Bruxism (Teeth Grinding) (2024)

ContentsOverviewSymptoms and CausesDiagnosis and TestsManagement and TreatmentPreventionOutlook / PrognosisLiving WithAdditional Common Questions

Overview

What is bruxism?

Bruxism is when you clench, grind or gnash your teeth. It usually occurs subconsciously, and it can happen when you’re awake or asleep.

Many people grind their teeth every now and then, especially during stressful times. But if you do it a lot, it can put extra strain on your teeth and jaws, leading to dental damage, headaches, jaw pain and other issues.

Anyone can develop bruxism, but it’s most common during childhood, adolescence and young adulthood. It’s difficult to know exactly how many people grind their teeth because it often happens during sleep.

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Symptoms and Causes

Bruxism symptoms

If you grind your teeth a lot, you might develop symptoms like:

  • Headaches or facial pain, especially in the morning.
  • Earaches.
  • Sore jaw muscles.
  • Tinnitus (ringing in your ears).
  • Pain when eating.
  • Difficulty opening and closing your mouth.

Types of bruxism

Bruxism can happen when you’re awake or asleep. The grinding action is the same, but awake and asleep bruxism are two separate conditions:

  • Awake bruxism: If you only brux (grind or clench) during waking hours, you might not need treatment — especially if you can find ways to increase your awareness and reduce stress. Feeling anxious, stressed or angry can make you grind your teeth. You might also notice your jaw clenching when you’re concentrating hard on something.
  • Sleep bruxism:Grinding or clenching your teeth in your sleep can cause more harm than bruxing during waking hours because you don’t realize it’s happening. People with sleep bruxism often need treatment to help manage the effects of grinding.

Bruxism causes

Healthcare providers don’t know exactly why some people grind their teeth and others don’t. Bruxism doesn’t have a single specific cause. Rather, there can be several contributing risk factors.

Risk factors

A risk factor is something that increases your chances of developing a certain condition. There are many risk factors for bruxism, including:

  • Stressandanxiety. Feeling overwhelmed and stressed can result in bruxism. If you have depression or anxiety disorders — like major depressive disorder (MDD) or generalized anxiety disorder (GAD) — you’re more prone to bruxism.
  • Lifestyle habits. People who smoke, drink alcoholand consume a lot of caffeine (more than six cups of coffee a day) are twice as likely to grind their teeth as people who don’t.
  • Certain medications. This includes a class of anti-anxiety drugs called selective serotonin reuptake inhibitors (SSRIs).
  • Sleep apnea. Research has confirmed a correlation between sleep apnea and teeth grinding, meaning that many people have both conditions. But it’s unclear whether sleep apnea causes bruxism or the other way around. Experts continue to study the relationship between teeth grinding and sleep disorders.

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Complications of this condition

Left untreated, teeth grinding can lead to:

  • Sleep disorders.
  • Dental damage like tooth erosion, and loose or cracked teeth.
  • Temporomandibular joint (TMJ) disorder.
  • Facial pain.

Diagnosis and Tests

How doctors diagnose bruxism

Healthcare providers (often dentists) typically diagnose bruxism based on a physical exam and your symptoms. But in some cases, you may need asleep study (polysomnography). This overnight test takes place in a sleep center and can provide a definitive diagnosis.

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Management and Treatment

How is bruxism treated?

If you have mild bruxism or only brux occasionally, you probably don’t need formal treatment. But in more severe cases, healthcare providers might recommend these bruxism treatments:

  • Mouth guards. A dentist can make a custom mouth guard to protect your teeth. This appliance can also place your jaw in a more favorable position to reduce TMJ muscle strain. You wear your mouth guard when you’re most likely to grind your teeth.
  • Stress reduction techniques. Finding ways to manage stress may reduce bruxism symptoms. This includes a wide range of therapies like meditation, exercise and cognitive behavioral therapy.
  • Lifestyle changes. If teeth grinding is a result of caffeine or alcohol consumption, reducing your daily intake can help. If you smoke, quitting can help you stop bruxing and get better quality sleep.
  • Medications. Taking a muscle relaxer before bedtime can reduce or prevent teeth grinding. Most healthcare providers only recommend this approach temporarily.
  • Botulinum toxin injections. In severe cases, healthcare providers might recommend Botox® for teeth grinding. These injections temporarily relax your jaw muscles and reduce pain. You’ll need repeat treatments to maintain your results — usually every three to four months.

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Prevention

Can bruxism be prevented?

You can’t always stop yourself from teeth grinding or clenching, especially if you brux during sleep. But there are steps you can take to reduce your overall risk:

  • Practice mindfulness to reduce daily stress.
  • Get regulardental checkups. A dentist can treat any dental damage before it gets worse.
  • Avoid smoking, recreational drugs and heavy alcohol consumption.

Outlook / Prognosis

What’s the outlook for people who grind their teeth?

Everyone is different, but the outlook is generally good. Children often outgrow bruxism by adolescence. For adult teeth grinding, mouth guards can help. If you get one, be sure to wear it regularly.

In many cases, bruxism eventually goes away. But it’s important to know how to manage symptoms if you have a flareup. To learn more, talk to your healthcare provider.

Living With

When should I see my healthcare provider?

If you develop bruxism symptoms that don’t go away — or if you have them more often than not — it’s time to tell a healthcare provider. Whether you need temporary treatment to get through a stressful period or a more long-term solution like a mouth guard, a provider can help.

Additional Common Questions

Is teeth grinding a serious problem?

It depends. If you only grind your teeth occasionally, it’s probably not a big deal. But if you do it a lot for a long time, it can lead to health issues down the road, including cracked teeth, headaches, temporomandibular joint disorder, tinnitus and other conditions.

A note from Cleveland Clinic

Do you wake up in the mornings with pain radiating down your face? Maybe you always have headaches early in the day. Or maybe you feel exhausted from poor sleep and you’re not sure why. Any of these mysterious symptoms could point to teeth grinding or clenching (bruxism). Your healthcare provider can confirm a diagnosis and help you find appropriate treatment.

Medically Reviewed

Last reviewed by a Cleveland Clinic medical professional on 12/18/2023.

Learn more about our editorial process.

Bruxism (Teeth Grinding) (2024)

FAQs

How do I know if my bruxism is severe? ›

Many cases of bruxism are mild and may not require treatment; however, severe bruxism can lead to damaged teeth, jaw pain or tiredness, and headache.

How do you prove teeth grinding? ›

Your dentist is the first person you should visit if you suspect that you are grinding your teeth. During a dental exam, your dentist will look for signs of bruxism such as excessive wear on your teeth, including cracks, chips or loose teeth.

How do you fix severe bruxism? ›

Medications
  1. Muscle relaxants. In some cases, your doctor may suggest taking a muscle relaxant before bedtime, for a short period of time.
  2. Botox injections. Injections of Botox, a form of botulinum toxin, may help some people with severe bruxism who don't respond to other treatments.
  3. Medication for anxiety or stress.
Aug 10, 2017

How does the VA rate bruxism? ›

The VA does not directly rate bruxism. However, bruxism's symptoms and disabling conditions are rated under the Schedule of Ratings for Dental and Oral Conditions, typically under the diagnostic codes 9905 or 9913, depending on symptoms and severity.

What happens if bruxism is left untreated? ›

Bruxism may lead to cracks or fractures of the teeth. Tooth enamel may wear away. If not treated, it may lead to jaw muscle and joint problems. You could even lose your teeth.

What does bruxism pain feel like? ›

Increased tooth pain or sensitivity. Tired or tight jaw muscles, or a locked jaw that won't open or close completely. Jaw, neck or face pain or soreness. Pain that feels like an earache, though it's actually not a problem with your ear.

What is the difference between clenching and bruxism? ›

Grinding or bruxism involves moving the jaw with the teeth held together. This results in substantial visible wear and flattening of the teeth which is usually obvious both to dentist and patient. Clenching is simply holding the teeth together and tightening the jaw muscles.

What are the stages of grinding teeth? ›

Patients should be diagnosed in three different stages of bruxism: Mild, Moderate & Severe. Once bruxism severity is determined, the proper thickness of a custom grind guard can be made for the patient.

What is the root cause of teeth grinding? ›

Daytime clenching is usually triggered by stress, anxiety, tension, or even concentration. Nighttime grinding is sometimes related to hyperactivity, sleep apnea, or acid reflux, and can appear as a side effect of certain medications intended to treat depression.

Does bruxism ever go away? ›

In most cases, bruxism can be successfully treated. Treatment may involve: Behavior changes. You may be taught how to rest your tongue, teeth, and lips properly.

What is the best medication for bruxism? ›

Dentists are most likely to prescribe benzodiazepine and muscle relaxant drugs for the management of severe bruxism. Prescribing clinicians should be familiar with the general effects, side effects, and potential drug interactions involving these classes of medications.

What medication is used to stop grinding teeth? ›

Many types of pain medications are used to treat patients who grind there teeth. Over the counter medications (OTC) such as Ibuprofen and Acetaminophen are very commonly used. Other medications include, steroids, muscle relaxants and antidepressants may be used for more advanced cases.

Can I get VA disability for teeth grinding? ›

Qualifying for VA Disability Benefits for Bruxism

The VA doesn't currently recognize a primary service connection for bruxism. However, bruxism may be caused or aggravated by a service-connected disability. In that situation, bruxism may be recognized as a secondary service-connected condition.

Can you get disability for bruxism? ›

Bruxism can wear down our teeth and in chronic cases, this condition can lead to teeth loss. If you are a veteran who has lost teeth due to this condition, you could pursue a disability rating under diagnostic code 9913 to receive VA compensation.

Is bruxism related to PTSD? ›

Post‐traumatic stress disorder (PTSD) is associated with painful temporomandibular disorder (TMD) and may be part of the aetiology of awake bruxism (AB) and sleep bruxism (SB).

What is considered severe bruxism? ›

The ICSD-R described three different severities of sleep bruxism, defining mild as occurring less than nightly, with no damage to teeth or psychosocial impairment; moderate as occurring nightly, with mild impairment of psychosocial functioning; and severe as occurring nightly, and with damage to the teeth, ...

How bad can bruxism get? ›

Chronic, involuntary teeth grinding – technically called bruxism – can lead to all sorts of health problems. You could crack or fracture your teeth, which may require crowns or dental implants. You could also wear down the enamel on your teeth, leading to periodontal disease or lost teeth.

Is bruxism a dental emergency? ›

If teeth grinding becomes severe or occurs for an extended period of time then it can eventually cause a dental injury that requires emergency dental care.

Why is my bruxism getting worse? ›

Oral health specialists often point to too much stress and certain personality types as causes of bruxism. Bruxism often affects people with nervous tension, such as anger, pain, or frustration. It also affects people with aggressive, hurried, or overly competitive tendencies.

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