Teeth grinding (bruxism): signs, causes and when a night guard helps

Teeth grinding, or bruxism, is the habit of clenching or grinding the teeth, most often during sleep. Many people only find out because a partner hears it, or because they wake up with a tired jaw, a headache or sensitive teeth. Mild grinding may need nothing more than attention, but regular grinding can wear the teeth down and damage fillings and crowns. A dentist can confirm the signs, and a custom-made night guard is the usual way to protect the teeth.

What bruxism is

Bruxism comes in two forms. Sleep bruxism happens at night, when you are not aware of it, and often comes in short bursts. Awake bruxism is mostly clenching during the day, for example while concentrating, driving or under stress. Some people have both.

The forces involved can be much higher than during normal chewing, and they last longer. Over months and years this is what causes the damage dentists see.

Signs that you may be grinding your teeth

• Teeth that look flatter, shorter or chipped at the edges
• Teeth that have become sensitive to cold
• Fillings, crowns or veneers that crack or come loose without an obvious reason
• A tired or painful jaw when you wake up, sometimes with a dull headache at the temples
• Marks of the teeth on the side of the tongue or a white line on the inside of the cheeks
• A partner who hears grinding at night

Not all of these signs mean bruxism, and some have other causes. An examination helps to tell them apart.

What causes it

There is rarely a single cause. The factors most often linked with grinding are:

• stress, anxiety and periods of intense concentration;
• sleep problems, including snoring and sleep apnoea;
• caffeine, alcohol and smoking, especially in the evening;
• some medicines, including certain antidepressants;
• in children, grinding during sleep is common and often settles on its own as they grow.

If you snore loudly, stop breathing during sleep or are very sleepy during the day, mention it to your doctor as well: sleep apnoea needs its own assessment.

What grinding can do to your teeth

The main risk is wear. Enamel that is ground away does not grow back. As the teeth wear, they can become sensitive, look shorter and change the appearance of the smile. Grinding also increases the risk of cracked teeth and of broken fillings, crowns and veneers. For people who already have veneers or crowns, protecting them is part of making them last.

Clenching can also strain the jaw muscles and joints. Read more about jaw pain and the jaw joint.

How a night guard helps

A night guard is a thin, custom-made plastic splint worn over the upper or lower teeth during sleep. It does not always stop the grinding, but it takes the wear instead of your teeth and spreads the forces more evenly. Many patients also notice less jaw tiredness in the morning.

1. The dentist examines your teeth, bite and jaw and checks for wear, cracks and damaged fillings.
2. Impressions or a digital scan are taken so that the guard fits your teeth exactly.
3. The guard is made and fitted, and the bite on it is adjusted so that it feels even.
4. At a follow-up visit, the fit and comfort are checked.

Over-the-counter boil-and-bite guards are thicker, fit less precisely and can be uncomfortable. They are not a good long-term substitute for a guard made from your own impressions.

What you can do yourself

• Notice daytime clenching: your teeth should normally be apart, with the lips closed and the jaw relaxed.
• Reduce caffeine and alcohol in the evening and avoid chewing gum all day.
• Find ways to manage stress that suit you, such as exercise or regular breaks.
• Keep regular dental check-ups so that wear is spotted early.

Teeth grinding: help at Ajam Dental Clinic in Tripoli

Ajam Dental Clinic is a dental practice on Fouad Chehab Boulevard in Tripoli, run by Dr. Abdel Rahman Ajam and Dr. Soumaya Ajam. At a consultation the dentist looks for signs of wear and damage and explains whether a night guard or another treatment makes sense for you. Patients come from across Tripoli — Al-Qobbeh, Bab al-Tabbaneh, Jabal Mohsen and Dam wa Farez — and from the rest of North Lebanon.

For a child who grinds at night, contact Dr. Soumaya Ajam. You can book a consultation by WhatsApp or phone.

This article provides general information for patients. It does not replace an examination by a dentist, who can advise you on your own situation.