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Why am I grinding my teeth?

If you're stressed and waking up with a sore jaw, try these tips

Do you wake up with sore facial muscles or pain in your jaw? Do you frequently have headaches in the morning? You could be grinding your teeth while sleeping. Medically known as bruxism, it is a repeated, unconscious clenching and grinding movement. It is involuntary, and you often aren’t aware that you are doing it, especially if you grind your teeth while sleeping. It’s difficult to consciously quit without strategies for how to stop grinding teeth.

What is bruxism?

Bruxism is the medical name for teeth grinding. Teeth grinding is the repeated rubbing together, or gnashing, of the biting surfaces of your teeth. You can apply up to 250 pounds of pressure on your teeth, according to the MSD Manual. That’s a lot of force.

What causes teeth grinding?

Teeth grinding is common. Up to one-third of adults exhibit bruxism behaviors during daytime hours; more than 1 in 10 have sleep bruxism (or nocturnal bruxism), according to the Cedars-Sinai Medical Center. Anywhere from 20% to 30% of children grind their teeth, usually while sleeping, according to familydoctor.org

There is no one root cause of teeth grinding. However, there are numerous contributing factors:

  • Stress: In times of high anxiety, many people grind their teeth. It can become a habit and continue even during calm times.
  • Genetics: Bruxism might be hereditary. As many as half the people who grind their teeth also have a close family member who also has bruxism.
  • Certain medical conditions: Bruxism is more common in children diagnosed with a hyperactivity disorder, such as ADHD, or certain health conditions, such as cerebral palsy. It’s more common in adults with depression, anxiety, acid reflux or gastroesophageal reflux disease (GERD), and certain eating disorders.
  • Sleep disorders: Teeth grinding is associated with snoring, obstructive sleep apnea, and frequently changing sleep patterns. For example, shift workers who alternate between daytime and nighttime sleep may be more likely to grind teeth.
  • Lifestyle factors: Tobacco use, alcohol consumption, and caffeine intake are all linked to bruxism. Though, more research is needed to determine how these risk factors may contribute to the condition.
  • Vitamin deficiencies: There is some speculation that certain vitamin deficiencies can contribute to bruxism. “Vitamin D deficiencies and a poor absorption of calcium are being studied as potential factors in teeth grinding,” says Cristi Freinberg-Trufas, DDS, a dentist at Hudson Valley Dental Care, PC. “There are many studies underway, but no conclusive evidence has emerged that the American Dental Association has adopted.” 

Medications that cause bruxism

Bruxism can be a potential side effect of some medications, according to a study published in 2019.  Possible culprits include antipsychotics and commonly used antidepressants, such as:

The median time for teeth grinding is three to four weeks after starting the medication, although some people start after only a few doses. It takes about three to four weeks after stopping the medicine for teeth clenching to stop.

How is bruxism diagnosed?

“Bruxism is fairly common, but people can be asymptomatic and not know they have this behavior,” says Mary Charles Haigler, DMD, an orofacial pain specialist at Carolinas Centers for Oral, Facial, Cosmetic & Dental Implant Surgery. This is often true when teeth grinding occurs at night. Sometimes a family member brings attention to it because of the noise—clicking, and popping—that interrupts their sleep. “Other people might notice side effects [of the grinding],” explains Haigler. “Some potential adverse effects seen by oral health professionals are cracked teeth, tension-type headaches, severe facial or jaw pain, and temporomandibular joint (TMJ) problems.” 

Early signs of bruxism include:

  • Facial or jaw pain
  • Headaches, especially in the morning
  • Stiffness in the jaw
  • Ear pain
  • Disrupted sleep

Without proper attention, bruxism can cause long-term damage, such as:

  • Abraded teeth
  • Dental problems, such as chipped, cracked, or loose teeth, crowns, or implants
  • Sensitive teeth caused by wearing down of tooth enamel
  • Tense facial and jaw muscles
  • Dislocation of jaw
  • Locking of jaw
  • Damage to the inside of the cheek
  • Flat areas on biting surface of teeth

Many times, bruxism is diagnosed through observation by a dentist or family members; however, a definitive diagnosis involves an overnight stay in a sleep clinic—called polysomnography. This sleep study is often expensive and time-consuming, and people might opt for the less invasive observation method, where a presumptive diagnosis is made.

How to stop grinding teeth

“In over 90% of cases, bruxism treatment is very simple and effective,” says Daniel Wolter, DMD, a restorative and general dentist in Arizona. “In most cases, this also helps with joint or muscle pain and headaches.”  

There are numerous treatment options:

1. Relaxation techniques

Some people can reduce grinding their teeth by practicing relaxation techniques; however, these are more successful for people with mild bruxism during the day. In young children, bruxism often goes away, and treatment is not needed. Until it resolves, creating a calming bedtime routine to promote relaxation might help, according to familydoctor.org. This includes limiting television and electronics for an hour or two before bedtime, playing calming music, taking a warm bath, and spending time reading.

2. Behavioral changes

Learning techniques such as how to rest the tongue, teeth, and lips properly—or to rest the tongue upward—can relieve discomfort in the jaw. Also, learning to identify triggers and use stress reduction and facial exercises can reduce bruxism. 

3. Mouth guards

Also called appliances or splints, mouth guards are used to prevent your teeth from rubbing together. They are made of soft material and fit over either the upper teeth or lower teeth. The splints are worn at night to relieve the pressure of clenching teeth together, according to the American Dental Association. Custom night guards are more expensive than over-the-counter mouth guards, but they’re a more effective treatment option. “It can be helpful to wear the night guard during the day to notice when you are grinding or clenching your teeth,” Dr. Freinberg-Trufas says. “Awareness around grinding can help you start to break the habit.”

4. A mandibular advancement device (MAD)

A MAD works by stabilizing the mouth and jaw to prevent clenching and grinding. It is placed inside the mouth at night and holds the lower jaw forward, and can also be used to reduce chronic snoring.

5. Biofeedback

This process uses an electronic instrument to measure muscle activity and signals when there is too much activity, so you can take steps to stop it, which is better suited for daytime bruxism. 

6. Medications

Prescriptions such as muscle relaxants, can reduce tension in the jaw muscles. These might not stop the clenching or grinding but can reduce the effects of bruxism. “Unfortunately, the dosages required to achieve relief are often too high for normal function, so it is difficult to use them realistically except in severe cases,” says Wolter. It is also essential to look at current medications to determine if the bruxism could be caused or aggravated by them, and, if so, talk about changing to a different medication.

7. Botox injections 

Botox injections paralyze jaw muscles used during teeth grinding. The FDA has not approved Botox for teeth grinding. Because it’s an off-label treatment, your insurance might not cover it. However, a study completed in 2018 found it helpful in reducing nighttime bruxism.

8. Dental procedures

Reshaping or reconstructing the biting surface could improve function if grinding and clenching caused an abnormal bite. Procedures can include filing high spots or using inlays or crowns to level teeth.

Work with your dentist or healthcare provider to find the best treatment for you.