Table of ContentsView AllTable of ContentsSigns of Awake BruxismSigns of Sleep BruxismCausesLong-Term EffectsDiagnosisTreatmentHow to Stop
Table of ContentsView All
View All
Table of Contents
Signs of Awake Bruxism
Signs of Sleep Bruxism
Causes
Long-Term Effects
Diagnosis
Treatment
How to Stop
“Bruxism"is the term for grinding, gnashing, or clenching your teeth, generally, when you are unaware of it. It is more common when people are awake, but it can also happen when you sleep. Experts estimate that anywhere from 8% to 31% of adults have bruxism, depending on the type of bruxism they have. It tends to happen less often as people age.
If bruxism is severe, it can affect more than your teeth. Here’s a look at the types of bruxism, the symptoms, and treatments.
D-Keine / Getty Images
Awake bruxism and sleep bruxism have similar signs and symptoms. It is easier to become aware of awake bruxism, though both are subconscious behaviors (you do them without effort or awareness). The signs of awake bruxism include:
Sleep bruxism, also known as nocturnal bruxism, is involuntary and sometimes considered a sleep disorder. People may notice they feel pain in the jaw, neck, or shoulders when they awaken. Sleep bruxism tends to occur during certain phases of sleep when you are sleeping more lightly or transitioning from one phase of sleep to another.
The signs of sleep bruxism include:
What Causes Bruxism?
Underlying reasons why people grind or gnash their teeth include mood, behaviors, medical conditions, family history, and medications. Experts classify bruxism as primary or secondary, depending on the cause.
Primary Bruxism
Primary bruxism is not related to a medical condition. Causes include:
Secondary Bruxism
Secondary bruxism develops in people who have certain medical conditions or take medications that may lead to teeth grinding, including:
What Are the Long-Term Effects of Bruxism?
Over time, bruxism can cause:
How Is Bruxism Diagnosed?
Healthcare providers diagnose bruxism with the following methods:
Your healthcare provider can also rule out other possible causes of jaw, neck, or shoulder pain, such as arthritis, ear infections, injury, or neurological conditions.
How Bruxism is Treated
Treatment depends on whether you experience bruxism when you’re awake or asleep bruxism and whether it is primary or secondary.
Mouth Guards and Splints
If you have sleep bruxism, you can be fitted for a splint or mouth guard, which you wear at night toprotect your teethfrom damage.They come in various designs, but they keep the upper and lower back teeth separated so the grinding doesn’t wear them down.
Splints are sometimes used to try to reposition the jaw. However, some experts believe that splints can cause jaw damage, so be aware of the pros and cons.
Sleep Hygiene
Sleep hygiene techniques can help you sleep better, which can reduce sleep bruxism. A study in children showed that it can be effective.These techniques include:
Pillows are sold that claim to help jaw pain from bruxism, but there is a lack of evidence to support their use. Lying flat without a pillow may help.
Contingent Electrical Stimulation
Contingent electrical stimulation, or CES, uses a device that senses when sleep bruxism occurs. It uses a low level of electrical energy (such as a brief impulse to the muscles) to relax the mouth and jaw muscles during sleep.Two early studies showed some promise using this technique.
Physical Therapy
If you have muscle pain and stiffness from grinding your teeth that affects your face, jaw, neck, or shoulders, a physical therapist can show you exercises that help you stretch the muscles and joints to release tension and relieve pain. You can do the exercises yourself, as needed.
Self-Care
Steps you can take to reduce pain and avoid damage from bruxism include:
Medication
If stress or depression is causing bruxism, antianxiety medications, sedatives, or muscle relaxers may help. Most are not meant to be used on a long-term basis, so make sure you understand the pros and cons of this approach.
Biofeedback and Alternative Therapies
Some treatments that have not been fully studied for sleep bruxism include biofeedback sessions, in which you view an electromyography (EMG) monitor, which detects when your jaw moves. You receive feedback in the form of a visual or sound cue so that you become aware of the pattern.
It can also be used while you sleep, with a device that sends sensations that wake you up when you begin to grind your teeth. Hypnosis is another path to retrain yourself to avoid bruxism.
Botox Injections
A low-dose Botox (onabotulinumtoxinA) injection to the jaw relaxes the masseter muscles, which you use when you open and close your mouth.Botoxcan reduce incidences of teeth grinding, the pain it causes, and the force of grinding. The result is temporary, lasting several months.
Treating Underlying Conditions
If you have a neurological condition or injury that may be causing your bruxism, talk to your healthcare provider about how they can address it.
Acid refluxis also associated with bruxism, and both conditions can wear down the teeth.If you have indigestion, talk to your provider about what they recommend to reduce it.
How to Stop Grinding Your Teeth
If you have bruxism, you cantake steps to make you less prone to grinding your teeth. One common treatment approach providers use is behavior modification, which reinforces positive actions, not negative ones.
Since bruxism is connected to tension and stress, learning strategies to reduce these factors in your life can help.Options include:
Summary
Treatments include devices to prevent teeth grinding while you sleep and behavioral therapies or counseling to help you break the pattern.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Yap AU, Chua AP.Sleep bruxism: current knowledge and contemporary management.J Conserv Dent. 2016;19(5):383. doi:10.4103/0972-0707.190007Khoury S, Carra MC, Huynh N, Montplaisir J, Lavigne GJ.Sleep bruxism-tooth grinding prevalence, characteristics and familial aggregation: a large cross-sectional survey and polysomnographic validation.Sleep. 2016;39(11):2049-2056. doi:10.5665/sleep.6242National Institute of Dental and Craniofacial Research.Bruxism.July 2022.Yap AU, Chua AP.Sleep bruxism: current knowledge and contemporary management.J Conserv Dent. 2016;19(5):383-389. doi:10.4103/0972-0707.190007. (faulty doi link)The Bruxism Association.What is bruxism?Johns Hopkins Medicine.Bruxism.Burke DJ, Seitz A, Aladesuru O, Robbins MS, Ch’ang JH.Bruxism in acute neurologic illness.Curr Pain Headache Rep. 2021;25(6):41. doi:10.1007/s11916-021-00953-4Giovanni A, Giorgia A.The neurophysiological basis of bruxism.Heliyon. 2021;7(7):e07477. doi:10.1016/j.heliyon.2021.e07477Health.mil.Teeth grinding: you won’t believe how harmful it really Is.February 28, 2022.Mesko ME, Hutton B, Skupien JA, Sarkis-Onofre R, Moher D, Pereira-Cenci T.Therapies for bruxism: a systematic review and network meta-analysis (protocol).Syst Rev.2017;6(4). doi:10.1186/s13643-016-0397-zThe TMJ Association.Splints.Tuncer A, Kastal E, Tuncer AH, Yazıcıoğlu İ.The effect of sleep hygiene and physiotherapy on bruxism, sleep, and oral habits in children with sleep bruxism during the COVID-19 pandemic.J Back Musculoskelet Rehabil. 2023;36(5):1047-1059. doi:10.3233/BMR-220235 (faulty doi link)Murali RV, Rangarajan P, Mounissamy A.Bruxism: conceptual discussion and review.J Pharm Bioallied Sci.2015;7(Suppl 1):S265-S270. doi:10.4103/0975-7406.155948 (faulty doi link)Herman Ostrow School of Dentistry USC.5 ways to treat bruxism.Guaita M, Högl B.Current treatments of bruxism.Curr Treat Options Neurol. 2016;18:10. doi:10.1007/s11940-016-0396-3American Academy of Oral Medicine.Tooth clenching or grinding.October 15, 2015.Shetty S, Pitti V, Satish Babu CL, Surendra Kumar GP, Deepthi BC.Bruxism: a literature review.J Indian Prosthodont Soc. 2010;10(3):141-148. doi:10.1007/s13191-011-0041-5Shehri ZG, Alkhouri I, Hajeer MY, Haddad I, Abu Hawa MH.Evaluation of the efficacy of low-dose botulinum toxin injection into the masseter muscle for the treatment of nocturnal bruxism: a randomized controlled clinical trial.Cureus.14(12):e32180. doi:10.7759/cureus.32180Nota A, Pittari L, Paggi M, Abati S, Tecco S.Correlation between bruxism and gastroesophageal reflux disorder and their effects on tooth wear. A systematic review.J Clin Med. 2022;11(4):1107. doi:10.3390/jcm11041107
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Yap AU, Chua AP.Sleep bruxism: current knowledge and contemporary management.J Conserv Dent. 2016;19(5):383. doi:10.4103/0972-0707.190007Khoury S, Carra MC, Huynh N, Montplaisir J, Lavigne GJ.Sleep bruxism-tooth grinding prevalence, characteristics and familial aggregation: a large cross-sectional survey and polysomnographic validation.Sleep. 2016;39(11):2049-2056. doi:10.5665/sleep.6242National Institute of Dental and Craniofacial Research.Bruxism.July 2022.Yap AU, Chua AP.Sleep bruxism: current knowledge and contemporary management.J Conserv Dent. 2016;19(5):383-389. doi:10.4103/0972-0707.190007. (faulty doi link)The Bruxism Association.What is bruxism?Johns Hopkins Medicine.Bruxism.Burke DJ, Seitz A, Aladesuru O, Robbins MS, Ch’ang JH.Bruxism in acute neurologic illness.Curr Pain Headache Rep. 2021;25(6):41. doi:10.1007/s11916-021-00953-4Giovanni A, Giorgia A.The neurophysiological basis of bruxism.Heliyon. 2021;7(7):e07477. doi:10.1016/j.heliyon.2021.e07477Health.mil.Teeth grinding: you won’t believe how harmful it really Is.February 28, 2022.Mesko ME, Hutton B, Skupien JA, Sarkis-Onofre R, Moher D, Pereira-Cenci T.Therapies for bruxism: a systematic review and network meta-analysis (protocol).Syst Rev.2017;6(4). doi:10.1186/s13643-016-0397-zThe TMJ Association.Splints.Tuncer A, Kastal E, Tuncer AH, Yazıcıoğlu İ.The effect of sleep hygiene and physiotherapy on bruxism, sleep, and oral habits in children with sleep bruxism during the COVID-19 pandemic.J Back Musculoskelet Rehabil. 2023;36(5):1047-1059. doi:10.3233/BMR-220235 (faulty doi link)Murali RV, Rangarajan P, Mounissamy A.Bruxism: conceptual discussion and review.J Pharm Bioallied Sci.2015;7(Suppl 1):S265-S270. doi:10.4103/0975-7406.155948 (faulty doi link)Herman Ostrow School of Dentistry USC.5 ways to treat bruxism.Guaita M, Högl B.Current treatments of bruxism.Curr Treat Options Neurol. 2016;18:10. doi:10.1007/s11940-016-0396-3American Academy of Oral Medicine.Tooth clenching or grinding.October 15, 2015.Shetty S, Pitti V, Satish Babu CL, Surendra Kumar GP, Deepthi BC.Bruxism: a literature review.J Indian Prosthodont Soc. 2010;10(3):141-148. doi:10.1007/s13191-011-0041-5Shehri ZG, Alkhouri I, Hajeer MY, Haddad I, Abu Hawa MH.Evaluation of the efficacy of low-dose botulinum toxin injection into the masseter muscle for the treatment of nocturnal bruxism: a randomized controlled clinical trial.Cureus.14(12):e32180. doi:10.7759/cureus.32180Nota A, Pittari L, Paggi M, Abati S, Tecco S.Correlation between bruxism and gastroesophageal reflux disorder and their effects on tooth wear. A systematic review.J Clin Med. 2022;11(4):1107. doi:10.3390/jcm11041107
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Yap AU, Chua AP.Sleep bruxism: current knowledge and contemporary management.J Conserv Dent. 2016;19(5):383. doi:10.4103/0972-0707.190007Khoury S, Carra MC, Huynh N, Montplaisir J, Lavigne GJ.Sleep bruxism-tooth grinding prevalence, characteristics and familial aggregation: a large cross-sectional survey and polysomnographic validation.Sleep. 2016;39(11):2049-2056. doi:10.5665/sleep.6242National Institute of Dental and Craniofacial Research.Bruxism.July 2022.Yap AU, Chua AP.Sleep bruxism: current knowledge and contemporary management.J Conserv Dent. 2016;19(5):383-389. doi:10.4103/0972-0707.190007. (faulty doi link)The Bruxism Association.What is bruxism?Johns Hopkins Medicine.Bruxism.Burke DJ, Seitz A, Aladesuru O, Robbins MS, Ch’ang JH.Bruxism in acute neurologic illness.Curr Pain Headache Rep. 2021;25(6):41. doi:10.1007/s11916-021-00953-4Giovanni A, Giorgia A.The neurophysiological basis of bruxism.Heliyon. 2021;7(7):e07477. doi:10.1016/j.heliyon.2021.e07477Health.mil.Teeth grinding: you won’t believe how harmful it really Is.February 28, 2022.Mesko ME, Hutton B, Skupien JA, Sarkis-Onofre R, Moher D, Pereira-Cenci T.Therapies for bruxism: a systematic review and network meta-analysis (protocol).Syst Rev.2017;6(4). doi:10.1186/s13643-016-0397-zThe TMJ Association.Splints.Tuncer A, Kastal E, Tuncer AH, Yazıcıoğlu İ.The effect of sleep hygiene and physiotherapy on bruxism, sleep, and oral habits in children with sleep bruxism during the COVID-19 pandemic.J Back Musculoskelet Rehabil. 2023;36(5):1047-1059. doi:10.3233/BMR-220235 (faulty doi link)Murali RV, Rangarajan P, Mounissamy A.Bruxism: conceptual discussion and review.J Pharm Bioallied Sci.2015;7(Suppl 1):S265-S270. doi:10.4103/0975-7406.155948 (faulty doi link)Herman Ostrow School of Dentistry USC.5 ways to treat bruxism.Guaita M, Högl B.Current treatments of bruxism.Curr Treat Options Neurol. 2016;18:10. doi:10.1007/s11940-016-0396-3American Academy of Oral Medicine.Tooth clenching or grinding.October 15, 2015.Shetty S, Pitti V, Satish Babu CL, Surendra Kumar GP, Deepthi BC.Bruxism: a literature review.J Indian Prosthodont Soc. 2010;10(3):141-148. doi:10.1007/s13191-011-0041-5Shehri ZG, Alkhouri I, Hajeer MY, Haddad I, Abu Hawa MH.Evaluation of the efficacy of low-dose botulinum toxin injection into the masseter muscle for the treatment of nocturnal bruxism: a randomized controlled clinical trial.Cureus.14(12):e32180. doi:10.7759/cureus.32180Nota A, Pittari L, Paggi M, Abati S, Tecco S.Correlation between bruxism and gastroesophageal reflux disorder and their effects on tooth wear. A systematic review.J Clin Med. 2022;11(4):1107. doi:10.3390/jcm11041107
Yap AU, Chua AP.Sleep bruxism: current knowledge and contemporary management.J Conserv Dent. 2016;19(5):383. doi:10.4103/0972-0707.190007
Khoury S, Carra MC, Huynh N, Montplaisir J, Lavigne GJ.Sleep bruxism-tooth grinding prevalence, characteristics and familial aggregation: a large cross-sectional survey and polysomnographic validation.Sleep. 2016;39(11):2049-2056. doi:10.5665/sleep.6242
National Institute of Dental and Craniofacial Research.Bruxism.July 2022.
Yap AU, Chua AP.Sleep bruxism: current knowledge and contemporary management.J Conserv Dent. 2016;19(5):383-389. doi:10.4103/0972-0707.190007. (faulty doi link)
The Bruxism Association.What is bruxism?
Johns Hopkins Medicine.Bruxism.
Burke DJ, Seitz A, Aladesuru O, Robbins MS, Ch’ang JH.Bruxism in acute neurologic illness.Curr Pain Headache Rep. 2021;25(6):41. doi:10.1007/s11916-021-00953-4
Giovanni A, Giorgia A.The neurophysiological basis of bruxism.Heliyon. 2021;7(7):e07477. doi:10.1016/j.heliyon.2021.e07477
Health.mil.Teeth grinding: you won’t believe how harmful it really Is.February 28, 2022.
Mesko ME, Hutton B, Skupien JA, Sarkis-Onofre R, Moher D, Pereira-Cenci T.Therapies for bruxism: a systematic review and network meta-analysis (protocol).Syst Rev.2017;6(4). doi:10.1186/s13643-016-0397-z
The TMJ Association.Splints.
Tuncer A, Kastal E, Tuncer AH, Yazıcıoğlu İ.The effect of sleep hygiene and physiotherapy on bruxism, sleep, and oral habits in children with sleep bruxism during the COVID-19 pandemic.J Back Musculoskelet Rehabil. 2023;36(5):1047-1059. doi:10.3233/BMR-220235 (faulty doi link)
Murali RV, Rangarajan P, Mounissamy A.Bruxism: conceptual discussion and review.J Pharm Bioallied Sci.2015;7(Suppl 1):S265-S270. doi:10.4103/0975-7406.155948 (faulty doi link)
Herman Ostrow School of Dentistry USC.5 ways to treat bruxism.
Guaita M, Högl B.Current treatments of bruxism.Curr Treat Options Neurol. 2016;18:10. doi:10.1007/s11940-016-0396-3
American Academy of Oral Medicine.Tooth clenching or grinding.October 15, 2015.
Shetty S, Pitti V, Satish Babu CL, Surendra Kumar GP, Deepthi BC.Bruxism: a literature review.J Indian Prosthodont Soc. 2010;10(3):141-148. doi:10.1007/s13191-011-0041-5
Shehri ZG, Alkhouri I, Hajeer MY, Haddad I, Abu Hawa MH.Evaluation of the efficacy of low-dose botulinum toxin injection into the masseter muscle for the treatment of nocturnal bruxism: a randomized controlled clinical trial.Cureus.14(12):e32180. doi:10.7759/cureus.32180
Nota A, Pittari L, Paggi M, Abati S, Tecco S.Correlation between bruxism and gastroesophageal reflux disorder and their effects on tooth wear. A systematic review.J Clin Med. 2022;11(4):1107. doi:10.3390/jcm11041107
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