Teeth grinding (bruxism): causes, symptoms and what to do

What is bruxism?

Cleveland Clinic describes bruxism as clenching, grinding or gnashing the teeth, usually without conscious awareness, while awake or asleep, and says many people do it occasionally, especially under stress. NIDCR says awake bruxism is more common, sleep bruxism has been studied more, and children and adults can both have it. Our guide on why babies grind their teeth covers children.

What causes it?

Cleveland Clinic says there is no single known cause. Risk factors include stress, anxiety and depression, smoking, heavy alcohol use, a high intake of coffee, certain medicines including SSRIs, and sleep apnoea, which often occurs alongside it. The NHS lists stress and anxiety as the most common links, plus sleep problems such as snoring and sleep apnoea, certain medicines for sleep, depression or anxiety, smoking, and heavy alcohol or caffeine use. NIDCR adds genetics and says some medicines for depression, seizures and ADHD may raise risk.

What are the symptoms?

Cleveland Clinic lists morning headaches or facial pain, earaches, sore jaw muscles, tinnitus, pain when chewing and trouble opening or closing the mouth. The NHS lists jaw pain, worn or broken teeth, tooth sensitivity, tooth or filling loss, headaches, earache and disturbed sleep. Because many people do not notice they grind, regular dental checkups help catch it, according to NIDCR.

What damage can it do?

Cleveland Clinic says long-term grinding can erode enamel and cause loose or cracked teeth, and can contribute to TMJ disorders, sleep problems and facial pain. NIDCR says grinding can flatten, chip, crack or loosen teeth, wear down enamel and cause tooth pain or sensitivity, and that dental repair such as crowns may be needed. Cleveland Clinic does not describe how damaged teeth are repaired; see our guides on cracked teeth and fixing worn teeth.

Does bruxism go away?

Cleveland Clinic says often, yes: children frequently outgrow it by adolescence, in many adults it eventually stops, and mild or occasional grinding usually needs no formal treatment. HealthyChildren.org says most children outgrow it, typically by about age 6. Whether grinding that began on an SSRI stops after the medicine changes is not covered by any source we read; Cleveland Clinic lists SSRIs as a risk factor, so do not stop a medicine on your own and ask your prescriber and dentist.

How is it treated?

Cleveland Clinic lists a custom mouth guard worn during the times you grind most, stress reduction such as meditation, exercise or cognitive behavioral therapy, cutting back on caffeine and alcohol and quitting smoking, short-term muscle relaxants at bedtime and Botox injections for severe cases. The NHS says treatment is not always necessary, that a dentist may make a custom mouth guard or splint to wear at night, and that a GP can help with stress, anxiety, smoking and alcohol or drug concerns. NIDCR describes mouth guards as appliances that keep the teeth apart, protecting them and possibly reducing grinding-related muscle activity. See our night guard guides.

What can you do yourself?

The NHS suggests relaxation methods such as breathing exercises, music and regular exercise, a consistent bedtime routine, over-the-counter pain relief and a cold pack wrapped in a cloth for jaw pain or swelling, regular dental check-ups, avoiding smoking, excess alcohol and caffeine, and avoiding chewing gum or hard foods when your teeth or jaw hurt.

When does grinding matter most?

Cleveland Clinic says if symptoms persist or occur more often than not, see a healthcare provider, that dentists often diagnose bruxism through an exam, and that a sleep study may be needed in some cases. It says to cut back on caffeine and alcohol and quit smoking, and that mild or occasional grinding usually needs no treatment. Regular dental checkups can catch damage early, which is the most practical step.

Questions to ask your dentist

Take these to a check-up.

• Do I have signs of grinding or clenching?
• Do I need a night guard, and what kind?
• Is my sleep or a medicine involved?
• Has my enamel worn, and does anything need repair?
• Who should I see about stress or sleep?

Guides in this topic

Frequently asked questions