Many people grind or clench their teeth without realising it, often during sleep. Over time this can damage teeth, jaw muscles, and cause significant pain.
Bruxism is the medical term for grinding, clenching, or gnashing your teeth. It can happen while you are awake or, more commonly, while you are asleep. Sleep bruxism is particularly tricky because most people are unaware they are doing it.
It is surprisingly common — studies suggest that around 1 in 10 adults grind their teeth to some degree. It can affect people of all ages, including children.
Occasional mild grinding may not cause problems, but frequent or severe bruxism can lead to worn teeth, jaw pain, headaches, and damage to dental restorations.
What causes bruxism?
The exact causes are not fully understood, but several factors are linked to bruxism:
Stress and anxiety — the most commonly identified trigger. Many people grind more during stressful periods in their life.
Sleep disorders — particularly obstructive sleep apnoea. Bruxism is significantly more common in people who snore or stop breathing during sleep.
Stimulants — caffeine (coffee, energy drinks), alcohol, smoking, and recreational drugs (particularly MDMA) are all associated with bruxism.
Certain medications — especially some antidepressants (SSRIs) can trigger or worsen grinding.
Personality type — people who are naturally driven, competitive, or perfectionist may be more susceptible.
Family history — bruxism can run in families.
Signs and symptoms
Many people only find out they grind when a partner tells them or a dentist notices the signs. You may notice:
Worn, flattened, or chipped teeth — particularly on the biting edges of front teeth
Tooth sensitivity to cold or heat
Jaw pain or stiffness — especially on waking
Headaches — a dull ache in the temples, often worse in the morning
Earache — from jaw muscle tension near the ear
Facial pain or tired, aching jaw muscles
Disrupted sleep — your own or your partner's
Scalloped edges on the tongue or ridges on the inside of the cheeks — signs of pressing or biting
Broken or repeatedly cracking fillings and restorations
How is bruxism managed?
There is no single cure for bruxism, but it can be effectively managed. Your dentist will work with you to protect your teeth and address contributing factors:
Occlusal splint (nightguard) — a custom-made hard acrylic appliance worn over the teeth while you sleep. It does not stop grinding, but it absorbs the forces and protects the teeth from further wear. This is the most common first-line dental treatment. Hard stabilisation splints (sometimes called Michigan splints) are generally preferred over soft flexible guards — soft guards can actually worsen clenching in some people.
Stress management — therapy, relaxation techniques, and exercise can significantly reduce stress-related bruxism. Cognitive behavioural therapy (CBT) has good evidence for this.
Review medications — if an SSRI may be a contributing factor, your GP may consider an alternative. Never change medication without medical advice.
Treatment for sleep apnoea — if this is a contributing factor, managing it may reduce bruxism.
Botulinum toxin injections — in severe cases, injections into the jaw muscles can reduce the intensity of grinding. This is not a first-line treatment and is usually reserved for cases where other approaches have not worked.
Repairing damaged teeth — fillings, crowns, or composite bonding may be needed to restore teeth that have been worn or damaged.
What you can do at home
You can take steps to reduce the impact of bruxism:
Reduce caffeine and alcohol — especially in the evenings.
Practise relaxation techniques before bed — such as slow breathing, meditation, or progressive muscle relaxation.
Try to become aware of clenching during the day — if you notice your teeth are clenched together, consciously relax your jaw. Your teeth should only touch when you are eating or swallowing.
Apply a warm compress to your jaw if it aches — this helps relax the muscles.
Avoid chewing on hard objects — pens, ice, fingernails — which can exacerbate wear.
Talk to your GP if you think stress or anxiety is a major factor.
When to see your dentist
Please make an appointment if:
You are waking with jaw pain or headaches regularly
A partner tells you that you are grinding your teeth at night
You notice your teeth appear shorter, flatter, or more sensitive than before
Fillings or dental restorations are breaking repeatedly for no clear reason
Your dentist will examine your teeth, jaw muscles, and joints to assess the severity and recommend the most appropriate management plan.
This leaflet is for general information only and does not replace professional dental advice. Your dentist will discuss your individual circumstances and any risks and treatment specific to you. Treatment outcomes vary between patients depending on individual circumstances.
References
Aligned with guidance from: NICE, FGDP(UK), SDCEP.