Bruxism (Teeth Grinding)

What is Bruxism?

Bruxism is the habit of grinding or clenching one’s 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.

This habit is relatively common—it may affect nearly a third of adults.¹ 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.^{1, 2} Several treatment methods exist, including mouthguards, therapy, and even Botox.

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.^{3, 4}

Sleep or nocturnal bruxism can have different causes from awake bruxism. It’s sometimes associated with sleep apnea.

What Can Cause Bruxism?

There is no one cause, though some common contributing factors exist. Some risk factors or 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.⁵

Highly anxious people are also more likely to experience bruxism. One study found that people high in anxiety or neuroticism were more likely to notice bruxism even if their teeth didn’t show signs of it.⁶

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.⁷ Hangovers and alcohol withdrawal also increase anxiety, which is associated with bruxism.⁸

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 above conditions can run in families, so there may be genes associated with bruxism. 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.⁹

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.⁷

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.

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. Some medications that may have an impact on bruxism include:

• 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. When used for sleep bruxism, these are usually called night guards.

These devices will not cure bruxism because they don’t address any root causes. However, they may offer needed protection for 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.

Note: 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.