If you grind or clench your teeth at night, you likely have what is known as sleep bruxism. The difficulty with this type of bruxism, however, is that you’re asleep when it happens, and as a result, you may not even know you’re doing it. Furthermore, teeth grinding or clenching can lead to complications to your dental health and overall well-being.
In this article, we’ll walk you through the potential causes and risk factors for sleep bruxism, as well as important symptoms to look out for, treatment options, and when you should reach out to your dentist or doctor.
According to Dr. Asher Diamond, DDS, of Diamond Dental Sleep Solutions, bruxism is “a condition characterized by excessive teeth grinding or jaw clenching.” There are two types1 of bruxism: awake and sleep. Awake bruxism is when you do these motions during the day, whereas sleep bruxism is when they occur at night while you sleep.
A Dutch study2 on the prevalence of bruxism in adults found that sleep bruxism was the more common of the two, with 16.5 percent of participants having sleep bruxism compared to just 5 percent having awake bruxism. A second study3 also found a similar trend in the Dutch adolescent population.
According to the Mayo Clinic, bruxism at night is considered a sleep-related movement disorder1. Sleep-related movement disorders4 can cause a person to exhibit movements just before or during sleep that can impact their ability to fall or stay asleep. Other examples of sleep-related movement disorders include restless legs syndrome (RLS), periodic limb movement disorder (PLMD), and rhythmic movement disorder (RMD).
Symptoms of Sleep Bruxism
As mentioned, sleep bruxism is when you grind your teeth or clench your jaw while asleep, which means most people don’t realize they do it5 . According to Johns Hopkins Medicine, the following symptoms are associated with bruxism:
- Teeth scraping
- Chipped or cracked teeth
- Facial pain
- Increased tooth sensitivity
- Tension in the facial and jaw muscles
- Jaw dislocation
- Tetanus (lockjaw)
- Wearing away of tooth enamel
- A popping or clicking sound in the temporomandibular joint (TMJ)
- Indentations on the tongue
- Damage inside the cheek
- Smoothing of teeth-biting surfaces
Certain symptoms, particularly pain-related ones, could affect sleep by making it harder to doze off. As a result, you might not get enough sleep at night.
In most cases, a dentist can provide a formal diagnosis if they notice any of the aforementioned symptoms. Dr. Jennifer Silver, DDS of Macleod Trail Dental explains this process. “During routine dental examinations, your dentist will look for indicators of bruxism, such as flattened tooth tips. If signs and symptoms are present, your dentist or other healthcare professional will monitor the situation over the course of the following several appointments before initiating therapy.”
Sleep Bruxism Treatment Options
The good news is that just as your dentist can help diagnose sleep bruxism, they can also provide treatment options. According to Delia Pena-Gay, a dental assistant with 11 years of experience, the best method is to use a custom-made night guard.
“The best way to treat bruxism is to have a prefabricated night guard made by your dentist. Night guards are available in drug stores but are not made the same. A night guard made in a dental lab begins with an impression taken at your dentist's office so that it is customized to your mouth. There is a certain thickness in a lab-made night guard that isn't present in a store-bought guard. Lastly, lab-made guards can be adjusted so that it's comfortable.” However, Delia adds that you should keep your mouth guard away from pets when you’re not using it. “Dogs will chew on it like it's a chew toy. I can't tell you the number of times patients need a new one because their dog ate it.”
Dr. Silver further explains that these mouthguards (as well as sprints) can help “prevent the damage caused by clenching and grinding by keeping the teeth apart.” Therefore, a bite guard could be an excellent preventative measure if you are prone to sleep bruxism.
Along with using oral devices to protect the teeth, Dr. Diamond encourages practicing habits to manage your bruxism, such as yoga, meditation, or exercise, and avoiding stimulating activities, alcohol, and caffeine before bed. Dr. Diamond goes on to say that therapy, medications, and even Botox could be additional sources of treatment.
“Behavioral therapy, such as biofeedback or stress management techniques, can be effective for managing bruxism. Medications, such as muscle relaxants or antidepressants, may also be prescribed. In some cases, Botox injections to the jaw muscle may also be used to treat bruxism.”
When to Consult Your Doctor
Your dentist may notice signs of bruxism during your regular visits, in which case they’ll bring up treatment options to prevent further damage or discomfort. You should also alert your dentist if you notice any of the above-mentioned symptoms, either during your next visit or by calling their office to schedule an appointment. Even if your symptoms aren’t related to bruxism, your dentist will be able to help rule it out as a source.
Causes of Sleep Bruxism
While there’s no clear-cut answer as to why people develop bruxism, much of it appears to be rooted in stress. As mentioned above, Dr. Diamond notes that stress management activities like yoga, meditation, exercise, and behavioral therapy could help manage bruxism symptoms.
Research backs this up as well. In a 2022 study that focused on the association between bruxism and stress in students, the researchers found that nearly 89 percent6 of participants with self-evaluated bruxism also reported feeling stressed.
Another 2022 study looked more in-depth at psychological factors and bruxism7, concluding that stress and anxiety were “favorable factors” for both sleep and awake bruxism. However, they add that depression, specifically, was only associated with awake bruxism.
Along with stress, the Mayo Clinic adds that there are certain risk factors that could increase a person’s chance of developing this sleep-related movement disorder1. These include:
- Age. Bruxism tends to be more common in children and typically goes away in adulthood.
- Personality. If someone has an aggressive, competitive, or hyperactive personality, they are more likely to have bruxism.
- Medications. People who take certain antidepressant medications may develop bruxism.
- Substances. Smoking, consuming alcohol or caffeine, and using recreational drugs could lead to bruxism.
- Family history. If you have a family history of bruxism, this could increase your chances of developing this condition.
- Other disorders. Bruxism is linked to other disorders, including Parkinson's disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, night terrors, sleep apnea, and attention-deficit/hyperactivity disorder (ADHD).
Effects of Bruxism on Well-Being
One of the most significant effects bruxism has on your well-being is that it can impact your dental health.
Dental assistant Delia Pena-Gay explains, “the consequences of bruxism are that you can break your teeth, wear down the enamel, cause gum recession, and wear your teeth down.” Dr. Silver adds to this by emphasizing that the wear and tear can “cause sensitivity or the inability to chew properly.”
This damage to your teeth can also create a financial burden since you would have to invest in dental work such as reshaping the chewing surfaces of your teeth or implementing crowns1.
Other symptoms of bruxism, such as headaches and facial pain, can make it difficult to get through the day. We also mentioned earlier that someone with sleep bruxism could develop a popping or clicking sound in the temporomandibular joint, which is known as TMJ. Even if this sound isn’t painful, it may feel embarrassing for the person who has it.
Last Word of Advice
You may have bruxism and not even know it. However, this disorder can create complications to your dental health and overall well-being, which means it’s important to be mindful of symptoms associated with bruxism. Regular checkups and alerting your dentist of symptoms can help ensure you’re able to access the right treatments if and when needed.
While the people and sources we cite are reputable, we here at Sleep Advisor are not medical or dental experts ourselves. Therefore, if you have concerns about sleep bruxism, we also encourage you to discuss this topic with your dentist.
- “Bruxism (teeth grinding)”. Mayo Clinic. Last modified August 10, 2017. https://www.mayoclinic.org/diseases-conditions/bruxism/symptoms-causes/syc-20356095.
- Wetselaar, Peter., Vermaire, Erik J.H., Lobbezoo, Frank., Schuller, Annemarie A. “The prevalence of awake bruxism and sleep bruxism in the Dutch adult population”. Journal of Oral Rehabilitation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849828/#!po=77.2727. 2019.
- Wetselaar, Peter., Vermaire, Erik J.H., Lobbezoo, Frank., Schuller, Annemarie A. “The prevalence of awake bruxism and sleep bruxism in the Dutch adolescent population”. Journal of Oral Rehabilitation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7821114/#__ffn_sectitle. 2021.
- “Sleep-Related Movement Disorders”. University of California at Irvine Health. Webpage accessed January 22, 2023. https://www.ucihealth.org/medical-services/sleep-services/sleep-related-movement-disorders.
- “Bruxism”. Johns Hopkins Medicine. Webpage accessed January 22, 2023. https://www.hopkinsmedicine.org/health/conditions-and-diseases/bruxism#:~:text=Bruxism%20is%20a%20problem%20in,even%20realize%20you%20have%20it.
- Vlăduțu, Diana., Popescu, Sanda Mihaela., et. al. “Associations between Bruxism, Stress, and Manifestations of Temporomandibular Disorder in Young Students”. International Journal of Environmental Research and Public Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9102407/#!po=60.5263. 2022.
- Flueraşu, Mirela Ioana., Bocşan, Ioana Corina., et. al. “The Epidemiology of Bruxism in Relation to Psychological Factors. International Journal of Environmental Research and Public Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775973/#!po=67.8571. 2022.
Jill Zwarensteyn is the editor for Sleep Advisor and a certified sleep science coach. She is enthusiastic about providing helpful and engaging information on all things sleep and wellness.
Based in Los Angeles, she is an experienced writer and journalist who enjoys spending her free time at the beach, hiking, reading, or exploring new places around town.
She’s also an avid traveler who has a personal goal of being able to successfully sleep on an airplane someday.