Why Do You Grind Your Teeth—and What Can You Do About It?

Teeth grinding, medically known as bruxism, is when a person repeatedly grinds, clenches, or rubs their teeth together. With bruxism, the top and bottom teeth scrape against each other with significant force. It can occur while you're awake or asleep. While most research has focused on bruxism during sleep, teeth grinding while awake is more common. 

Bruxism can affect both children and adults. Studies show that anywhere from 4-40% of children grind their teeth while sleeping. As people get older, bruxism becomes less common, with experts estimating that about 7.4% of adults grind their teeth during sleep.

In many cases, bruxism is mild and may not need any treatment. However, grinding your teeth can strain the muscles and tissues in and around your jaw, which may damage your teeth and cause other health problems over time. There are several treatment options for bruxism, depending on the type and underlying cause.

Types of Teeth Grinding

There are two main types of bruxism. Each type depends on when the problem occurs—while you're awake or during sleep.

Awake Bruxism

As the name states, awake bruxism—also called wakeful or diurnal bruxism—is when you clench or grind your teeth while awake. Even though you're awake, you might not realize you're doing it. Awake bruxism may happen when you feel stressed, anxious, or very focused on something. You might catch yourself grinding or clenching your teeth while working, studying, or driving.

Sleep Bruxism

Sleep bruxism—or nocturnal bruxism—is when you grind or clench your teeth while asleep. Sleep bruxism can be more difficult to control than wakeful bruxism since you're not awake to stop it. You may not realize you have sleep bruxism unless someone who sleeps near you hears the grinding noise. Most of the time, your dentist can also tell if you have bruxism. 

When you grind or clench your teeth while sleeping, your jaws can create a lot of pressure. This overuse of your jaw muscles can lead to pain, tiredness, or trouble moving your jaw when you wake up in the morning. Sleep bruxism is often related to sleep problems like sleep apnea (a breathing disorder where a person's breathing repeatedly stops and starts during sleep) or snoring.

Teeth Grinding Symptoms

There are a few signs and symptoms that could indicate you have bruxism, such as:

• Your teeth look worn down, chipped, or cracked
• The enamel (outer layer) of your teeth is wearing away
• Your teeth feel sensitive when eating hot or cold foods
• Your jaw muscles feel sore, tight, or tired
• You hear clicking or popping sounds when you move your jaw, especially in the morning
• Your jaw muscles look bigger than usual
• You wake up with headaches
• You have pain in your face or your ears
• You have marks or indents on the sides of your tongue
• You toss and turn while sleeping, wake up often during the night, or feel sleepy during the day
  

What Causes Teeth Grinding?

The exact cause of bruxism is unclear, but a few things can increase its likelihood. Experts divide the common problems that can lead to bruxism into two categories: primary and secondary bruxism.

Primary Bruxism

Primary bruxism is any bruxism that's not related to a medical condition. Primary bruxism is likely due to your lifestyle, genetics, or certain habits you might have. Examples include:

• Stress: People under a lot of stress may be more likely to clench or grind their teeth. A study found that university students with stress and symptoms of depression were more likely to have self-reported sleep bruxism. The link between stress and bruxism is not yet fully understood.
• Genetics: If someone in your family has bruxism, you are more likely to have it. Researchers looked at a large group of young adult twins and found that genetics had a significant influence on sleep-related bruxism. They didn't find any differences regarding the participants' gender.
• Stimulants: Regularly drinking coffee, smoking tobacco, or excessive alcohol consumption may increase how often or severely someone grinds their teeth at night.

Secondary Bruxism

Secondary bruxism is when something else is going on in your body that's causing you to grind your teeth, such as another health condition or a side effect from medication. The following can cause secondary bruxism:

• Sleep disorders: Certain sleep-related conditions can make bruxism more likely. Adults with obstructive sleep apnea tend to have higher rates of sleep bruxism. The same goes for people with restless leg syndrome (a condition that causes a strong urge to move the legs, especially during rest) and periodic limb movement during sleep (another condition that causes leg movement at night).
• Neurological disorders: Researchers believe there's a link between bruxism and certain conditions that affect the brain and nervous system, such as Parkinson's disease.
• Medications: Selective serotonin reuptake inhibitors (SSRIs) are medications used to treat depression and anxiety. SSRIs have been linked to the development of bruxism.

Bruxism often occurs due to a combination of factors rather than a single trigger. Someone may grind their teeth because of several factors working together, like stress, sleep disorders, and medications.

How Is Teeth Grinding Diagnosed?

If you think you might be grinding your teeth, the first step is to visit your dentist. They can help determine if you have bruxism and figure out the best way to treat it. Here's what to expect during the diagnosis process:

• Medical history: Your dentist will ask about your symptoms, such as jaw pain or headaches. They'll also ask about any medical conditions you have, medications you take, and your lifestyle habits, like smoking or drinking alcohol. This information can help them identify possible causes of your bruxism.
• Dental examination: Your dentist will carefully check your teeth, jaw, and mouth for signs of bruxism. They'll look for wear and tear on your teeth, such as flattened or chipped surfaces. They may also check for tenderness in your jaw muscles and clicking or popping sounds when you open and close your mouth.
• Sleep study (polysomnography): If your dentist suspects you have sleep bruxism, they may refer you to a sleep specialist for a sleep study. During this test, you'll sleep overnight in a laboratory while a medical team monitors your brain waves, heart rate, breathing, and muscle activity. You can sometimes do a sleep study at home. A sleep study can help diagnose sleep disorders like sleep apnea that may contribute to your bruxism.
  

Treatment

The goal of bruxism treatment is to reduce teeth grinding and prevent further damage to your teeth and jaw. Treatment also helps to manage any underlying conditions that may be contributing to your bruxism.

If bruxism is related to an underlying condition like sleep apnea, treating the condition can help reduce your bruxism symptoms. If a medication is causing your bruxism, your healthcare provider may have you stop using that drug or switch to a different one.

The treatment plan will depend on whether you have awake or sleep bruxism, as well as the severity of your condition. Here are some common treatments for both types of bruxism:

• Stress management: Since stress is a common trigger for both awake and sleep bruxism, finding ways to manage stress, like deep breathing, meditation, or yoga, can be an important part of treatment.
• Behavior modification: For awake bruxism, your dentist may recommend strategies to help you break the habit of teeth grinding. You can set reminders to check your jaw positioning to stay aware of when you're clenching your teeth throughout the day. Your healthcare provider may also suggest lifestyle changes to improve your sleep quality, like avoiding tobacco, coffee, or alcohol before bed and keeping your bedroom quiet and dark.
• Mouthguards or splints: These are custom-made plastic devices that fit over your teeth. They provide a cushion between your teeth and absorb some of the pressure from your jaw muscles while preventing damage. You'll usually wear a mouthguard or splint at night for sleep bruxism, but you can also use them during the day. They mainly reduce symptoms and tooth damage versus treating the underlying cause.
• Medications: Your healthcare provider may prescribe short-term medications to help manage bruxism, including muscle relaxants to reduce jaw tension or anti-anxiety medications to help with stress. Your healthcare provider may also suggest Botox injections to temporarily paralyze the jaw muscles and control teeth grinding.
• Other treatment options: Psychotherapy may help you manage stress and be more aware of when you're grinding your teeth. Physical therapy can help reduce symptoms like pain or stiffness in your jaw muscles. Biofeedback is an option that uses sensors to show you when you're tensing your jaw muscles so you can learn to relax them.
  

How To Prevent Teeth Grinding

While it's not always possible to prevent teeth grinding, lifestyle changes can reduce your likelihood of developing the habit or reduce the frequency and severity of bruxism. Many of these prevention strategies are similar to the treatment methods discussed earlier, such as:

• Practice relaxation techniques: Techniques like deep breathing, meditation, yoga, or regular exercise can help you unwind and reduce tension.
• Maintain good sleep hygiene: Stick to a consistent sleep schedule and develop a calming bedtime routine to promote better sleep quality.
• Avoid stimulants: Limit or avoid consuming caffeine, nicotine, and alcohol, particularly in the hours before bedtime, as these substances can interfere with sleep and contribute to bruxism.
• Be mindful of your jaw: Use sticky notes or set reminders throughout the day to relax your jaw muscles and minimize clenching.
• Visit your dentist regularly: Schedule routine dental checkups to monitor your oral health and address any signs of bruxism early on.

If you have an underlying health condition that could contribute to bruxism, work with your healthcare provider to manage the condition. If you have sleep apnea, using a continuous positive airway pressure (CPAP) machine or making lifestyle changes can help manage your symptoms and lower the risk of teeth grinding.

Complications

Constant bruxism may eventually lead to:

• Significant wear and tear on your teeth, causing sensitivity, cracks, chips, or broken teeth
• Gums pulling away from your teeth, exposing the sensitive roots and making them more prone to decay
• Temporomandibular joint (TMJ) disorders, causing pain in your jaw, face, neck, and shoulders, as well as difficulty opening your mouth wide or chewing
• Frequent headaches or migraines
• Ear pain or a feeling of fullness in your ears
• Sleep disruption, leading to daytime fatigue and concentration problems
  

A Quick Review

Bruxism occurs when you grind, clench, or repeatedly rub your teeth together, whether awake or asleep. Experts aren't sure exactly what causes it, but stress, genetics, some medications, and sleep disorders may play a role. If you have bruxism, your jaw may feel sore, you may get headaches, and you may have trouble sleeping. Learning to manage stress, wearing a mouthguard, or trying different kinds of therapy can help treat bruxism. 

If you suspect that you may have bruxism, talk to a dentist or healthcare provider. They can help figure out what's causing the teeth grinding and determine a treatment plan.