Most people who grind their teeth do it while they sleep. They have no memory of it. Their bed partner might notice the sound — a rhythmic, grating noise in the night — but often no one notices at all. The grinding happens, the person wakes up, and life goes on.
Until it doesn’t.
Bruxism — the clinical term for teeth grinding and jaw clenching — is more common than most people realize. Estimates suggest it affects somewhere between 8% and 31% of the population, with sleep bruxism being particularly prevalent. And while mild, occasional grinding may not cause significant harm, chronic bruxism can result in serious, expensive, and irreversible damage to your teeth, jaw, and surrounding structures.
Because most grinding happens during sleep, people often don’t know they’re doing it until a dentist points out the evidence — or until symptoms become noticeable. Signs to watch for include:
Worn, flattened, or chipped teeth. The biting surfaces of the teeth should have a natural contour. In someone who grinds heavily, they become flat, worn down, and sometimes chipped. The enamel thins, often exposing the yellower dentin beneath and making teeth appear shorter.
Jaw pain or soreness. Especially in the morning. The jaw muscles work hard during grinding and can feel fatigued or tender upon waking, much like sore muscles after exercise.
Headaches. Tension headaches, particularly at the temples, are a common symptom of bruxism. The temporalis muscle — one of the primary muscles used in chewing — wraps around the temple, and sustained activation during nighttime grinding can cause significant headache pain.
Facial pain and ear pain. Bruxism can stress the temporomandibular joints (TMJ) — the hinge joints just in front of your ears — causing pain that can radiate into the face, neck, and ears.
Tooth sensitivity. As enamel wears away, teeth become more sensitive to temperature changes and sweet foods.
Sleep disruption. Some people are awakened by their own grinding, though most are not. Partners are more likely to notice.
Indentations on the tongue or cheeks. Clenching causes the tongue and cheeks to press against the teeth, leaving scalloped marks on the sides of the tongue or ridges on the inside of the cheeks.
The causes of bruxism aren’t fully understood, but several factors are consistently associated with it:
Stress and anxiety are the most commonly cited factors. Many people unconsciously carry tension in their jaw, and that tension often expresses itself during sleep when conscious control is relaxed.
Sleep disorders, particularly sleep apnea, are strongly associated with bruxism. People with obstructive sleep apnea grind their teeth at higher rates than the general population, possibly as a reflex response to airway obstruction.
Medications, particularly SSRIs (commonly prescribed antidepressants), are known to cause or worsen bruxism in some patients.
Caffeine and alcohol are associated with increased bruxism severity when consumed in excess.
Misaligned bite can contribute, though the relationship between bite problems and bruxism is complex and debated.
Teeth are remarkably durable, but they’re not designed to sustain the sustained heavy forces of grinding. The damage accumulates over years:
Enamel loss is irreversible. Enamel does not regenerate. Once worn away, the underlying dentin is exposed — softer, more decay-prone, and more sensitive.
Fractures and cracks. Grinding can cause teeth to crack. Cracked teeth are complex to treat and, depending on the extent of the fracture, may require crowns, root canals, or extraction.
Damage to existing restorations. Crowns, fillings, and veneers can all be cracked or worn down by heavy bruxism, requiring replacement prematurely.
TMJ dysfunction. Chronic stress on the jaw joints can lead to clicking, popping, locking, and chronic pain — conditions that are often difficult to treat once established.
Gum recession. The lateral forces from grinding can contribute to gum recession and bone loss around the teeth.
The most common treatment for bruxism is a custom nightguard — a precisely fitted appliance made from an impression of your teeth that you wear while sleeping. It doesn’t stop the grinding behavior, but it protects the teeth and jaw from the forces involved.
An over-the-counter nightguard from a pharmacy is better than nothing, but it’s a poor substitute for a properly fitted custom appliance. An ill-fitting guard can alter your bite, cause soreness, and in some cases worsen clenching. A custom guard distributes the forces evenly, protects the joints, and is far more comfortable to wear consistently.
Beyond the nightguard, addressing contributing factors is important:
Repairing damage from bruxism — whether that means bonding, crowns, or more extensive reconstruction — is also part of the treatment picture for patients who have been grinding for years without intervention.
Like so many dental conditions, bruxism is much easier and less expensive to address early. If you suspect you grind your teeth — or if it’s been a while since your teeth have been examined — come in. We can assess the wear patterns on your teeth, evaluate your jaw joints, and discuss options.
A well-fitted nightguard is a small investment. Reconstructing a set of worn-down teeth is not.
— Dr. Dane Boren
