or clench) during waking hours, you might not need treatment — especially if you can find ways to increase your awareness and reduce stress. Feeling anxious, stressed or angry can make you grind your teeth. You might also notice your jaw clenching when you’re concentrating hard on something.
• Sleep bruxism: Grinding or clenching your teeth in your sleep can cause more harm than bruxing during waking hours because you don’t realize it’s happening. People with sleep bruxism often need treatment to help manage the effects of grinding.

Bruxism causes

Healthcare providers don’t know exactly why some people grind their teeth and others don’t. Bruxism doesn’t have a single specific cause. Rather, there can be several contributing risk factors.

Risk factors

A risk factor is something that increases your chances of developing a certain condition. There are many risk factors for bruxism, including:

• Stress and anxiety. Feeling overwhelmed and stressed can result in bruxism. If you have depression or anxiety disorders — like major depressive disorder (MDD) or generalized anxiety disorder (GAD) — you’re more prone to bruxism.
• Lifestyle habits. People who smoke, drink alcohol and consume a lot of caffeine (more than six cups of coffee a day) are twice as likely to grind their teeth as people who don’t.
• Certain medications. This includes a class of anti-anxiety drugs called selective serotonin reuptake inhibitors (SSRIs).
• Sleep apnea. Research has confirmed a correlation between sleep apnea and teeth grinding, meaning that many people have both conditions. But it’s unclear whether sleep apnea causes bruxism or the other way around. Experts continue to study the relationship between teeth grinding and sleep disorders.

Complications of this condition

Left untreated, teeth grinding can lead to:

• Sleep disorders.
• Dental damage like tooth erosion, and loose or cracked teeth.
• Temporomandibular joint (TMJ) disorder.
• Facial pain.

How doctors diagnose bruxism

Healthcare providers (often dentists) typically diagnose bruxism based on a physical exam and your symptoms. But in some cases, you may need a sleep study (polysomnography). This overnight test takes place in a sleep center and can provide a definitive diagnosis.

How is bruxism treated?

If you have mild bruxism or only brux occasionally, you probably don’t need formal treatment. But in more severe cases, healthcare providers might recommend these bruxism treatments:

• Mouth guards. A dentist can make a custom mouth guard to protect your teeth. This appliance can also place your jaw in a more favorable position to reduce TMJ muscle strain. You wear your mouth guard when you’re most likely to grind your teeth.
• Stress reduction techniques. Finding ways to manage stress may reduce bruxism symptoms. This includes a wide range of therapies like meditation, exercise and cognitive behavioral therapy.
• Lifestyle changes. If teeth grinding is a result of caffeine or alcohol consumption, reducing your daily intake can help. If you smoke, quitting can help you stop bruxing and get better quality sleep.
• Medications. Taking a muscle relaxer before bedtime can reduce or prevent teeth grinding. Most healthcare providers only recommend this approach temporarily.
• Botulinum toxin injections. In severe cases, healthcare providers might recommend Botox® for teeth grinding. These injections temporarily relax your jaw muscles and reduce pain. You’ll need repeat treatments to maintain your results — usually every three to four months.

Can bruxism be prevented?

You can’t always stop yourself from teeth grinding or clenching, especially if you brux during sleep. But there are steps you can take to reduce your overall risk:

• Practice mindfulness to reduce daily stress.
• Get regular dental checkups. A dentist can treat any dental damage before it gets worse.
• Avoid smoking, recreational drugs and heavy alcohol consumption.

What’s the outlook for people who grind their teeth?

Everyone is different, but the outlook is generally good. Children often outgrow bruxism by adolescence. For adult teeth grinding, mouth guards can help. If you get one, be sure to wear it regularly.

In many cases, bruxism eventually goes away. But it’s important to know how to manage symptoms if you have a flareup. To learn more, talk to your healthcare provider.

When should I see my healthcare provider?

If you develop bruxism symptoms that don’t go away — or if you have them more often than not — it’s time to tell a healthcare provider. Whether you need temporary treatment to get through a stressful period or a more long-term solution like a mouth guard, a provider can help.

Is teeth grinding a serious problem?

It depends. If you only grind your teeth occasionally, it’s probably not a big deal. But if you do it a lot for a long time, it can lead to health issues down the road, including cracked teeth, headaches, temporomandibular joint disorder, tinnitus and other conditions.