Bruxism (Teeth Grinding): How Do I Stop It?

Medically Reviewed by Zilpah Sheikh, MD on December 14, 2023
7 min read

Bruxism is clenching, grinding, or gnashing your teeth, either while you're awake or asleep.

Most people probably grind and clench their teeth from time to time. Occasional teeth grinding doesn't usually cause harm, but when it happens regularly, you can damage your teeth. Bruxism can lead to other health problems, too. 

There are two types of bruxism. 

If you're clenching your teeth while awake, that's called awake, or diurnal, bruxism. 

If you're grinding your teeth while sleeping, that called sleep, or nocturnal, bruxism. 

Researchers think these two types may have separate causes. 

Health-care professionals sometimes refer to "primary" and "secondary" bruxism. If you have primary bruxism, it's not related to any other medical condition. Secondary bruxism is linked to some other medical issue, such as a neurological problem. It can also be a side effect of some drugs. 

If you grind your teeth while you're awake, it's probably linked to stress or anxiety in your daily life. You might also do it when you're concentrating hard.

Grinding your teeth while asleep is considered a "sleep related movement disorder." It starts as a problem in your central nervous system. 

Lifestyle and medical factors can play a role in bruxism. They include: 

  • High caffeine intake, the equivalent of more than six cups of coffee each day 
  • Alcohol use 
  • Smoking 
  • Using recreational drugs 
  • Taking certain prescription drugs, including selective serontonin reuptake inhibitors (SSRIs) 
  • Family history of teeth grinding 
  • Parkinson's disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, night terrors, sleep-related disorders such as sleep apnea, and attention deficit hyperactivity disorder (ADHD)

 

Because grinding often occurs during sleep, most people are unaware that they do it. You might learn you grind your teeth from a loved one who hears the grinding at night.

Symptoms of bruxism can include: 

  • Flattened, chipped, or loose teeth
  • Worn tooth enamel
  • Tooth pain or sensitivity
  • Tight jaw muscles 
  • Your jaw won't open or close completely
  • Pain in your jaw, face, or neck 
  • Pain that feels like an earache
  • Dull headache in your temples
  • Chewing the inside of your cheek 
  • Pain when you eat
  • Clicking or popping in your jaw, which is a sign of a problem with your temporomandibular joint (TMJ) 

Do I Need a Sleep Study?

Your dentist may be able to diagnose bruxism by checking your teeth and jaw. In some cases, though, you may need a sleep study – called polysomnography – to know for sure if you have bruxism. These tests are done at hospitals or special sleep centers. You'll be hooked up to monitors while you sleep. Your heart rate, oxygen level, brain waves, breathing, and other stats are recorded. 

Researchers have found that many people with nocturnal bruxism also have obstructive sleep apnea. When you have it, you struggle to breathe at night because your airway becomes blocked. You might gasp, snort, choke, or briefly stop breathing. Scientists don't fully understand the relationship between the two conditions. If you have bruxism, it's important to know the symptoms of sleep apnea. If you think you may have it, talk to your doctor. You may need a sleep study to check for sleep apnea. 

In some cases, chronic teeth grinding can result in a fracturing, loosening, or loss of teeth. The chronic grinding may wear teeth down to stumps. When these events happen, bridges, crowns, root canals, implants, partial dentures, and even complete dentures may be needed.

Not only can severe grinding damage teeth and result in tooth loss, but it can also affect your jaws, cause or worsen TMD/TMJ, and even change the appearance of your face.

The first step to dealing with bruxism is identifying the cause. Your doctor or dentist will ask questions about your lifestyle, medications, and sleep habits. That will help determine your treatment. 

Mouth guards for teeth grinding. Your dentist can fit you with a mouth guard to protect your teeth from grinding during sleep. Most are made out of plastic. If you have a latex allergy, be sure to let your dentist know. 

Dental correction: Dentists sometimes try to treat bruxism by changing the way your teeth fit together, for instance, grinding down certain teeth. But there's no evidence that this approach works. If your bite is off, meaning your top and bottom teeth don't align when you close your mouth, your dentist might suggest braces. This problem is called malocclusion. Braces will fix malocclusion, but it's not clear that they help bruxism. 

Stress reduction. If stress is causing you to grind your teeth, ask your doctor or dentist about options to reduce your stress. Attending stress counseling, starting an exercise program, seeing a physical therapist, or obtaining a prescription for muscle relaxants are some of your options.

Sleep hygiene. This is what medical professionals call setting the stage for a restful night's sleep. It includes keeping your bedroom quiet and dark and avoiding physical activities or things that might stimulate you mentally and keep you awake. Good sleep hygiene helps your overall health, though the research on whether it helps bruxism isn't clear. 

Botox for teeth grinding. Injections of this toxin are used for a number of medical conditions. It inhibits muscle movement. Research has found that injections into the muscles involved in chewing ease symptoms of bruxism. 

Sleep apnea and bruxism. Treatment for your sleep apnea may help your bruxism as well. If you use a CPAP or BiPAP machine, your airway will be kept open by the air forced into your nose or mouth, or both. This may reduce your teeth grinding. Another treatment for sleep apnea is a mandibular advancement device, or MAD. It's a mouthpiece that forces your jaw forward to keep your airway open. It may also keep you from grinding your teeth. 

Lifestyle changes can help with bruxism. These include: 

  • Avoid or cut back on foods and drinks that contain caffeine, such as colas, chocolate, and coffee.
  • Avoid alcohol. Grinding tends to intensify after alcohol consumption.
  • Do not chew on pencils or pens or anything that is not food. Avoid chewing gum as it allows your jaw muscles to get more used to clenching and makes you more likely to grind your teeth.
  • Train yourself not to clench or grind your teeth. If you notice that you clench or grind during the day, position the tip of your tongue between your teeth. This practice trains your jaw muscles to relax.
  • Relax your jaw muscles at night by holding a warm washcloth against your cheek in front of your earlobe.

Exercises can help you manage the pain of bruxism and keep your jaw muscles flexible. 

To relax your jaw: 

  1. Close your lips but don't let your top and bottom teeth touch.
  2. Press your tongue against the roof of your mouth. It shouldn't touch your teeth. 
  3. Hold the position. 
  4. Repeat several times a day.

To help your jaw move more freely: 

  1. Put your hands on the joints where your lower jaw connects. 
  2. Open your mouth slowly. 
  3. Hold for 5-10 seconds. 
  4. Close your mouth slowly. 
  5. Do this for 10 minutes at a time, three times a day. 

The problem of teeth grinding is not limited to adults. Approximately 15% to 33% of children grind their teeth. Children who grind their teeth tend to do so at two peak times -- when their baby teeth emerge and when their permanent teeth come in. Most children lose the teeth grinding habit after these two sets of teeth have come in more fully.

Most commonly, children grind their teeth during sleep rather than during waking hours. No one knows exactly why children grind their teeth, but possible causes include improperly aligned teeth or irregular contact between upper and lower teeth, illnesses and other medical conditions (such as nutritional deficiencies, pinworm, allergies, endocrine disorders), and psychological factors including anxiety and stress.

Though it may be tough to hear, teeth grinding in babies or children is rarely serious. But it can cause jaw pain, headaches, wear on the teeth, and TMD. Consult your dentist if your child's teeth look worn or if your child complains of tooth sensitivity or pain.

Specific tips to help a child stop grinding their teeth include:

  • Decrease your child's stress, especially just before bed.
  • Try massage and stretching exercises to relax the muscles.
  • Make sure your child's diet includes plenty of water. Dehydration may be linked to teeth grinding.
  • Ask your dentist to monitor your child's teeth if they are a grinder.

No intervention is usually required with preschool-age children. However, older children may need temporary crowns or other methods, such as a night guard, to prevent the grinding.

 

Is teeth grinding genetic?

You're at higher risk of bruxism if someone else in your family has it. But researchers haven't found a specific gene tied to teeth grinding. 

What deficiency causes teeth grinding?

One small study found that people with bruxism have lower levels of vitamin D and low amounts of calcium in their diets. But researchers aren't sure what the findings mean, and it's not clear that any deficiency causes bruxism.