Teeth grinding (Bruxism)

Teeth grinding is when you rub or clench your teeth together without meaning to. There are lots of possible causes, like stress, sleep disorders, or too much caffeine. Teeth grinding doesn’t always need treatment. But if it’s causing you pain, tooth damage, or disturbing your sleep, a dentist can help.

What is bruxism?

The medical name for teeth grinding is bruxism. You might not realise you’re doing it, because teeth grinding often happens when you’re stressed or asleep. If you clench your teeth during the day, it’s known as awake bruxism. Whereas teeth grinding at night is called sleep bruxism.

Gritting teeth symptoms (bruxism)

Grinding your teeth doesn’t always cause symptoms. But if it does, you might have:

• headaches
• earache
• pain around your face
• pain in your jaw, known as TMJ dysfunction, which could be worse when you wake
• trouble opening your mouth
• broken, worn down, or sensitive teeth 
• cuts on your tongue or the inside of your cheek
• disturbed sleep

You might not notice that you’re grinding your teeth, particularly if you do it while sleeping. So it’s possible that someone else will notice first. If you share a bed with someone, it may sometimes be loud enough to wake them.

Self-help for teeth grinding (bruxism)

There are some things you can try to stop grinding your teeth naturally and ease any pain.

• Take over-the-counter painkillers like paracetamol or ibuprofen.
• Apply a heat or cold pack to your jaw.
• Cut down on how much alcohol and caffeine you drink.
• If you smoke or take recreational drugs, try to stop.
• Pay attention to when you’re clenching or grinding your teeth, and consciously release the tension.
• Create a calming bedtime routine, like keeping your room cool and quiet.
• Practise jaw stretching exercises, such as opening your mouth wide 10 times, twice a day. A physiotherapist can help with this.
• Try relaxation techniques like meditation, yoga, music, or journaling, or see your GP for help with stress.

Diagnosis of teeth grinding (bruxism)

If your bruxism (teeth grinding) is caused by stress, anxiety, alcohol, smoking, drugs or medication, make an appointment to see a GP . They can give you further advice and support to help with this. If grinding your teeth is causing pain or swelling in your teeth or jaw, make an appointment to see a dentist.

• Dental check-up

  Your dentist will do a thorough examination of your mouth, feel your jaw, and look for signs of bruxism like tooth damage. They’ll also ask some questions about your lifestyle, any medications you’re taking, and which symptoms you’re experiencing.

• Diary and mouth guards

  Sometimes, your dentist may ask you to keep a diary of how often you’re grinding your teeth and how bad it is. If you share a bed with someone, it might be helpful for them to fill this out too. Or they might ask you to wear a plastic mouth guard over your teeth at night for a while so they can examine it and determine exactly where your teeth are digging in.

• Electromyography (EMG) recorder

  Your dentist might recommend you take home a small electronic device called an electromyography (EMG) recorder. This uses electrodes to record how active the muscles in your jaw are. You place the electrodes over the skin on your jaw for an hour at a time, and it helps to diagnose bruxism.

• Polysomnography (PSG)

  In special cases, if your doctor or dentist suspects that your bruxism (teeth grinding) is related to a sleep disorder, they may refer you to a sleep specialist for an overnight sleep study called a polysomnography (PSG). This monitors things like your brain waves, heart rate, and muscle activity while you sleep. It’s used to diagnose sleep disorders, including sleep apnoea, narcolepsy, and sleep bruxism.

Treatment of teeth grinding (bruxism)

Although there’s no way to stop grinding teeth completely, there are things that can help. If your bruxism is mild, you might not need any treatment. But if it’s causing you pain, problems with your dental health, or sleep, your doctor or dentist may recommend the following:

A mouth guard or mouth splint

Cognitive behavioural therapy (CBT)

If stress or anxiety is causing you to grind your teeth, your doctor might suggest cognitive behavioural therapy (CBT). This therapy helps you identify the triggers for your bruxism. It teaches you ways to manage stress and rethink negative thoughts, helping to reduce the tension and stop teeth grinding.

Physiotherapy

If your bruxism is causing a lot of pain in your jaw, a physiotherapist may be able to help. They can teach you how to relax your jaw and create space between your teeth. They can also show you exercises to stretch the muscles in your jaw. Your physiotherapist might massage the muscles around your neck, jaw, and shoulders to relax them and ease the pain.

Dental treatment

If grinding your teeth has damaged them in any way, your dentist might suggest an implant, crown, or filling to repair or replace them. If your bruxism is due to misaligned teeth, you might benefit from orthodontic treatment to straighten them.

Medication

Your doctor may suggest taking muscle relaxers before you sleep for bruxism (teeth grinding). These help to relax the muscles in your jaw and reduce the tension that leads to teeth grinding and pain. But they’re only a short-term solution.

Botox injections

If other treatments like stress management and mouth guards haven’t worked, your dentist might advise injecting botulinum toxin (Botox) into the muscles surrounding your jaw. This weakens the muscles, so you can’t clench so hard. Treatment can last up to six months, so you’ll need to have it done again.

Complications of teeth grinding (bruxism)

If you only grind your teeth occasionally, it’s unlikely to cause any complications. But if you grind your teeth a lot or for a long time, it can put strain on your mouth and sometimes lead to other problems, such as:

• Temporomandibular joint (TMJ) dysfunction. This is a problem with your jaw joint. It can make it difficult to open and close your mouth, cause pain as well as popping and clicking sounds.
• Damaged teeth. Over time, your teeth may become worn down, loose, or cracked. If you have a filling, dental crown, or implant, these could also become damaged and need replacing.
• Tension headaches. You might develop very bad headaches, particularly around your temples.
• Changes to the shape of your face. Using your jaw muscles more than normal can slowly cause them to grow. Over time, this might make your jaw look bigger and more square.

Prevention of teeth grinding (bruxism)

It’s not always possible to stop teeth grinding from happening, especially if you do it while sleeping. But there are some things you can do to reduce the chances.

• See a dentist for regular check-ups . They can spot the signs of teeth grinding and treat any damage early.
• Practise stress-management techniques, such as yoga and meditation.
• Limit how much caffeine and alcohol you drink.
• Avoid smoking and recreational drugs.