Do you grind or clench your teeth while you sleep? It’s thought that at least one in ten adults do so regularly, and some also grind during the day. Unless your bedmate tells you, you may be unaware of it—until your dentist notices signs of ground-down teeth and tells you that you have bruxism (the technical term for tooth grinding). You may also become aware of the problem because of symptoms such as jaw pain, headaches, a clicking sound in your jaw, and sensitive teeth.
Bruxism can not only impair sleep quality and damage teeth, but in severe cases it can lead to TMJ (temporomandibular joint) disorders, painful conditions affecting the jaw and facial muscles. Over time, bruxism can also worsen periodontal disease.
There’s still some disagreement about the probable causes—anatomical, psychological, neurological, or behavioral—of bruxism and about treatments. Emotional stress is one likely culprit. People who grind their teeth often report that they are experiencing stress or anger. Ironically, some antidepressants may promote, rather than prevent, bruxism.
Other known or possible contributing factors include a family history of bruxism, certain facial abnormalities, smoking, heavy drinking, and sleep apnea. People under 50 seem to have higher rates of nighttime bruxism than older people. Malocclusion (an uneven bite) may also increase the likelihood of bruxism.
Guarding against tooth grinding
Because bruxism can have many causes (or no identifiable cause), there is no single treatment. If you are under lots of stress, try relaxation techniques such as meditation or biofeedback or something as simple as a warm bath before bedtime. A cognitive behavioral therapist may be able to identify factors that increase your grinding and find strategies to counter them. If you drink alcohol, see if it helps to cut back or abstain, at least in the late evening.
The main treatment for bruxism is to wear a mouth guard (technically called an occlusal splint) during sleep. Your dentist can custom fit a device made of soft or hard acrylic. A guard won’t prevent all grinding, but it can redistribute the forces exerted while grinding and thus help protect teeth. And it may help you get used to keeping your jaw unclenched, even during the day when you aren’t wearing it. Custom-made night guards usually cost $400 or more. If you get new crowns or there are other changes in your teeth, you may need to be fitted for a new mouth guard.
Inexpensive over-the-counter mouth guards (some marketed specifically for bruxism) are bulkier than dentist-made guards, won’t fit as well for most people, and are likelier to cause problems, such as sores and altered bite. Discuss such devices with your dentist before using one.
Also see The Truth About Teeth Whitening.