Bruxism: Teeth Grinding at Night 4/19/24, 3:19 AM
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Bruxism: Teeth Grinding at Night
Updated April 3, 2024
Eric Suni Kimberly Truong Fact-Checked Up-to-Date
Staff Writer Sleep Medicine Physician
Key Takeaways
Bruxism involves teeth grinding and jaw clenching during sleep.
Stress is the most common cause, but correlations have been found between bruxism and
obstructive sleep apnea.
Night guards can help prevent dental issues and chronic pain.
Teeth clenching and grinding are common involuntary reactions to anger, fear, or stress. In some
people, this reaction plays out repeatedly through the day, even if they are not responding to an
immediate stressor. This involuntary teeth grinding is known as bruxism.
Bruxism can happen while awake or asleep, but people are much less likely to know that they grind
their teeth when sleeping. Because of the force applied during episodes of sleep bruxism, the condition
can pose serious risks to tooth and jaw health and may require treatment to reduce its impact.
What Is Sleep Bruxism?
Sleep bruxism is teeth grinding that happens during sleep, and is marked by movement of the
masticatory muscles responsible for chewing. Sleep bruxism and waking bruxism are considered to be
distinct conditions 1 , even though the physical action is similar. Of the two, awake bruxism is more
common.
It is often much harder for people to be aware that they are grinding their teeth while sleeping, which
makes diagnosis challenging. A sleeping person cannot perceive their bite strength, so they may clench
more tightly and grind their teeth, employing up to 250 pounds of force 2 .
How Common Is Sleep Bruxism?
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Sleep bruxism is more common in children, adolescents, and young adults than middle-aged and older
adults. Exact numbers of how many people have sleep bruxism are hard to come by because many
people are not aware that they grind their teeth at night.
Statistics about sleep bruxism in children are the hardest to pin down. Studies have found anywhere
from around 6% to up to nearly 50% of children 3 experience nighttime teeth grinding. It can affect
children as soon as teeth come in, so some infants and toddlers may grind their teeth. Some sleep
disorders 4 , including sleep talking, sleepwalking, and bedwetting, are believed to increase risk of
sleep bruxism in children.
In adolescents, the prevalence of sleep bruxism is estimated to be around 15% 5 . The condition
becomes less common with age, as around 8% of middle-aged adults and only 3% of older adults are
believed to grind their teeth during sleep.
What Are the Symptoms of Sleep Bruxism?
The main symptom of sleep bruxism is involuntary clenching and grinding of the teeth during sleep.
People with sleep bruxism don’t grind their teeth throughout the night, but have episodes of clenching
and grinding which usually last up to one second. The frequency of episodes is often inconsistent, and
teeth grinding may not occur every night.
Some amount of mouth movement is normal during sleep. Up to 60% of people make occasional
chewing-like motions known as rhythmic masticatory muscle activities (RMMA), but in people with sleep
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bruxism, these occur with greater frequency and force.
It is normal for people who grind their teeth at night to not be cognizant of this behavior unless they are
told about it by a family member or bed partner. However, some symptoms, like jaw and neck pain, can
be an indication of sleep bruxism.
The majority of sleep bruxism takes place early in the sleep cycle, during stages 1 and 2 of non-REM
sleep, but the pain and discomfort may only be noticed after waking up. Pain occurs due to the
tightening of jaw muscles during episodes of bruxism. Morning headaches that feel like tension
headaches and unexplained damage to teeth can also be a sign of nighttime clenching and grinding of
teeth.
What Are the Consequences of Sleep Bruxism?
Long-term consequences of sleep bruxism can include significant harm to the teeth 6 . Teeth may
become painful, eroded, and mobile. Dental crowns, fillings, and implants can also become damaged.
Teeth grinding can increase the risk of problems with the joint that connects the lower jaw to the skull,
known as the temporomandibular joint (TMJ). TMJ issues 7 can provoke difficulty chewing, chronic jaw
pain, popping or clicking noises, locking of the jaw, and other complications.
Not everyone with sleep bruxism will have serious effects. The extent of symptoms and long-term
consequences depend on the severity of the grinding, the alignment of a person’s teeth, their diet, and
whether they have other conditions that can affect the teeth like gastroesophageal reflux disease
(GERD).
How to Stop Teeth Grinding (Without Going to the Dentist)
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Why Do I Grind My Teeth at Night?
Multiple factors influence the risk of sleep bruxism, so it can be difficult to identify a single cause for why
people grind their teeth. That said, certain risk factors are associated with a greater probability of sleep
bruxism.
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High stress levels: Stress is one of the most significant risk factors. Clenching the teeth when
facing negative situations is a common reaction, which can carry over to episodes of sleep bruxism.
Teeth grinding is also believed to be connected to higher levels of anxiety.
Genetics: Researchers have determined that sleep bruxism has a genetic component and can run in
families. As many as half of people with sleep bruxism will have a close family member who also
experiences the condition.
Irregular sleep patterns: Episodes of teeth grinding appear to be connected to changing sleep
patterns or microarousals from sleep. Most teeth grinding is preceded by increases in brain and
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cardiovascular activity. This may explain the associations that have been found between sleep
bruxism and obstructive sleep apnea (OSA), which causes temporary sleep interruptions from
lapses in breathing.
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Lifestyle: Numerous other factors have been associated with sleep bruxism including cigarette
smoking, alcohol consumption, caffeine intake, depression, and snoring. Further research is
needed to better understand potential connections and how these factors may affect sleep bruxism.
Medications: Research suggests certain medications, including selective serotonin reuptake
inhibitors (SSRIs), amphetamines, and antipsychotics may increase risk of sleep bruxism. It is
important to discuss dosage and potential side effects of any medications with your doctor.
How Is Sleep Bruxism Diagnosed?
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Sleep bruxism is diagnosed by a doctor or a dentist , but the diagnostic process can vary depending
on the type of health professional providing care.
An overnight study in a sleep clinic, known as polysomnography, is the most conclusive way to
diagnose sleep bruxism. However, polysomnography can be time-consuming and expensive and may
not be necessary in certain cases. Polysomnography can identify other sleep problems, like OSA, so it
may be especially useful when a person has diverse sleep complaints.
Home observation tests can monitor for signs of teeth grinding, but these tests are considered to be
less definitive than polysomnography.
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What Are the Treatments for Sleep Bruxism?
There is no treatment that can completely eliminate or cure teeth grinding during sleep, but several
approaches can decrease episodes and limit damage to the teeth and jaw.
The best treatment for sleep bruxism varies based on the individual, and should always be overseen by
a doctor or dentist who can explain the benefits and downsides of a therapy in the patient’s specific
situation.
Stress Reduction
Taking steps to reduce and manage stress may help naturally decrease teeth grinding. Reducing
exposure to stressful situations is ideal, but of course, it is impossible to completely eliminate stress. As
a result, many approaches focus on combating negative responses to stress in order to reduce its
impact.
Techniques for reframing negative thoughts are a component of cognitive behavioral therapy for
insomnia (CBT-I), a form of talk therapy for improving sleep that may address anxiety and stress as
well. Improving sleep hygiene and employing relaxation techniques can have added benefits for
falling asleep more easily.
Medications
Medications help some people reduce sleep bruxism. Most of these drugs work by altering brain
chemicals to reduce muscle activity involved in teeth grinding. Botox injections are another way of
limiting muscle movement and have shown effectiveness in more severe cases of sleep bruxism.
Medications may have side effects that make them unsuitable for some patients or difficult to use long-
term. It is important to speak with a doctor before taking any medication for sleep bruxism in order to
best understand its potential benefits and side effects.
Mouthpieces
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Various types of mouthpieces and mouthguards, sometimes called night guards, are used to reduce
damage to the teeth and mouth that can occur because of sleep bruxism.
Dental splints can cover the teeth so that there is a barrier against the harmful impact of grinding.
Splints are often specially designed by a dentist for the patient’s mouth but are also sold over-the-
counter. They may cover just a section of teeth or cover a wider area, such as the whole upper or lower
rows of teeth.
Other types of splints and mouthpieces, including mandibular advancement devices (MADs), work to
stabilize the mouth and jaw in a specific position and prevent clenching and grinding. MADs work by
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holding the lower jaw forward, and they are commonly used to reduce chronic snoring .
Symptom Relief
Avoiding gum and hard foods can cut down on painful movements of the jaw. A hot compress or ice
pack applied to the jaw may provide temporary pain relief.
Facial exercises help some people reduce the pain in their jaw or neck. Facial relaxation and massage
of the head and neck area may further reduce muscle tension. A doctor or dentist may be able to
suggest specific exercises or make a referral to an experienced physical therapist or massage therapist.
Medical Disclaimer: The content on this page should not be taken as medical advice or used as a recommendation for any specific treatment or
medication. Always consult your doctor before taking a new medication or changing your current treatment.
About Our Editorial Team
Medically Reviewed by
Written By
Kimberly Truong, Sleep Medicine
Eric Suni, Staff Writer
Physician PhD
Eric Suni has over a decade of experience as a Dr. Truong is a Stanford-trained sleep physician with
science writer and was previously an information board certifications in sleep and internal medicine.
specialist for the National Cancer Institute. She is the founder of Earlybird Health.
Learn more about our Editorial Team
References 12 Sources
1. Yap, A. U., & Chua, A. P. (2016). Sleep bruxism: Current knowledge and contemporary
management. Journal of Conservative Dentistry, 19(5), 383–389.
https://pubmed.ncbi.nlm.nih.gov/27656052/
2. Hennessy, B.J. (2022, February). Teeth grinding. Merck Manual Consumer Version.
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https://www.merckmanuals.com/home/mouth-and-dental-disorders/symptoms-of-oral-and-dental-
disorders/teeth-grinding
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