Teeth grinding or clenching of the teeth during sleep, known as bruxism (from the Greek brychein, meaning "to gnash the teeth"), can cause facial soreness and pain, headaches, and fractured or abraded teeth, as well as the jawbone pain known as TMD (temporomandibular disorders). Nearly everybody is thought to have occasional episodes of nighttime grinding, but only a small percentage grind so much that they damage their teeth and jaws.
Episodes may occur eight or more times a night and can easily awaken a person in the same room. If your bedmate doesn’t tell you, your dentist, at a routine exam, may notice the signs of ground-down teeth and inform you that you’re a bruxer.
Symptoms of Teeth Grinding
- Grinding or gnashing of the teeth at night; may occur occasionally or so frequently that teeth are worn down or damaged.
- Clicking sound and/or pain in your jaw
- Eating disorders
- Jaw pain, earache, headache or facial pain upon awakening
- Sensitive teeth and/or toothache
What Causes Teeth Grinding?
Bruxism is a complex phenomenon. There’s still argument about probable causes and appropriate treatments.
Emotional stress is a likely cause. People who grind their teeth often report that they are undergoing marital or financial difficulties, taking final exams, fearful of losing their jobs, or otherwise under pressure.
Studies have not agreed on whether one particular personality is associated with bruxism. One small study found that shy, unhappy people tend to grind, but other studies have suggested that hard-driving perfectionists do.
Genetics may play a role, since bruxism seems to run in families. Malocclusion (faulty contact between upper and lower teeth) or restorative dentistry that isn’t quite right can cause mouth discomfort that, in turn, makes jaw muscles contract at night. People with sleep disturbances may also be prone to bruxism. Mood-altering substances, including alcohol and amphetamines, can promote the problem.
What If You Do Nothing?
Occasional or light teeth grinding is not considered a serious problem. However, chronic, heavy grinding can result in jaw and ear pain and can contribute to periodontal disease and even the loss of teeth, as well as fractured teeth or broken restorations.
Dealing With A Cracked Tooth
A common side effect of nighttime grinding is a cracked tooth. This is a fracture in the tooth enamel caused by wear and tear; aging; chewing ice, gum, nuts, or hard candies; or biting down hard on a bone, pit, or other hard object. It may be hard for a dentist to diagnose a cracked tooth because the crack may not be visible, even on an x-ray. The first symptom is usually pain in the tooth when you bite down hard or discomfort when inhaling cold air through the mouth.
A crack can get larger and deeper with further wear and may cause serious injury to the tooth or promote infection. In some cases grinding down the chewing surface of the tooth may relieve pressure on the bite and keep the crack from opening when you chew. However, a crack won’t heal, and you’ll probably need some kind of restorative dentistry.
Home Remedies for Teeth Grinding
- Reduce stress in your life. If you suspect that abnormal daily stress is causing the problem, find ways to address the problem. Relaxation techniques may help you to deal with stress or anger. Even something as simple as a warm bath before bedtime may help.
- Warm your facial muscles. Place a warm washcloth on your face in the morning. This may help relax your muscles.
- Chew softly. Avoid foods like hard candies and crusty bread or bagels, as well as chewing gum. Don’t chew on things like pencils or ice.
- Take pain relievers. Aspirin, acetaminophen, and other over-the-counter pain relievers can help reduce jaw pain.
- Reduce or eliminate alcohol intake. Teeth grinding often gets worse after consuming alcoholic beverages.
Follow the tips listed above.
Beyond Home Remedies: When To Call Your Doctor
Contact your dentist if symptoms of teeth grinding interfere with your normal activities or if you notice that your teeth are being damaged by the grinding.
What Your Doctor Will Do
After a careful examination to rule out other ailments that may cause jaw or ear pain, such as TMD, your dentist may recommend stress reduction counseling to reduce any stress and anxiety. Some simple physical therapy may also be recommended. The dentist should also check for signs of malocclusion and, of course, should repair any damage to your teeth or crowns and bridges.
Occlusal appliance therapy, consisting of an individually fitted mouthguard or splint made of soft or hard acrylic, is a popular item now in preventive dentistry—and frequently suggested for bruxers. Usually worn at night, mouthguards are not designed to prevent clenching or grinding, but they do redistribute the forces exerted while grinding and thus help protect teeth. They can cost several hundred dollars.
You may want to seek a second opinion before investing in a mouthguard. If you do get one, you’ll need to go for a checkup every four to six months to make sure it still fits and to get any needed adjustments. You’ll also need to keep it clean, brushing it with toothbrush and toothpaste after each use.
A much less expensive solution may be a simple athletic mouthguard, sold at sporting goods stores for about $10. If it fits properly, it should spread the clenching pressure evenly across your mouth. It may not be as comfortable as a custom-made splint and will certainly be bulkier and more visible. You should discuss this measure with your dentist, and should have dental checkups every six months.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media