Teeth Grinding (Bruxism): Causes, Signs and How a Night Guard Helps

Teeth grinding, or bruxism, is the involuntary clenching or grinding of the teeth, and it can happen during sleep or while awake. Most people are unaware of it; it is often noticed by a partner hearing the noise, by morning jaw pain, or by a dentist spotting wear during an examination.

Occasional mild clenching is usually not a serious problem. When it is frequent and forceful, however, it can lead to worn and cracked teeth, sensitivity, jaw joint problems and fractures in restorations such as veneers and crowns.

What causes bruxism?

There is rarely a single cause; several factors usually play a part. Awake bruxism is more often linked to stress and concentration, while sleep bruxism is associated with sleep patterns and the central nervous system. The idea that an uneven bite alone is the main cause is no longer as widely accepted as it once was.

• Stress, anxiety and a busy lifestyle
• Sleep disorders such as snoring and sleep apnoea
• Caffeine, alcohol and smoking
• Some medicines, including certain antidepressants
• A family history of bruxism

Signs and symptoms of teeth grinding

The signs can creep up slowly. If you recognise several of the following, it is worth having a dental assessment.

• Jaw, facial or temple pain and tiredness in the morning
• Headaches that start on waking
• Flattened, shortened or chipped teeth
• Increased sensitivity to hot and cold
• Clicking in the jaw joint or difficulty opening your mouth
• Tooth marks on the inside of the cheeks or the sides of the tongue

How bruxism affects teeth and veneers

The force produced during sleep clenching can be much greater than normal chewing force and may continue for long periods. Over time this repeated load wears enamel, cracks teeth and breaks fillings. As teeth become shorter, the smile can start to look older.

Porcelain veneers, zirconia crowns and implant restorations are affected too. Bruxism is one of the leading reasons veneers chip or debond. That is why grinding habits should be assessed before any cosmetic treatment and, where necessary, protective measures planned from the start.

How is bruxism diagnosed?

Diagnosis usually starts with a dental examination. Your dentist looks for wear facets on the teeth, cracks in fillings and restorations, the condition of the chewing muscles and how the jaw joint moves. Information from you, and from a partner if possible, such as grinding noises at night or morning pain, completes the picture.

Photographs or models can be compared over time to see whether wear is progressing. If a sleep disorder such as sleep apnoea is suspected, you may be referred for a sleep study.

Night guards and other treatment options

There is no single cure that switches bruxism off; the aims are to protect the teeth and restorations, ease symptoms and reduce triggers. The most widely used tool is a custom night guard.

Made from impressions or a digital scan of your teeth, a custom night guard stops the teeth grinding directly against each other and spreads the force over a wider area. Off-the-shelf guards may not fit well and can be uncomfortable. Your guard should be checked at regular visits and replaced when worn.

Managing stress, improving sleep habits and cutting down on caffeine and alcohol in the evening can also help. During the day, try to notice clenching and return to a relaxed position: lips together, teeth slightly apart. If sleep apnoea is suspected, a referral to a sleep specialist may be needed, and approaches such as physiotherapy are sometimes considered.

If you think you may be grinding your teeth, you can book an examination with Dr. Merve Hakan in Baku to have your teeth and any restorations assessed.