Bruxism, also known as teeth grinding or jaw clenching, is a common condition that affects about 22% of people all over the world.[1] It often happens without you noticing, especially during sleep.

Without treatment, bruxism can wear down enamel, crack teeth, trigger morning headaches, and aggravate temporomandibular joint (TMJ) pain. Find out what bruxism is, why it happens, and how it can be treated.

What Is Bruxism?

Bruxism is a condition characterized by involuntary clenching or grinding of the teeth,[2] either while you’re awake or while you sleep. Sleep bruxism is classified as a sleep-related movement disorder that may involve bursts of jaw-closing muscle activity, but you don’t remember it in the morning.[3]

The signs of bruxism include flattened or chipped teeth, tooth sensitivity, jaw or facial pain, earaches, and headaches upon waking.[4] Some people realize they have bruxism when their partner hears them grinding during sleep.

Dentists often diagnose bruxism based on history, symptoms, and an exam that looks for tooth wear, cracked restorations, tongue indentations, or enlarged chewing muscles.

What Causes Bruxism?

Bruxism is a multifactorial condition. It doesn’t have one single cause, but multiple contributing factors:[5]

• Stress, anxiety, and poor sleep
• Sleep disorders like obstructive sleep apnea
• Medications and substances like caffeine, alcohol, nicotine, and some drugs that affect serotonin or dopamine, like stimulants or antidepressants
• Personality traits like hypervigilance or daytime habits like sustained jaw tension

Treatment for Bruxism

Bruxism treatment has a few goals:[6]

• Protect the teeth from damage
• Reduce pain and muscle tension for TMJ relief
• Address triggers like stress, sleep problems, or medications/drugs
• Most therapies seek to manage bruxism instead of “curing” it.

Home Remedies for Bruxism

Bruxism requires an evaluation from a dentist or orthodontist, but there are some things you can do at home to reduce the damage:[7]

• Stress and sleep hygiene: Prioritize a nighttime routine with consistent sleep and wake times. Get up at the same time every day, even on weekends.
• Practice nighttime relaxation: Try relaxation techniques like breathing, yoga, or meditation to relax before bed and relieve stress or anxiety.
• Reduce caffeine and other substance use: Stimulants like caffeine and nicotine or depressants like alcohol can aggravate teeth grinding, so try reducing your intake.
• Jaw awareness training: Set reminders on your phone to consciously relax your jaw.
• Calm jaw muscles: If you have TMJ pain, use short courses of ibuprofen (if safe for you), moist heat or ice, and gentle jaw stretches to calm the joint and surrounding muscles.
• Check other contributing factors: If you snore, wake unrefreshed, or feel tired during the day, ask your doctor about screening for sleep apnea or other sleep conditions that may be contributing to bruxism.

Dental Treatment for Bruxism

Night Guards

A night guard, or occlusal splint, is a custom-made, thin acrylic appliance that fits over your teeth.[8] It can’t cure bruxism, but it can protect your enamel, fillings, and restorations from heavy force. It may also reduce morning jaw soreness by distributing the load across your bite, instead of certain areas.

Though over-the-counter night guards are available, they’re not as effective as a custom-fit device. Custom guards are also more comfortable to wear, ensuring that you use it regularly.

Daytime Guards

If you grind your teeth during the day, a daytime version of occlusal splints with a thinner, low-profile design can be helpful. These are meant to be used while you work or drive, providing a gentle reminder of grinding and limiting tooth-to-tooth contact.

Botox

Botulinum toxin (Botox) can help people with severe, refractory bruxism or significant hypertrophy (enlargement of muscles) and pain. Targeted Botox injections into the masseter or temporalis can reduce muscle activity and pain for several months.

Randomized trials and recent reviews support short-term benefits, especially for symptom relief.[9] However, it’s used off-label for bruxism, and the effects are temporary. You may have side effects, such as chewing fatigue, asymmetry, and, with repeated high-dose use, unpleasant changes in muscle or nearby bone.

Medications

There’s no simple pill for bruxism, but short courses of muscle relaxants taken at bedtime may help in some cases. Clonazepam may be considered for sleep-related movement disorders, while buspirone can help when bruxism is caused by selective serotonin reuptake inhibitors (SSRIs).[10] The benefits of these treatments are limited, and there are risks and side effects, so your doctor and dentist need to coordinate your treatment.

Dental Repair

If your bruxism has already caused damage to your teeth, your dentist can plan restorative work like bonded composites, crowns, or onlays to fix worn or damaged teeth. It’s important that these treatments occur after a protection strategy, like a nightguard, is in place to prevent the new work from becoming damaged.

Pediatric Bruxism

Pediatric bruxism can occur in children and teens, but it’s often self-limited. Many kids simply outgrow it. However, if there’s significant tooth wear, pain, or sleep problems, pediatric bruxism may require interventions like a soft guard to protect the teeth and jaw.

When to See a Dentist or Doctor for Bruxism

If you notice flattened or chipped teeth, cracks, persistent jaw or facial pain, limited opening or locking of the jaw, or frequent morning headaches, it may be time for a checkup to ensure that your teeth aren’t damaged from nighttime grinding.

If your symptoms are accompanied by snoring and feeling tired after a long night’s sleep, ask for a sleep apnea assessment to check if you have sleep issues contributing to bruxism.

Get Treatment for Bruxism and Its Effects

Bruxism is a common and often unconscious behavior, but it can cause damage to your teeth and pain in the jaw if it’s left untreated. If you’re ready to stop grinding your teeth and save your smile, Kunik Orthodontics can help. We’ll examine your teeth, determine underlying causes, and prepare a personalized plan. Book a free consultation today!

Frequently Asked Questions About Bruxism