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Bruxism/Teeth Grinding


Disease: Bruxism/Teeth Grinding Bruxism/Teeth Grinding
Category: Mouth and teeth diseases
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Disease Definition:

The grinding, gnashing or clenching of the teeth is a condition called bruxism. A person might unconsciously clench their teeth together during the day if they have bruxism. But when they grind their teeth at night, it means that they have a condition called sleep bruxism.

In some cases, this condition may be mild and may not require treatment. But in other cases, it might be frequent and severe enough to lead to headaches, damaged teeth, jaw disorders and other problems. It is essential to know the signs and symptoms of bruxism and seek regular dental care, because a person may have sleep bruxism and not be aware of it until complications develop.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


Some of the signs and symptoms of bruxism are:


  • Worn tooth enamel, exposing deeper layers of the tooth
  • Increased tooth sensitivity
  • Teeth grinding or clenching that could be loud enough to awaken the person's sleep partner
  • Headache
  • Indentations on the tongue
  • Enlarged jaw muscles
  • Chipped, worn down, fractured or flattened teeth
  • Jaw pain or tightness in the jaw muscles
  • Chronic facial pain
  • Earache, not because of a problem with the ear, but because of severe jaw muscle contractions
  • Chewed tissue on the inside of the cheek.

In case others complain that the person is making a grinding noise while they sleep, or if they have pain in their jaw, face or ear, or if their teeth are sensitive, worn or damaged they should see a doctor or a dentist.

A person should also contact the dentist in case they notice that their child is grinding his/her teeth or has other signs of symptoms of this condition.


The exact cause of bruxism is still not known, but some of the possible psychological or physical causes are:


  • Changes that occur during sleep cycles
  • Growth and development of the jaws and teeth (for children)
  • An uncommon side effect of some psychiatric medications, including certain antidepressants
  • Abnormal alignment of upper and lower teeth, a condition called malocclusion
  • Stress, tension or anxiety
  • Aggressive, competitive or hyperactive personality type
  • Response to pain from an earache or teething (in children)
  • Suppressed anger or frustration
  • Complication resulting from a disorder, such as Parkinson’s disease or Huntington’s disease.



In most cases, bruxism doesn't cause serious complications. On the other hand, severe bruxism may lead to:


  • Facial pain
  • Tension-type headaches
  • Damage to the teeth, including restorations and crowns, or damage to the jaw
  • Temporomandibular disorders that occur in the temporomandibular joints (TMJs), which are located just in front of the ears and felt when opening and closing the mouth.


In most cases of bruxism, no treatment is necessary because many kids outgrow bruxism without special treatment, and most adults don’t grind or clench their teeth badly enough to require therapy. Nonetheless, treatment options include certain therapies and medications in case the problem is severe.

Some of the types of therapies include:

Stress management:
Bruxism can be prevented with professional counseling or strategies that promote relaxation, including exercises and medication, in case the grinding of teeth is due to stress. But in case a child is grinding his/her teeth because of tension or fear, the child should talk about those fears just before bed or relax with a favorite book or warm bath.

Dental approaches:
A person with bruxism may be suggested a mouth guard or protective dental appliance (splint), in order to prevent damage to the teeth.
Usually, splints are constructed of hard acrylic and fit over the upper or lower teeth. Some splints are made in the doctor’s office, while others are sent to a laboratory to be made.
The dentist can make a custom mouth guard to fit the patient's mouth. These are cheaper than splints, but they usually don’t fit well and can dislodge during teeth grinding. These mouth guards are available over the counter and from the dentist.

In case bruxism is associated with dental problems, correcting misaligned teeth could help. However, the dentist may need to use overlays or crowns to entirely reshape the chewing surfaces of the teeth, in case the tooth wear has led to sensitivity or the inability to chew properly.
Reconstructive treatment may not stop the bruxism, even though it will correct the wear. This treatment can be quite extensive.

Behavior therapy:
By practicing proper mouth and jaw position, a person may be able to change this behavior. In order to keep the teeth from grinding and the jaw from clenching, a person should focus on resting their tongue upward with their teeth apart and lips closed.

A person may also benefit from biofeedback in case they're having a hard time changing their habits. A form of complementary and alternative medicine, biofeedback uses a variety of monitoring procedures and equipment to teach a person how to control involuntary body responses.

Electrical sensors are applied to different parts of the body during a biofeedback session, which monitor the body’s physiological responses to stress, such as teeth grinding, and then feed the information back to the patient through visual and auditory cues. Due to this feedback, the person will start associating teeth grinding or clenching with stress and try to change their behavior. These cues could be beeping sounds or flashing lights. A portable biofeedback could also be used at home.

Although the patient may be suggested taking a muscle relaxant before bedtime, medications aren’t very effective for treatment of bruxism. However, botulinum toxin  injections could be of help to some people with severe bruxism in case they haven’t responded to other treatments. In case bruxism is a side effect of an antidepressant medication, this medication could be changed, or the patient could be prescribed another medication in order to counteract their bruxism.


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