Understanding Tooth Grinding (Bruxism)
Many people grind or clench their teeth without knowing, often while asleep. Over time this can damage teeth and jaw muscles and cause a lot of pain.
What is bruxism?
Bruxism is the medical name for grinding, clenching or gnashing your teeth. It can happen while you are awake. It happens more often while you are asleep.
Grinding in your sleep is hard to spot, because most people do not know they are doing it.
It is more common than you might think. Studies suggest around 1 in 10 adults grind their teeth to some degree. It can affect people of all ages, including children.
Mild grinding now and then may not cause problems. But frequent or severe grinding can lead to worn teeth, jaw pain, headaches and damage to fillings, crowns and other dental work.
What causes bruxism?
The exact causes are not fully known. But several things are linked to bruxism:
- Stress and anxiety. This is the most common trigger. Many people grind more at stressful times in their life.
- Sleep problems, mainly obstructive sleep apnoea. Bruxism is much more common in people who snore or stop breathing in their sleep.
- Stimulants. Caffeine (coffee, energy drinks), alcohol, smoking and recreational drugs (mainly MDMA) are all linked to bruxism.
- Some medicines. Some antidepressants (SSRIs) in particular can start or worsen grinding.
- Personality. People who are very driven, competitive or perfectionist may be more likely to grind.
- 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 spots the signs. You may notice:
- Worn, flat or chipped teeth, mostly on the biting edges of front teeth
- Tooth sensitivity to cold or heat
- Jaw pain or stiffness, mostly when you wake up
- Headaches. This is often a dull ache in the temples that is worse in the morning.
- Earache from tense jaw muscles near the ear
- Face pain, or tired, aching jaw muscles
- Broken sleep, for you or your partner
- Wavy edges on your tongue, or ridges inside your cheeks. These are signs of pressing or biting.
- Fillings and other dental work that break or crack again and again
How is bruxism managed?
There is no single cure for bruxism, but it can be well managed. Your dental team will work with you to protect your teeth and deal with the things that add to it:
- A bite guard (occlusal splint or night guard). This is a custom-made, hard plastic (acrylic) guard. You wear it over your teeth while you sleep. It does not stop grinding. But it takes the force and protects your teeth from more wear. It is the most common first dental treatment.
- Hard guards (stabilisation splints, sometimes called Michigan splints) are usually preferred over soft, bendy guards. In some people, soft guards can make clenching worse.
- Managing stress. Therapy, relaxation and exercise can greatly reduce grinding caused by stress. Talking therapy (cognitive behavioural therapy, or CBT) has good evidence for this.
- Checking your medicines. If an SSRI may be playing a part, your GP may think about another medicine. Never change a medicine without medical advice.
- Treating sleep apnoea. If this plays a part, treating it may reduce grinding.
- Botulinum toxin injections. In severe cases, injections into the jaw muscles can make grinding less forceful. This is not a first treatment. It is usually kept for cases where other treatments have not worked.
- Repairing damaged teeth. You may need fillings, crowns or composite bonding to repair worn or damaged teeth.
What you can do at home
You can take steps to reduce the effects of grinding:
- Cut down on caffeine and alcohol, mostly in the evening.
- Relax before bed. Try slow breathing, meditation, or tensing and relaxing your muscles one by one (progressive muscle relaxation).
- Try to notice clenching in the day. If your teeth are clenched together, relax your jaw on purpose. Your teeth should only touch when you eat or swallow.
- Put a warm compress on your jaw if it aches. This helps relax the muscles.
- Do not chew hard things like pens, ice or fingernails. This can make wear worse.
- Talk to your GP if you think stress or anxiety is a big factor.
When to see your dental team
Make an appointment if:
- You often wake up with jaw pain or headaches
- A partner tells you that you grind your teeth at night
- Your teeth look shorter or flatter, or feel more sensitive, than before
- Fillings or other dental work keep breaking for no clear reason
Your dental team will check your teeth, jaw muscles and jaw joints. They will see how severe it is and suggest the best plan for you.
This leaflet is for general information only and does not replace professional dental advice. Your dental team will discuss your individual circumstances and any risks and treatment specific to you. Treatment outcomes vary between patients depending on individual circumstances.
Sources
- Teeth grinding (bruxism). NHS website (nhs.uk), reviewed April 2026.
- Jaw problems and headaches. Oral Health Foundation.
Links checked 18 October 2026.
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