What's the Fix for Teeth Grinding?
More and more people are clenching and grinding their teeth. Here’s what to do about it
illustration by Kate Traynor
When my dentist suggested I get fitted for a night guard (a plastic dental appliance), I wasn’t exactly surprised. I had been waking up with headaches and jaw pain, symptoms of teeth clenching and grinding—a condition officially known as bruxism. I knew I was holding a lot of tension in my jaw, but I just popped an ibuprofen in the morning and moved on. But when my dentist noted that I had some gum recession—due to inflammation caused by grinding and clenching—I realized how much damage the habit was causing.
Bruxism is common, especially sleep bruxism, which affects an estimated 16.5 per cent of adults. Experts have seen a surge in patients with tooth and gum damage from clenching and grinding in recent years, particularly during the stressful days of Covid-19 lockdowns.
“When you’re really stressed, you might be putting a lot of tension in your masseter muscles, which are the muscles in the cheek responsible for chewing,” explains Dr Pujaa Patel, a UK-based dentist, facial aesthetics expert and chief medical officer of UNNDOO, a platform for booking at-home facial aesthetic treatments. “Because everything in the head and neck is linked, patients come in with tension headaches, jaw pain, earache and shoulder pain.” Related factors such as smoking or chewing tobacco, excessive caffeine consumption, workplace stress, and improper brushing and flossing practices exacerbate the damage.
Whether bruxism occurs while awake or during sleep, most people don’t realize they’re clenching and grinding until they start experiencing symptoms. Either way, it’s important to see an expert to identify the cause.
While the most common factor is stress, especially if the patient is doing it while awake, bruxism could also be a symptom of an underlying medical condition or a sleep disorder, says Dr Mirissa Price, a paediatric dentist and spokesperson for the American Dental Association. In these cases, bruxism can often be resolved by treating the underlying cause.
The movement the jaw makes while clenching and grinding is similar to chewing, but the force is up to 10 times greater. That amounts to about 17 kilograms of pressure per square centimetre. Over time, it leads to cracked teeth or worn-down molars. Consistent grinding also weakens the ligament that holds the tooth in place, which can lead to tooth loss, says Price.
For stress-related bruxism, Patel recommends relaxation techniques, such as meditation or yoga. “Some patients have success with cognitive behavioural therapies to manage their stress and change the behaviour,” says Price. For daytime bruxism, Price suggests chewing gum during stressful situations, which can offset the desire to grind, or snapping a rubber band bracelet as a reminder to relax the jaw.
If you grind while asleep, your dentist can fit you for a night guard. “The guard takes the pressure instead of your teeth,” explains Patel. Because it prevents your jaw from fully clamping down, it reduces the activity of the masseter muscle, helping it relax.
Guards can be expensive, especially if not covered by health insurance, but Price cautions against opting for a cheaper, over-the-counter product. “If you get a mouth guard that doesn’t fit properly, you can actually worsen the problem,” she says.
Another treatment involves injecting botulinum toxin (Botox is one brand) into the masseter muscle on each side of the jaw, temporarily blocking nerve signals and essentially paralyzing the muscle. Patients might bruise at the site of the injection, but it’s safe and simple, and the results can be felt in two to six weeks. The treatment also relieves tension headaches and shoulder and neck pain.
Patients generally have injections every four to six months, and over time, as the muscles begin to relax, the gap between treatments can be extended. It’s a great option for people who experience bruxism almost exclusively while awake, says Price, since a night guard isn’t designed to be worn while talking and eating.
Meanwhile, researchers at UK’s Nottingham Trent University are working on a smart headband that trains the wearer to control the grinding impulse. Worn at night, the device deploys a gentle vibration to relax clenched jaw muscles, while also creating a subconscious awareness of the habit. A prototype is in development.
