Have you been told you make repetitive grinding sounds with your teeth when you sleep? Perhaps you’ve noticed some damage or wearing to one or more of your teeth? If so, it could be that you suffer from bruxism.
Bruxism is the habit of either grinding your teeth or clenching your jaw. It’s not the same as normal teeth grinding though, such as when eating. It happens involuntarily and automatically.
Around 10% of people are thought to suffer from bruxism, both adults and children. There are two kinds – awake bruxism (usually more jaw clenching than grinding), and sleep bruxism. I’ll be talking mainly about the sleep kind though in this article.
Symptoms & consequences of Bruxism
Grinding teeth persistently at night can cause various problems. Some of these will stop if you get the grinding under control, but others are more permanent. Here are the main symptoms and consequences you might experience:
- Worn teeth, shortened teeth, tooth fractures, increased sensitivity, tooth loosening or loss.
- Ear ache.
- Jaw ache.
- Disruption of both you and your partner’s sleep.
- Pain in the muscles of the face.
- Gum problems, such as receding and inflammation.
- Problems with the Temporomandibular joint (TMJ).
- Shoulder stiffness or tightness.
- Problems opening the mouth.
As with many sleep disorders, the exact cause of bruxism is still debated. There seem to be various possible explanations, and it could be that a combination of more than one is responsible.
Let’s take a look at the main theories:
1. Stress or anxiety
While I was trying to find out what might be causing my teeth grinding, stress came up a lot as a possibility. This made sense to me, as I had a very stressful job at the time I first realized I was doing it every night.
However, there are some who don’t view stress as a significant factor. For example an Italian review of 45 research studies found that stress is a major factor in daytime bruxism, but not in sleep bruxism.
Interestingly though, stress and anxiety are seen as common causes of a similar problem, teeth chattering.
2. Other sleep disorders
Both the Bruxism Association and the NHS say that you’re more likely to grind your teeth if you have a sleep disorder, such as the following:
- Obstructive Sleep Apnea.
- Moving about violently in your sleep.
- Sleep talking.
- Sleep paralysis.
- Sleep hallucinations.
Estimates are that between 21% and 50% of people who have bruxism also have an immediate family member who have it.
4. Medication and drugs
Some medicines and recreational drugs are thought to contribute to bruxism. For example cocaine, amphetamines such as ecstasy and some SSRI anti-depressants. It’s also thought that too much caffeine or alcohol could contribute to it.
How to stop teeth grinding
The first step is to speak to your dentist or your primary care doctor. They can check for signs of damage to your teeth, look into the possible cause and recommend further treatment.
There are various possible treatment options, though it does depend on the possible causes. Some of these won’t cure it, but can help with either with the consequences or severity.
1. Check for breathing disorders
If you have Obstructive Sleep Apnea, it’s a potentially serious, but manageable sleep disorder. Researchers in 2002 found that many people stop grinding their teeth when using a Continuous Positive Airway Pressure (CPAP) machine.
If you or your partner ever notice any breathing irregularities in your sleep, such as stopping breathing for brief moments, or regular snoring, it’s a good idea to talk to your doctor about it.
Your doctor might recommend further assessments of your breathing and sleep, possible including a sleep study.
2. Dentist check-up
Because bruxism can cause tooth damage, it’s a good idea to go for regular dental check ups if you suffer from it. There’s also the possibility of doing reconstruction work to fix any damage already caused.
3. Wearing a mouth guard
This was the treatment which I resisted, mainly because I remembered how uncomfortable they were playing sport as a kid. The idea is that you protect your teeth at night with a rubber or plastic protective shield.
You can buy mouth guard kits to make a mold yourself, or pay more for your dentist to make one that fits well. A mouth splint is similar, but harder and again costs more.
Night guards might help reduce the damage, but probably won’t stop the actual grinding. So in that way you’re only really treating the symptom and not the cause.
4. MADs (Mandibular Advancement Devices)
These kinds of devices are normally used for treating apnea or sometimes severe snoring. But research has shown they can also work as a bruxism treatment. The problem is though that these devices can also be uncomfortable and so people might not continue using them.
5. Psychological help and hypnotherapy
If your teeth grinding is caused by stress or other psychological issues, there are many effective talking therapies available, such as Cognitive Behavioral Therapy (CBT).
Some research has also shown good results with hypnotherapy, both with a therapist and self-hypnosis. If you do an online search for ‘hypnosis for bruxism’ you’ll find a huge amount of people offering their services, and even self-hypnosis recordings.
Whether it works or not I imagine will depend on both your susceptibility to hypnosis and what’s actually causing your bruxism.
6. Self-help and relaxation techniques
As with so many sleep problems, treatment often ends up coming back to taking action yourself to deal with problems like stress or anxiety. Even though I quoted earlier the research which suggests stress isn’t a major factor, my personal opinion is that it still could well be.
I know that when I left my stressful job, within weeks I wasn’t grinding my teeth in my sleep nearly as much. It could be coincidence, but I do believe it was related.
So dealing with stress in the long term, and also doing relaxation exercises before bed, might help. Have a read of the section on relaxation techniques for sleep for some ideas.
I’d like to know what you think about the stress debate. Do you think factors like stress, anxiety or worry can lead to bruxism? Or do you think it’s something else?
And what’s your experience with trying to stop grinding your teeth in your sleep? Feel free to leave your thoughts and ideas below.