Bruxism is the habit of clenching or grinding the teeth without realising it. It mostly happens during sleep; people find out either from the noise their partner hears or from wear their dentist notices.
What is bruxism?
Normally our teeth touch only when we swallow and chew, for a short time in total each day. In bruxism the jaw muscles contract with far more force than in chewing, and for long periods. There are two forms:
- Sleep bruxism: Clenching and grinding during sleep. The person cannot control it.
- Awake bruxism: Clenching during the day, especially when concentrating or under stress. It can be controlled once noticed.
Symptoms
- Tiredness, pain or stiffness in the jaw on waking
- Pain at the temples and in front of the ears, morning headaches
- Teeth that look flattened or shorter, chipped edges
- Notch-shaped loss of tooth at the gum line
- Sensitivity to cold and heat
- Fillings that break and teeth or porcelain that crack for no clear reason
- A white line inside the cheek, tooth marks on the edge of the tongue
- Clicking, locking or limited opening of the jaw joint
What causes it?
There is no single cause. Stress and anxiety are the best-known triggers. Sleep disorders such as sleep apnoea, caffeine, alcohol and smoking, and some antidepressants can also increase bruxism. It is common in children and usually lessens by itself as the permanent teeth come through.
Effects on the teeth and jaw
Untreated bruxism can in time lead to:
- Wearing down of the enamel and shortening of the teeth
- Cracks and fractures in the teeth
- Damage to fillings, crowns and implants
- Gum recession and loose teeth
- Jaw joint disorders and chronic muscle pain
Treatment options
Night guard
A clear guard made from an impression of your teeth, usually worn on the upper teeth. It does not stop the clenching, but the guard takes the force instead of the teeth; it protects the teeth from wear and the joint from overload. Ready-made guards sold in pharmacies do not fit properly and can upset the bite; they are not recommended.
Awareness and changing the habit
The most effective method for daytime clenching. At rest the lips should be closed, the teeth apart and the tongue resting lightly on the palate. Check yourself during the day; a small reminder note on your screen works.
Stress management and sleep routine
Regular exercise, cutting down on screens and caffeine before bed and relaxation exercises can reduce the intensity of clenching.
Help for muscle pain
Warm compresses on the jaw muscles and avoiding hard foods and things that need long chewing, like gum, bring relief. In some cases physiotherapy or botulinum toxin injections into the chewing muscles may be recommended by the dentist.
Repairing worn teeth
In advanced wear the teeth are restored to their former length with fillings or crowns. Wearing a night guard after the repair is essential to protect the restorations.
Frequently asked questions
How can I tell if I clench my teeth?
Morning jaw tiredness and headaches, a grinding noise your partner hears and flattened tooth tips are the most common clues. Your dentist makes a definite assessment by looking at wear marks on the teeth and at the jaw muscles.
How long is a night guard worn for?
For as long as the bruxism continues. The guard wears over time; it is checked at appointments and replaced when necessary.
My child grinds their teeth in their sleep. Is treatment needed?
Teeth grinding is common in children and usually passes as they grow. An examination is recommended if there is marked wear, pain or a sleep problem.
This article is for general information and is not a substitute for diagnosis or treatment. If you have a complaint, please see your dentist.