Most people who grind their teeth have no idea they do it, because it happens while they are asleep. It usually announces itself through flattened teeth, morning headaches or restorations that keep breaking. Clenching and grinding often happen during sleep or stress and show up as flattened teeth, chips, sensitivity and sore jaw muscles, and the treatment ranges from a protective night guard to dealing with the causes, such as stress, sleep problems, medications or a bite that does not meet evenly.
Reasons people ask about teeth grinding and clenching
- Waking with a tight or aching jaw
- Morning headaches around the temples
- Teeth looking flattened, shortened or chipped
- A partner reporting grinding noises at night
Approaches that may be discussed
- A custom night guard to protect the teeth
- Identifying and addressing contributing stress or sleep factors
- Adjusting the bite where a specific interference is found
- Rebuilding worn teeth once the habit is controlled
- Assessment for sleep-disordered breathing where indicated
How grinding is assessed
The wear pattern tells a dentist a great deal before you say anything.
- Examining teeth for flattening, chipping and shine on the wear facets
- Checking the jaw muscles and joint
- Assessing how the teeth meet
- Discussing sleep, stress and medications
- Considering whether sleep-disordered breathing may be involved
- A custom night guard where protection is needed
How common grinding is, and what the evidence on splints shows
Published estimates of bruxism vary widely with how it is measured. One review put awake bruxism at roughly 24 percent of adults and sleep bruxism at about 16 percent. Self-report and sleep-lab studies do not agree, which is why a dentist looks for wear on the teeth and not only for the patient's account.
The evidence on night guards is less tidy than the marketing. A systematic review of 14 randomised trials found insufficient evidence that a splint beats no treatment for the grinding itself, while a later review of 15 studies concluded that splints are a viable treatment for sleep bruxism, with adjustable designs doing best. What a guard reliably does is protect enamel and crowns from the wear.
Stock and boil-and-bite guards commonly last a few months to a year. Custom guards last two to five years with cleaning. The NHS also lists stress, poor sleep, smoking, alcohol and caffeine as common triggers worth changing alongside any guard.
Common questions
Teeth Grinding and Clenching: questions people ask
How do I know if I grind at night?
Most people do not until a dentist points out the wear, or a partner hears it. Morning jaw ache and headaches are common clues.
Can grinding damage be repaired?
Worn teeth can be rebuilt, but doing so before the habit is controlled tends to mean the new work breaks too. Protection usually comes before reconstruction.
Is it caused by stress?
Stress is one recognized contributor among several, including sleep factors and medications. It is rarely a single cause, which is why the assessment covers more than stress.
Will a guard fix my headaches?
It may help if the headaches come from clenching, but it is not a guaranteed outcome and headaches have many causes. It is worth discussing with a physician as well.
What are the signs of grinding and clenching?
Waking with a tight or aching jaw. Morning headaches around the temples. Teeth looking flattened, shortened or chipped. Increasing sensitivity with no decay found. A partner reporting grinding noises at night. Restorations that keep breaking. Most people who grind have no idea, because it happens asleep.
What may be done about grinding?
A custom night guard to protect the teeth. Identifying and addressing contributing stress or sleep factors. Adjusting the bite where a specific interference is found. Rebuilding worn teeth once the habit is controlled. Assessment for sleep-disordered breathing where indicated.