Teeth grinding and clenching (bruxism)
Teeth grinding and clenching is a habit where you rub or squeeze your teeth together. This can happen when you are awake or asleep. Teeth grinding is common in tamariki (children) and rangatahi (young people), but it can happen in people of any age. Most tamariki grow out of teeth grinding.
Causes of teeth grinding and clenching
It is not always clear what causes teeth grinding and clenching, but it is often linked to:
- stress and anxiety
- sleep problems like snoring or sleep apnoea
- an abnormal bite and crooked or missing teeth
- some medications, including a type of antidepressant known as selective serotonin reuptake inhibitors (SSRIs)
- smoking
- drinking lots of alcohol or caffeinated drinks such as tea, coffee or energy drinks
- taking illicit drugs like ecstasy and cocaine.
Symptoms of teeth grinding and clenching
You may not know that you grind your teeth while you are asleep. You might learn that you do from someone sharing your bed or someone sleeping in the same room as you. They might tell you they heard grinding sounds and noises. Not everyone who grinds their teeth makes a noise.
Your teeth are not meant to be clenched and in contact all the time. Your bottom and top teeth should only briefly touch each other when you swallow or chew. If they are in contact too often or too forcefully, it can wear down your tooth enamel (the outer layer that covers each tooth). Without the enamel to protect the inner parts of your teeth, you may develop dental problems.
Other symptoms may include:
- flattened, fractured, chipped or loose teeth
- increased tooth pain or sensitivity
- tired or tight jaw muscles, or a locked jaw that will not open or close completely (temporomandibular disorder)
- jaw, neck or face pain
- pain that feels like an earache, but it is actually not a problem with your ear
- a dull headache
- damage from chewing on the inside of your cheek
- disturbed sleep.
Self care for teeth grinding and clenching
There are several things you can try that may help if you grind or clench your teeth.
You can reduce stress by:
- listening to music
- having a warm bath or taking a shower
- being physically active
- doing activities that are fun and that you enjoy
- trying calming breathing, yoga, pilates or tai chi
- reducing muscle tension (progressive muscle relaxation).
Eating hard or sticky foods can make tooth and jaw pain worse, for example:
- nuts
- popcorn
- raw apples
- hard lollies
- peanut butter.
Caffeinated drinks and alcohol may make teeth grinding worse. Try to avoid them in the evening and after dinner.
Getting a good night’s sleep may help reduce teeth grinding and clenching.
- Go to bed at the same time every night.
- Relax before bedtime.
- Make sure your bedroom is dark, cool and quiet.
You are less likely to clench or grind your teeth when you sleep on your back. This position allows your jaw to rest naturally without any pressure pushing down on your face. Your pillow should support your face, jaw and neck.
If you have sleep apnoea or snore, side sleeping is best. This is because sleeping on your back can make snoring and sleep apnoea worse.
Some exercises can help reduce pain and relax the muscles involved in teeth grinding. Try the following exercises several times a day to see if they help.
Tongue press
- Close your lips gently while keeping your top and bottom teeth slightly apart.
- Press your tongue against the roof of your mouth without it touching your teeth.
- Hold your tongue in this position for as long as you can.
Yawning
Yawn widely and hold the yawn for a few seconds.
Shoulder roll
- Move your shoulders upwards then roll them backwards.
- Complete the circular motion and repeat until your shoulders feel more relaxed.
- If your shoulders are relaxed, you will be less inclined to grind your teeth.
Ice helps reduce swelling and pain. Heat helps relax your muscles and increases blood flow.
For severe pain
Use an ice pack (or bag of frozen peas) wrapped in a cloth or paper towel for severe pain.
Place it on your jaw, face or neck for 10 to 15 minutes. Repeat as needed.
For mild to moderate pain
Use heat for mild to moderate pain.
Apply a moist warm towel or a warm wheat bag to your jaw muscles for 10 to 15 minutes. Repeat as needed.
Taking pain relief medicines can help to relieve your pain. Talk to your healthcare provider if you still need pain relief after 1 to 2 weeks.
Pain relief medicines for adults
Getting help with teeth grinding and clenching
If your symptoms do not get better with self care or you have concerns about your teeth or jaw, see your healthcare provider or dentist.
If your teeth grinding is causing tooth pain or sensitive teeth, your dentist may suggest wearing a mouthguard. This may also be called a night guard or dental splint. It is like a sports mouthguard but harder. You wear the mouthguard to protect your teeth from damage. You can buy mouthguards online or at a sports store. A dentist can also custom make one to fit precisely over your upper teeth.
A physiotherapist with a special interest in jaw problems or a trained massage therapist can give you treatment and exercises that can help. A physiotherapist can also check for other issues contributing to the problem, such as poor posture.
If your teeth grinding is severe, you may be unable to chew properly. If this happens, your dentist may need to reshape the chewing surfaces of your teeth. Or they may need to use crowns to repair the damage.
Getting treatment for an underlying condition such as sleep apnoea or anxiety may help.
If your symptoms are severe and not improving with other measures, talk to your healthcare provider. They may suggest a trial of medication such as a muscle relaxant tablet or Botox injections. These treatments do not work for everyone and can have unwanted side effects.