Waking up in the morning with sore jaws? Can’t sleep because of a partner loudly grinding their teeth? Read on to learn all about grinding in your sleep; the symptoms, causes and how to help eliminate the problem.
The Key Facts
- Grinding ones teeth at night (or clenching your jaws together), habits that are also known as ‘bruxism’, or parafunction, are a common problem.
- The problem occurs for up to 10% of the population.
- Problems that result can include jaw pain, toothache and headaches. This is a common cause of migraines.
- Most people who are grinding their teeth are not even aware of this habit! It can come to light when a partner complains of the noise this makes when the person is sleeping, or once the bruxism produces some symptoms.
- The habit can occur at any age, including childhood. But it is most commonly symptomatic/problematic in the 20-50 age range.
- Bruxism is often classified as either nocturnal (‘grinding teeth in sleep’) or day-time. Day-time bruxism often occurs while the person is under stress and/or concentrating on some task (e.g. driving, working) and usually involves jaw clenching more so than grinding. Night-time parafunction usually involves involuntary jaw movements which can be severe in force.
- The difference between the two habits are subtle: Clenching implies jaw tension while the teeth are kept closed, while grinding implies excessive movements of the jaws (i.e. up and down, side to side).
Grinding Teeth Causes
The precise cause can be unclear in many people. In some cases there are no obvious causes and it is thought to be a habit that has formed over time. Factors that are known to bring on or make problem worse include:
Stress and Psychological Factors
Stress, whatever its cause, has a very strong causing link to parafunctional habits, both at night and during daytime hours. It has been found through research that as much as three quarters of cases of bruxism can be linked to stress, depression or anxiety. Many patients complain of an increase in the severity of symptoms at times of increased stress and upset in their lives.
Bruxism has also been documented as a side effect to certain medications including anti-depressants.
Bruxism is found more commonly in people who have an existing sleep disorder. Sleep disorders can include snoring, talking in sleep, violent behavior whilst asleep and breathing disruption during sleep, i.e. Obstructive Sleep Apnoea (OSA). These disorders occur during disruptions to deep sleep and bruxism also occurs during disruptions. Current research suggests a particularly strong link between OSA and teeth grinding.
The habits are also associated with the following factors:
- Age group.
- Social and economic status.
- Alcohol intake.
- High caffeine intake.
- Tobacco usage.
- Substance abuse, including cocaine and ecstasy.
Other Possible Causes
Grinding and jaw clenching (especially during the day) can be associated with certain medications such as antidepressants and disorders such as Parkinson’s disease, depression and major anxiety.
Problems with teeth occlusion can also trigger symptoms- i.e. the teeth do not meet as they should when you bite.
Some rare diseases (like Huntington’s Disease) can result in bruxism as a symptom.
The Symptoms and Effects
There are many possible symptoms which you may experience as a result of tooth grinding and jaw clenching. These include:
- Breaking of fillings, tooth structure wearing down or cracking parts of teeth.
- Teeth can become slightly looser and can fall out, but only in very extreme cases.
- Bigger jaw muscles, as a result of an increased work-out!
- Limited opening of the mouth.
- Possible clicking of the jaw-joint.
- Disruption of sleep of grinder and of anyone who shares sleeping area!
- Long term bruxism can lead to the problem of temporo-mandibular joint disorder (TMJ symptoms).
The following types of pain can occur:
- Pain on moving the jaw.
- Jaw pain or tightness (especially on opening your mouth) and dull headaches when waking up in the morning.
- Pain at the TMJ area, which lies just in front of your ear-lobe, or anywhere in the facial area.
- Tooth sensitivity to hot and cold.
- More severe toothache and pain on biting down on food.
- Tightness, stiffness and pain in the shoulders.
- Headaches are a common symptom. Indeed headaches occur three times more commonly in patients with bruxism.
A note on children
About one in three children will show signs of this habit. It is commonest in children under 5 years-of-age. In the large majority of kids, the habit will go as the child gets older with no permanent damage to the teeth.
If you have any of the above symptoms consult your dentist. Your dentist will help diagnose based on your symptoms and an examination of your mouth and face.
Your dentist will take a detailed history of your complaints and any possible causes. He/she will pay particular attention to:
- Any evidence of grinding on your teeth and gums. Sometimes a line will be present on the inner cheek.
- Tenderness in your jaw joints and muscles.
- Jaw deviation and clicking on opening.
- Missing and/or broken teeth and problems with the bite.
“How to Stop Grinding Your Teeth?”
Treatment to help you to stop this will depend on any causes that are identified. Some of the following may help, not only with stopping but also preventing the habit from recurring:
- Stress reduction. If stress is a factor, it should be dealt with. Your dentist or doctor may recommend professional counseling or psychotherapy. Relaxation strategies, such as meditation or hypnosis may help in some cases.
- It may help to cut down on alcohol, tobacco and caffeine.
- Your dentist may prescribe a muscle relaxant such as diazepam in acute cases. For example if you are experiencing severe pain or difficulty opening and closing your mouth.
- If it has been identified that you are grinding your teeth in sleep, your dentist can make an appliance for you to wear at night. This is often called an occlusal splint, a mouth guard, a nocturnal bite plate or a nightguard. It is a common and effective bruxism treatment and prevention tool. This will serve to protect your teeth from damage and also relieve pressure on the aching jaw muscles and joint. It will also reduce the noise caused by night-time grinding which may be a nuisance to the partner of the patient. Read more on mouth guards here.
- In acute cases of severe pain, heat packs applied to the area of pain can help with relief.
- Dental problems. If dental problems with are contributing to the habit, your dentist may need to correct this. Treatment may include orthodontics, crowns and onlays. Such treatment can be quite complex and would not be undertaken without a lot of planning and forethought.
- Jaw exercises can help retrain the TMJ and strengthen the muscles to relieve symptoms.
- If a medicine you are taking is causing the bruxism, your doctor may be able to prescribe an alternative.
- If necessary, your dentist may decide to refer you to an oral surgeon (more here) or to a dentist who specializes in such complaints.
In teenagers and adults, the outlook is excellent if bruxism is treated properly and in a timely manner.
The problems of grinding teeth in sleep and jaw clenching are common. These habits can be quite harmful both in terms of damaging your teeth and causing jaw pain and headaches. Always seek help from your dentist. They will help you get to the root of the problem and advise what can be done to help relieve any symptoms.
If you want to know more about jaw problems see our section on TMJ disorder.