Bruxism (teeth grinding)
Bruxism is chronic, involuntary grinding or clenching of teeth. It usually occurs during sleep, but it may also occur while awake.
The exact cause of bruxism is unknown, but it is believed to be related to:
- Stress and anxiety
- Abnormal alignment of the teeth or jaws
Bruxism is more common in people aged 40 years and younger. Women aged 27-40 years old are also likely to get bruxism.
Other factors that may increase your chance of bruxism include:
- Chronic stress or anxiety
- Aggressive or competitive personality
- Smoking tobacco or drinking caffeinated beverages
- Abuse of drugs or alcohol, especially methamphetamines
- Post-traumatic stress disorder
- Family member with bruxism
- Facial or oral trauma
- Use of psychiatric medications, especially antidepressants
- Prior serious head injury
- Complication resulting from a disorder, such as Huntington's or Parkinson's disease
Symptoms may include:
- Grinding sounds during sleep
- Teeth that are sensitive to heat, cold, or brushing
- Tense facial or jaw muscles
- Teeth that are worn down, flattened, fractured, or chipped
- Hairline cracks or wearing of the enamel on some teeth
- Sore teeth
- Swollen gums
- Headache, especially when waking in the morning
- Damage to the inside of the cheek—from biting or chewing
You will be asked about your symptoms and medical history. An examination of your teeth and jaw will be done. With bruxism, teeth will have flattened tips, excessive wear, thin enamel, or sensitivity. X-rays may be done to check for further damage to your teeth or the underlying bone.
Methods of treatment include:
Behavioral or Cognitive Treatment
This method focuses on changing behavior through various techniques, such as:
- Cognitive behavioral therapy
- Stress management
- Relaxation therapy or exercises
Your dentist may advise:
- A protective mouth appliance, such as a night guard. It can absorb the pressure of constant night grinding.
- Correction of misaligned teeth if your bruxism might be caused by this.
Medication is only recommended for short-term use. Medications may include:
- Muscle relaxants before sleep
- Mild sleeping aids
- Injection of botulinum toxin (Botox) into jaw muscle—for severe cases or if other treatments are not working
Bruxism that is not treated may result in gum damage, tooth loss, and jaw-related disorders.
The same methods used to treat bruxism can be used to prevent the condition. In addition, avoid caffeinated drinks at night.
Make sure to see your dentist regularly for check-ups
Academy of General Dentistry
Mouth Healthy—American Dental Association
Canadian Dental Association
Dental Hygiene Canada
Bruxism. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/general/sleep/bruxism.html. Updated October 2012. Accessed August 5, 2015.
Chang H. Botulism toxin: use in disorders of the temporomandibular joint. Dent Today. 2005;24(12):48,50-51.
Tan EK, Jankovic J. Treating severe bruxism with botulinum toxin. J Am Dent Assoc. 2000;131:(2)211-216.
Teeth grinding. Mouth Healthy—American Dental Association website. Available at: http://www.mouthhealthy.org/en/az-topics/t/teeth-grinding. Accessed September 9, 2014.
Teeth grinding. National Sleep Foundation website. Available at: http://sleepfoundation.org/sleep-disorders-problems/bruxism-and-sleep. Accessed August 5, 2015.
Last reviewed September 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.