What is bruxism?
Bruxism means clenching or grinding the teeth involuntarily, outside normal chewing and swallowing. There are two forms, which can occur together:
- Sleep bruxism: grinding or clenching during the night, often in episodes. People who do it are usually unaware of it; sometimes it is a partner or family member who hears the noise.
- Awake bruxism: mainly clenching the jaw during the day, at a screen, while driving or when concentrating, usually without grinding.
Clenching your teeth now and then is perfectly normal. Bruxism becomes a problem when it is frequent or forceful enough to damage the teeth, tire the jaw muscles or cause pain.
Warning signs to look out for
Because bruxism often happens during sleep, it is usually its effects that give it away. Mention it to your dentist if you notice:
- teeth that look shorter, flattened or worn along their edges;
- sensitivity to cold that develops without any obvious decay;
- small cracks in the enamel or chips along the edges of the teeth;
- a stiff or painful jaw on waking, or tiredness when chewing;
- morning headaches, often around the temples;
- clicking or discomfort in the joints just in front of the ears;
- tooth marks along the sides of the tongue or inside the cheeks;
- fillings or crowns that repeatedly break or come loose.
None of these signs is enough on its own to make a diagnosis, as other causes can explain them: that is exactly why an examination matters.
Why do people grind their teeth?
The causes of bruxism are usually multiple and not all of them are fully understood. Several factors are, however, well recognised:
- Stress and anxiety, which play an important role, especially in daytime clenching.
- Certain sleep disorders, such as snoring or sleep apnoea, which are often associated with night-time grinding.
- Alcohol, tobacco and caffeine, particularly in the evening.
- Some medicines, including certain antidepressants, as well as some recreational drugs.
Bruxism was long blamed on badly positioned teeth. Current knowledge links it more to stress, sleep and the way the nervous system works. Reshaping the teeth by grinding them down is therefore not considered a treatment for bruxism.
Effects on the teeth and jaw
The forces involved in night-time clenching can be stronger and last longer than those of normal chewing. Repeated night after night, they eventually leave their mark:
- Wear of the enamel, then of the softer dentine underneath, which speeds up wear and can make teeth sensitive.
- Cracks and fractures, especially in teeth already weakened by large fillings.
- Damaged restorations: fillings, crowns or bridges that chip or come loose.
- Muscle pain in the jaw, face and sometimes the neck.
- Discomfort in the jaw joints (temporomandibular joints), with clicking or difficulty opening the mouth wide in some people.
When wear is advanced, the teeth can be rebuilt, for example with crowns, or with dental veneers in carefully selected cases. These restorations still need protecting, though: if the bruxism is not managed, they are exposed to the same forces as natural teeth.
The occlusal splint: protecting your teeth at night
An occlusal splint, also called a night guard, is the most common way of managing sleep bruxism. It is a resin appliance, custom-made from an impression of your teeth, that you wear at night.
It is important to understand what it does:
- it protects the teeth from wear and spreads the forces;
- it can help relieve the muscles and joints;
- however, it does not remove the cause of the bruxism.
A splint made by your dentist is adjusted to the way you bite and then checked at follow-up appointments. Over-the-counter mouth guards are not designed for this purpose and often fit poorly. If you snore or sleep apnoea is suspected, say so: it affects the choice of appliance, and a medical opinion may be helpful.
Everyday habits that help
A splint protects your teeth at night, but your habits matter too, particularly for daytime clenching:
- Become aware of clenching: at rest, the lips are together but the teeth do not touch. A few reminders during the day (a note on your screen, a phone alarm) help you relax your jaw.
- Tackle stress: physical activity, relaxation or breathing techniques and, if needed, support from a professional.
- Look after your sleep: regular hours and less screen time before bed.
- Cut down on alcohol, caffeine and tobacco, especially in the evening.
- Avoid chewing pens, nails or gum all day long, which keeps the muscles tense.
If a medicine seems to be involved, do not stop it on your own: talk to the doctor who prescribed it.
When to see a dentist and what the assessment involves
Book an appointment if you recognise several of the signs described above, if a tooth cracks or a restoration breaks for no obvious reason, or if jaw pain persists. The earlier bruxism is managed, the better the teeth are preserved.
At the appointment, the dentist asks about your symptoms, your sleep and your lifestyle, then examines the wear on your teeth, your jaw muscles and joints. X-rays may complete the examination. Depending on the situation, you may be offered a splint, lifestyle advice and sometimes a referral to a doctor, particularly if sleep apnoea is suspected.
At German Dental Clinic in Agdal, impressions can be taken with an intraoral scanner, without impression paste. If you live in or near Rabat and think you may be grinding your teeth, book an appointment for an assessment.
Sources
Frequently asked questions
Can bruxism be cured for good?
There is no treatment that is certain to make bruxism disappear. It often varies with periods of stress and may ease when the factors behind it are better controlled. The main aims are to protect the teeth, relieve the jaw and address what keeps the habit going.
Is it hard to get used to a splint?
For the first few nights the splint may feel bulky and you may produce a little more saliva. Most people get used to it within a few days to a few weeks. If it feels tight, causes pain or changes the way you bite in the morning, tell your dentist: an adjustment is often needed.
My child grinds their teeth at night. Is it serious?
Grinding is common in children and often temporary, particularly while they are growing and their teeth are changing. It does not always need treatment. Do mention it at check-ups, though, especially if there is marked wear, pain or heavy snoring.
Can bruxism damage a crown or a veneer?
Yes. Restorations are exposed to the same forces as natural teeth and can chip or come off. Before placing crowns or veneers for someone who grinds their teeth, the dentist assesses the bruxism and usually plans a protective splint.
The information on this page is general. Only a consultation allows a diagnosis and a suitable treatment plan.
