Teeth grinding (bruxism) – NHS

Teeth grinding (also called bruxism) is often related to stress or anxiety. There are things you can do to help and treatments available from a dentist or GP.

Causes of teeth grinding

It’s not always clear what causes people to grind their teeth.

It’s often linked to:

• stress and anxiety – this is the most common cause of teeth grinding
• sleep problems like snoring and sleep apnoea
• taking certain medicines, including a type of antidepressant known as selective serotonin reuptake inhibitors (SSRIs)
• smoking, drinking lots of alcohol and caffeine, and taking drugs like ecstasy and cocaine

Teeth grinding is common in children and teenagers, particularly during sleep. It often stops when they reach adulthood and their adult teeth have come through.

How to reduce teeth grinding

There are a number of things you can try that may help if you grind your teeth.

Do

• find ways to relax – for example, by doing breathing exercises, listening to music and taking regular exercise

• try to improve your sleep by going to bed at the same time every night, relaxing before bedtime and making sure your bedroom is dark and quiet

• take painkillers like paracetamol or ibuprofen if you have jaw pain or swelling

• use an ice pack (or bag of frozen peas) wrapped in a tea towel for 20 to 30 minutes to help reduce jaw pain or swelling

• have regular dental check-ups

Don’t

• do not smoke

• do not drink too much alcohol

• do not take drugs like ecstasy or cocaine

• do not chew gum or eat hard foods if you have tooth or jaw pain

Symptoms of teeth grinding

Teeth grinding can happen while you’re awake or asleep.

As well as grinding your teeth and clenching your jaw, other symptoms can include:

• face, neck and shoulder pain
• a painful jaw, which can lead to a condition called temporomandibular disorder (TMD)
• worn-down or broken teeth, which can cause increased sensitivity and loss of teeth and fillings
• headaches
• earache
• disturbed sleep

Non-urgent advice: See a dentist if:

• you grind your teeth and have tooth damage or sensitive teeth
• you grind your teeth and have pain in your jaw, face or ear
• your partner says you’re grinding your teeth in your sleep
• you’re worried about your child grinding their teeth

See a GP if you need help with some of the causes of teeth grinding, such as stress, anxiety, smoking, drinking too much or taking drugs.

Treatments for teeth grinding

Treatment for teeth grinding is not always needed.

Treatments from a dentist

A dentist may recommend a mouth guard or mouth splint.

These are worn at night and protect your teeth from damage. They can be made by a dentist to fit precisely over your upper or lower teeth

Treatments from a GP

A GP can give you advice and recommend treatments for reducing stress.

They will also be able to help if you want to give up smoking, or if you need advice about drug addiction or cutting down on alcohol.

Page last reviewed: 27 June 2022
Next review due: 27 June 2025

Why Jaw Clenching Happens & How To Stop It

If you’re noticing pain or tightness in your jaw, are struggling to open your mouth wide, or commonly experience “temple” headaches, it may be caused by excessive jaw clenching.

In this article, we explore the symptoms of jaw clenching, how it relates to teeth grinding (known as bruxism), what causes the issue, and offer some home and professional remedies to give you relief.

What is jaw clenching?

Jaw clenching is an excessive clenching of your jaws, which can be accompanied by teeth grinding. This may happen at night, during the day, or both, and lead to pain and tightness in your jaw, damaged teeth, and facial disorders like TMJ or TMD.

People who clench their jaw excessively may not necessarily grind their teeth, but the two often go hand in hand.

Jaw clenching symptoms

Excessive jaw clenching can be a difficult thing to identify, especially if it’s happening at night when you’re asleep. But there’s some telltale jaw clenching symptoms that will help you diagnose the problem. The most obvious of these is having jaw pain, usually accompanied by a feeling of tightness. If you experience this when you wake up in the morning, there’s a good chance you’ve been clenching your jaw and grinding your teeth during the night. If you sleep with a partner, they may also hear your teeth grinding at night.

People who clench their jaws may also have difficulty opening their mouths wide, due to the tightness and pain caused by excessive clenching. This can lead to headaches (particularly those that start in the temples) as well as earaches. If you grind your teeth at night, you may find that you often wake up feeling tired, in which case you should consider talking to a specialist about a potential disorder like sleep apnea (we discuss the full range of treatment options below).

Finally, the last glaring sign of excessive jaw clenching is having worn or loose teeth, or broken fillings. Although this is usually a severe case, and should be addressed immediately to prevent further damage to your precious teeth.

Jaw clenching causes

Jaw clenching is usually caused by emotional issues like stress and anxiety. Muscle tension is a common symptom of these emotions, which can include a consistent clenching of your jaw, leading to some of the issues described above.

For bruxism, misaligned teeth are another common cause, because they can rub together more easily.

Other potential causes for jaw clenching (or things that can make it worse) include:

• Clenching your teeth when focusing on something difficult. This can quickly form into a bad habit.
• Taking stimulating drugs like ecstasy and amphetamine, or cocaine to a lesser extent.
• Other illnesses or disorders like sleep apnea, ADHD, Parkinson’s disease, gastroesophageal reflux disorder (GERD), epilepsy, and night terrors.
• Drinking alcohol. This can trigger your jaw muscles to hyperactivate, leading to teeth nighttime grinding.
• Smoking. In one study, young heavy smokers were more than twice as likely to experience bruxism¹.
• Nutritional deficiencies such as a lack of vitamin D and calcium².
• Dehydration
• SSRI antidepressants

Jaw clenching is most common in children, adolescents, and young adults, but tends to go away when getting older. It might also be found more commonly in people who have an aggressive, hyperactive, or competitive personality type.

How to stop clenching your jaw—home remedies

There’s a few home remedies on how to stop clenching your jaw, but their effectiveness will depend on the cause of your jaw clenching. If you suspect it’s caused by being overly stressed or anxious, it’s best to incorporate some relaxing routines into your life, like meditation, reading, listening to soothing music, and getting regular massages. If possible, you should also consider fixing the source of the stress itself.

If you clench your jaw at night, focusing on your sleep hygiene can help a lot. There’s plenty you can do to get a better night’s rest, including:

• Drinking less caffeine during the day (particularly after 2 pm), or cutting it out completely.
• Getting more aerobic exercise during the day.
• Getting between 30 to 60 minutes of direct sunlight each day in order to encourage a healthy circadian rhythm. This works best between the hours of 6 am and 9 am³. Be sure to use sunscreen to protect against skin cancer.
• Avoid your screens like your phone and television two hours before going to bed. These devices emit blue light, which your brain identifies as sunlight, and blocks melatonin production (the hormone that regulates your circadian rhythm).
• Have a consistent sleep schedule, even on weekends.

If you catch yourself grinding during the day, you can try putting the tip of your tongue between your teeth each time. With persistence, a habit will form that prevents you from clenching your jaw.

Jaw clenching treatment—professional remedies

Your first port of call with jaw clenching is a visit to the dentist. By assessing damage to your teeth, they can give you some idea of how badly you clench your jaw, and whether it has led to issues like TMJ or TMD. They’ll fix any damaged teeth you may have, and also be able to provide you with a mouth guard to wear at night (if this is when the clenching usually happens). If the problem is severe enough, and the dentist has the necessary qualifications, they may even recommend botox injections to relax your jaw muscles.

The dentist may recommend that you visit a GP, to address other issues outside of their scope. A GP can get a better understanding of whether your jaw clenching is stress-related, and potentially refer you to a therapist to improve your mental health. They might also recommend a relaxation therapist to teach you how to voluntarily relax your jaw muscles, as well as a sleep specialist to improve your sleep hygiene.

Finally, the last professional treatment that can help with jaw clenching is a head and neck massage, which helps to relax the muscles in those areas and reduce any pain or tension you’re feeling.

References

1. K. Rintakoski, D.D.S., J. Ahlberg, D.D.S., Ph.D., C. Hublin, M.D., Ph.D., F. Lobbezoo, D.D.S., Ph.D., R. J. Rose, Ph.D., H. Murtomaa, D.D.S., Ph.D., and J. Kaprio, M.D., Ph. D, Tobacco use and reported bruxism in young adults: A nationwide Finnish Twin Cohort Study, Nicotine & Tobacco Research
2. Mohammad J Alkhatatbeh, Zainab L Hmoud, Khalid K Abdul-Razzak, Esam M Alem, Self-reported sleep bruxism is associated with vitamin D deficiency and low dietary calcium intake: a case-control study, BMC Oral Health
3. Bright Light Therapy, Drug and Alcohol Services South Australia

causes, symptoms, prevention and treatment

Types of bruxism

There are three forms of bruxism:

• Noisy bruxism or grinding. Grinding of the teeth occurs when the chewing muscles and lower jaw move. The long course of the disease is dangerous pathological abrasion of teeth.

• Silent bruxism or clenching of teeth. A typical symptom is a tightly clenched jaw without extraneous sounds. To a lesser extent provokes a decrease in enamel. More often leads to the formation of cracks in the tooth enamel.

• mixed form. Combines the features of the two forms described above.

Depending on the time of occurrence of dental grinding, bruxism is divided into daytime, nighttime and combined (episodes are repeated regardless of the time of day).

Causes of bruxism

In infants, bruxism is regarded as a variant of the norm. In this way, the child tries to reduce the intensity of the discomfort associated with the eruption of milk teeth.

Help! The prevalence of bruxism in children under 7 years of age is 50-80%. The second peak of the disease occurs at the age of 13–18 years.

At any other age, the manifestation of teeth grinding is based on a combination of several causes:

• hereditary predisposition. The chance of bruxism in a child is 50% higher if first-line relatives suffered from this disease.

• dental factors. Episodes of involuntary teeth grinding provoke congenital and acquired disorders in the structure and functioning of the dental system. Due to the deformation and trauma of the teeth, malocclusion, developmental anomalies, the jaws do not completely close, and in order to ensure the coordinated operation of the chewing apparatus, the muscles come into tone, the muscle fibers involuntarily contract. Poor-quality dental treatment, incorrectly selected prostheses and braces, arthritis and arthrosis of the temporomandibular joint initiate bruxism.

• Diseases of the nervous system. Teeth grinding can occur as a result of birth or traumatic brain injury, damage to the central nervous system during fetal development or during childbirth (perinatal encephalopathy).

• Pathology of ENT organs. At risk are patients who have permanently disturbed nasal breathing due to adenoids, deviated nasal septum, chronic rhinitis.

• Disorders of the psyche and behavior. Stress, neurosis, anxiety and constant experiences provoke an involuntary spasm of the masticatory muscles and gnashing of teeth. Bruxism occurs in people who constantly experience psycho-emotional overstrain, have a negative emotional mood.

• neurological and movement disorders. A favorable condition for the manifestation of bruxism is considered deviations in the activity of the central and peripheral nervous system. The course of bruxism is often accompanied by sleep disturbance: nightmares, snoring, short-term respiratory arrest (apnea), enuresis. Tonic spasm of masticatory muscles (trismus) and bruxism occur due to damage to the motor neurons of the trigeminal nerve. Teeth grinding is one of the symptoms of neurological complications associated with the use of neuroleptic drugs (antipsychotics).

Other causes of bruxism are not widely recognized, but they do exist. These include: reflux esophagitis (reflux of gastric contents into the esophagus), helminthic invasions, osteochondrosis of the cervical spine. In the occurrence of bruxism, bad habits are of some importance: smoking, alcohol addiction, coffee and chewing gum abuse, and malnutrition.

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Symptoms of bruxism

Episodes of bruxism are accompanied by grinding and tapping of teeth. The attack lasts from a few seconds to several minutes. During the night can be repeated many times. Usually a similar symptom is observed by parents or spouses, since a person does not control his condition during sleep. After multiple nocturnal episodes of bruxism, the next morning the patient feels facial muscle and jaw pain, dizziness, headache, lack of sleep.

Daytime bruxism is characterized by uncontrollable clenching of the teeth. Usually, a spasm of the masticatory muscles provokes some kind of stressful situation or event that requires prolonged concentration: playing on a computer, doing homework.

Help! If teeth grinding occurs during sleep, then this is bruxism. If the episodes recur during the daytime, this condition is regarded as bruxiomania.

With a combination of daytime and nighttime bruxism, the patient has concomitant symptoms:

• instability in behavior

• headache and dizziness,

• problems with sleep and falling asleep,

• pain and ringing in the ears

• daytime sleepiness,

• biting a pencil and pen,

• frequent use of chewing gum,

• discomfort when closing teeth,

• waking up exhausted.

With a long course of bruxism, a pathological decrease in the enamel of individual or all teeth develops, chips and cracks in the enamel, fillings and dentures are formed, the sensitivity of the teeth to cold, hot, salty, sweet is exacerbated.

Injury to the periodontal tissues provokes inflammation of the periodontium (tissues surrounding the tooth), followed by mobility and premature loss of the tooth. Gingivitis, stomatitis, oral fibroma are the consequences of constant traumatization of the oral mucosa.

Complications of bruxism

Long-term undesirable consequences include dysfunction of the TMJ. This is a violation of the temporomandibular joint. The condition is accompanied by pain in the temples, neck, head, inability to open the mouth wide, clicks in the joint when yawning and chewing. The disease without treatment is dangerous by the development of arthrosis and immobilization of the temporomandibular joint.

Chronic nocturnal bruxism is complicated by pain in the muscles of the back and neck, migraine, dizziness. Almost 80% of patients experience toothache, 65% have injuries to the tongue, lips and inner surface of the cheeks.

Bruxism diagnostics

Bruxism is confirmed by the dentist on the basis of dental examination data, complaints of the patient or his relatives about the grinding of teeth. When examining the oral cavity, the doctor detects characteristic changes: a wedge-shaped defect, malocclusion, trauma to the tongue and mucous membranes of the cheeks, lips, violation of the integrity of the enamel or dental structures. On palpation, there is tension in the muscles of the face, pain in the area of ​​the temporomandibular joint.

For an objective assessment of bruxism, brux checkers are used. These are special caps made on the basis of a cast and model of the patient’s jaw in order to determine unwanted occlusal contacts of the teeth of the upper and lower jaws. After wearing the mouth guard at night, it is transferred to the laboratory for analysis and determination of which teeth are under increased stress.

Polysomnography is used to diagnose bruxism. Before going to bed, special sensors are applied to the patient’s body, which record any movements, brain activity, mobility of the temporomandibular joint. In patients with bruxism, the pathological activity of the masticatory muscles is determined.

To identify the true cause of teeth grinding, specialists of a different profile are often involved – a neurologist, otolaryngologist, gastroenterologist, psychologist.

Treatment of bruxism

Usually in young children, bruxism does not require special treatment, as it resolves on its own by the age of 7 years. To get rid of a pathological habit for adults, they use an integrated approach with the appointment of conservative therapy, dental treatment, psycho- and physiotherapy.

General recommendations for all groups of patients are fortified nutrition, moderate physical activity, alternating work and rest. It is also important to limit coffee and caffeinated drinks, alcohol, tobacco, and, if possible, eliminate stress and anxiety.

Conservative therapy

With bruxism aggravated by neurological disorders, anticonvulsant and nootropic drugs, neurovitamins of group B, and brain metabolites are prescribed. The course of treatment is long, from 2 to 4 months under the supervision of a neurologist.

To reduce the activity of the muscles of the masticatory muscles, calcium and magnesium preparations are used, to normalize the quality of sleep and eliminate anxiety, light sedatives and hypnotics are used. Treatment is supplemented with multivitamin complexes to reduce recovery time, strengthen immunity.

Dental treatment

At the first stage, caries and periodontal inflammation, if any, are treated. Further, according to an individual cast, a protective cap is made of soft plastic and rubber. A cap is put on the upper teeth to prevent their friction against the lower teeth, to prevent the destruction of the enamel.

After eliminating the causes and manifestations of bruxism, dentists are involved in the restoration of wedge-shaped defects, the installation of fillings, the manufacture of crowns, prostheses or veneers.

Psychotherapy

Psychological methods of influence come to the fore if the cause of bruxism is unfavorable psychological factors and events. Psychotherapy helps to identify and understand conflicts, change attitudes towards a stress factor, develop skills to cope with the difficulties of life more effectively and environmentally for the body. For this, methods of relaxation and self-control, trainings, art therapy, dance and movement therapy are used.

Physiotherapy

To enhance the functional activity of the muscles of the jaw, neck and collar zone, sessions of electrical stimulation of the muscles of the masticatory muscles are prescribed (exposure to direct and alternating current pulses). In some cases, manual therapy, massage, acupuncture, magnetotherapy, warm compresses on the jaw area show a good effect.

Prevention of bruxism

Prevention of bruxism is not specific, and involves maintaining a healthy lifestyle, getting rid of bad habits, learning self-control and forming the right life position.

Timely treatment of diseases of the nervous system minimizes the risk of bruxism. It is necessary to monitor your psycho-emotional state or the child, and, if necessary, seek psychological help.

An important link in the prevention of bruxism is a regular preventive examination 1-2 times a year at the dentist. Timely diagnosis of pathologies and the choice of adequate treatment can permanently get rid of this pathological habit.

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Bruxism in adults and children: causes and treatment

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Everyone is subject to stress. Nervous shock does not pass without a trace, the functionality of the body is disturbed. Dentists have noted a sharp increase in the incidence of bruxism in both adults and children.

Bruxism is a disease that causes the masticatory muscles to contract involuntarily, which tightens the jaw and gnashes the teeth.

A sharp contraction may last from a few seconds to several minutes. The attack is also accompanied by increased pressure, increased heart rate and respiratory failure. The specificity of the disease is such that it can manifest itself at any age. Bruxism in children is more common than in adults, but no one will give exact numbers. Most people are unaware of grinding their teeth at night in their sleep.

Bruxism, the causes of which are still not clearly defined, is caused by a sleep disorder. Doctors believe that aggressive people who hide anger relax only in their sleep, which is why bruxism manifests itself. Symptoms are also noticeable in people who have problems with bite, a violation of the structure of the face.

If you have identified brussism and its manifestation has no definite reasons, then it is worth visiting a doctor and undergoing an examination. The neglected form is dangerous by the occurrence of an epileptic attack, and the rattle irritates others. For people with bruxism, understanding and awareness of the need for medical care is important.

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• pathology of the lower jaw joint;
• teeth grinding;
• malocclusion;
• tooth hypersensitivity;
• brittle teeth, prone to fracture;
• frequent headaches, migraines;
• painful contractions of the facial muscles.

Bruxism is divided into day and night.

Nocturnal bruxism is more common and occurs during sleep. During the night, there may be several attacks, accompanied by strong clenching of the jaw and gnashing. Daytime bruxism is less common, but attacks correspond to nighttime ones.

Children’s bruxism is not much of a problem, and it’s more like a bad habit of grinding your teeth. But parents should pay attention, if the rattle is heard in a dream and the attack lasts more than 15 seconds, then this is dangerous for the rapid wear of teeth and damage to soft tissues. Severe attacks lead to the rise of the child with a severe headache and pain throughout the jaw. Such symptoms indicate that an urgent need to visit a doctor, only a qualified specialist will determine the severity of the disease and prescribe the right treatment.

An accurate diagnosis can be made using electromyography. Sensors are attached to the maxillofacial region and record impulses in a calm state and during chewing. According to the results, the doctor determines the severity of the disease, the nature and chooses a treatment strategy. It is also worth following some rules and watching your jaw. When closing, the upper and lower teeth should not touch. During the day, you should monitor your teeth and, in case of tension, try to relax your jaw. The right way to heal is to avoid stress. You need to learn self-control.

Teeth bruxism is also treated with the help of special caps, overlays on the teeth, which prevent their damage during attacks. Non-removable tires will allow you to set the head of the joint in the correct position and prevent muscle spasm, excessive pressure on the jaw. Any devices have the right to appoint and install a dentist, so come to us, we will restore the health of your teeth.

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More about therapeutic treatment

• Caries treatment
• Periodontitis
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• Seal installation
• Dental filling techniques
• Treatment of dental hyperesthesia
• Cervical caries
• Wedge-shaped defect of teeth
• Inflammation of the tooth
• Tooth abscess
• Treatment of granuloma
• Bruxism.