Bruxism (Teeth Grinding)
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What is Bruxism?
Bruxism is the habit of grinding or clenching your teeth. It can have multiple contributing factors, but it’s most often associated with stress and anxiety. People may brux during the day or while asleep.
It is relatively common and may affect nearly a third of adults. It can cause jaw pain, limited jaw movement, and tooth wear. Fortunately, it can be treated.

Just as there is no one cause for all cases of bruxism, there isn’t one single treatment option either. Several treatment methods exist, including mouthguards, therapy, and even Botox.
Symptoms of Bruxism
The most obvious symptom may be the grinding and clenching itself. However, you may not notice you are grinding your teeth, especially if it only happens during sleep.
Other symptoms of bruxism may include:
- Tender or sore jaw muscles
- Worn tooth enamel, which may cause tooth sensitivity
- Fractured teeth (in severe cases)
- Jaw tightness or limited mobility
- Headache
- Pain in the area of your jaw, cheeks, or ears
- Signs of damage on your inner cheeks
- Frequent waking at night
Complications and Risks of Bruxism
Untreated bruxism can lead to both minor and severe dental issues. Some potential complications include:
- Damage to teeth or dental restorations (such as crowns or fillings)
- Loss of teeth (in severe cases)
- Persistent jaw pain or headaches
- Temporomandibular joint disorders
- Loss of sleep
Prompt treatment for bruxism can prevent these complications. See your doctor if you notice symptoms of bruxism, such as signs of wear or damage to your teeth or inner cheeks.
What Can Cause Bruxism?
There is no single cause, though some common contributing factors exist. Risk factors and conditions linked to bruxism include:
Stress and Anxiety
Stress and anxiety are strongly associated with bruxism. Anxiety can have physical symptoms, and it can affect what bodily sensations you pay attention to.
Bruxism can start or become more intense during a period of high stress or frustration.
Highly anxious people are also more likely to experience bruxism. One study found that people high in anxiety or neuroticism were more likely to report bruxism even when their teeth showed no signs of wear.
Stimulants and Prescription Drugs
Stimulant medications or drugs can increase your heart rate and central nervous system activity. This can contribute to jaw clenching or teeth grinding.
Common stimulants include:
- Caffeine
- Nicotine
- ADHD medications such as Adderall and Vyvanse
- Recreational drugs like cocaine and methamphetamine
Some antidepressant or anti-anxiety medications, such as fluoxetine (Prozac) and paroxetine (Seroxat), may also increase bruxism.
Alcohol
Excessive alcohol consumption may increase bruxism, in particular during sleep. Hangovers and alcohol withdrawal also increase anxiety, which is associated with bruxism.
Other Factors
Bruxism is sometimes associated with other physical and psychological conditions, such as:
- Disorders of the jaw joint (TMJ)
- ADHD
- Parkinson’s disease
- Epilepsy
- Sleep apnea
- Acid reflux (GERD)
Bruxism and the conditions above can run in families, so genes may play a role. The habit can also be affected by age—many children brux and later grow out of it.
Bruxism and TMJ Disorders
Temporomandibular disorder (TMD) is a broad term for various jaw joint problems. People with TMD may experience jaw pain, poor jaw mobility, and jaw clicking or popping sounds.
TMD is often associated with bruxism, but the exact relationship isn’t clear. Bruxism may contribute to TMD over time. On the other hand, people may brux less if it contributes to TMD-related pain.
Both bruxism and TMD complaints may be related to anxiety and depression symptoms. People who experience more anxiety report greater jaw discomfort or more bruxism, or both.
Clenching Teeth While Awake
A habit of clenching or grinding one’s teeth while awake is called awake or daytime bruxism.
Even though it occurs while you’re awake, you may not notice that you’re grinding your teeth. It may be an unconscious response to stress or be caused by another condition.
Clenching Teeth During Sleep
Many people with bruxism mainly grind their teeth at night. Some amount of jaw muscle activity during sleep is normal. Usually, it doesn’t involve prolonged or severe grinding of teeth.
Sleep or nocturnal bruxism can have different causes from awake bruxism. It’s sometimes associated with sleep apnea.
Treatment Options for Bruxism
Most treatments for bruxism are intended to stop or reduce the habit itself. However, protecting teeth from damage and restoring already damaged teeth can also be important goals.
Here are six ways bruxism and its effects can be treated:
1. Changing Habits
Your habits and lifestyle may play a role in your teeth grinding or jaw clenching. Here are some changes you can make that may reduce or stop bruxism:
- Reduce your caffeine intake by cutting down on coffee, soda, tea, and chocolate
- Lower your alcohol consumption
- Avoid excessive gum chewing or chewing on objects
- Place your tongue between your teeth when you feel yourself clenching your jaw
- Reduce stress
2. Stress Management
If your bruxism is linked to stress, anxiety, or other mental health conditions, your doctor may recommend:
- Cognitive behavioral therapy (CBT)
- Behavioral therapies
- Stress management therapy
- Biofeedback treatment
- Relaxation techniques
By reducing stress and anxiety and helping you to manage them better, you may notice yourself grinding your teeth less.
3. Medications
Medications can be effective treatment options for bruxism.
- Muscle relaxants
- Botox injections
- Anti-anxiety medications
- Antidepressants
- Sleep medicine
Depending on the underlying cause of your bruxism, these medications might not be suitable for you. They’re often prescribed for other conditions. Some, like Botox, may be best thought of as a last resort if other treatments haven’t helped.
4. Treating Associated Conditions
Your bruxism may be linked to another condition, such as sleep apnea or gastroesophageal reflux disease (GERD). If this is the case, treatment for that condition may go hand-in-hand with alleviating bruxism.
5. Mouthguards
Mouthguards, or occlusal splints, can protect your teeth from damage caused by grinding.
These devices will not cure bruxism because they do not address any root causes. However, they may protect your teeth while you get treatment to reduce the habit.

6. Dental Restorations
If your teeth have already been damaged by bruxism, your dentist can offer restorative treatments. These include dental bonding if your teeth are chipped or crowns if the damage is more severe.
Bruxism can damage dental restorations just like natural teeth. These restorative procedures are not a replacement for treating the bruxism itself.
Summary
Bruxism refers to the habit of grinding or clenching your teeth. It may occur while you’re awake or during sleep. Severe bruxism can cause pain and damage your teeth.
While there are many potential causes, bruxism is often linked to stress and anxiety. In addition to addressing the underlying cause, bruxism treatment may also aim to protect or restore the teeth from damage.
Sources
- Mesko, Mauro Elias, et al. "Therapies for bruxism: a systematic review and network meta-analysis (protocol)." Systematic Reviews, 2017.
- Reddy, S. Varalakshmi, et al. “Bruxism: a literature review.” Journal of International Oral Health, 2014.
- Lavigne, G. J., et al. “Rhythmic Masticatory Muscle Activity during Sleep in Humans.” Journal of Dental Research, 2001.
- Kate Murphy. “Grind Your Teeth? Your Night Guard May Not Be the Right Fix.” New York Times, 2021.
- Chemelo, Victória dos Santos, et al. "Is There Association Between Stress and Bruxism? A Systematic Review and Meta-Analysis." Frontiers in Neurology, 2020.
- Sutin, Angelina R., et al. “Teeth Grinding: Is Emotional Stability related to Bruxism?” Journal of Research in Personality, 2010.
- Bertazzo-Silveira, Eduardo, et al. "Association between sleep bruxism and alcohol, caffeine, tobacco, and drug abuse: A systematic review." The Journal of the American Dental Association, 2016.
- Schuckit, Marc A. “Alcohol, Anxiety, and Depressive Disorders.” Alcohol Health and Research World, 1996.
- Ohlmann, Brigitte, et al. “Correlations between Sleep Bruxism and Temporomandibular Disorders.” Journal of Clinical Medicine, 2020.
- Beddis, H. et al. "Sleep bruxism: an overview for clinicians." British Dental Journal, 2018.
- Soto-Goñi, Xabier Ander, et al. "Adaptive Stress Coping in Awake Bruxism." Frontiers in Neurology, 2020.
- Emodi-Perlman, Alona, et al. “Awake Bruxism-Single-Point Self-Report versus Ecological Momentary Assessment.” Journal of Clinical Medicine, 2021.
- Bracci, Alessandro, et al. "Current Knowledge and Future Perspectives on Awake Bruxism Assessment: Expert Consensus Recommendations." Journal of Clinical Medicine, 2022.
Board-certified general dentist specializing in patient education and preventive dentistry.
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