Teeth Grinding (Bruxism): Causes, Symptoms, and How to Protect Your Teeth

What is bruxism?

Bruxism is the term for clenching or grinding your teeth. The most recent international consensus describes it as activity of the chewing muscles and separates two forms: sleep bruxism, which happens while you sleep, and awake bruxism, which happens during the day as repeated or sustained tooth contact or as bracing or thrusting of the jaw (Updating the Bruxism Definitions, J Oral Rehabil 2025).

The same consensus makes the point that bruxism is a motor behavior, not a disease in itself. It may cause no trouble at all, but when it is frequent or intense it can damage teeth and restorations and cause muscle pain.

Dentists see it often. In a 2021 survey by the ADA Health Policy Institute, more than 70% of dentists said they had noticed signs of grinding and clenching in their patients, and more than 60% had noticed temporomandibular joint problems (Teeth Grinding, ADA MouthHealthy). That figure describes what dentists observed, not the share of people who have bruxism.

Signs and symptoms

Many people have no idea they grind until a partner hears it or their dentist spots the wear. The ADA lists these signs:

• Chipped or cracked teeth, or worn spots along the edges.
• Pain or tenderness in the jaw.
• Dull headaches.
• Plugged, painful or itchy ears.
• Neck pain.

Over time, the wear can also lead to tooth sensitivity and affect restorations such as fillings, crowns or veneers.

What causes it?

There is no single cause. For years the bite was blamed, but a review published in JADA in 2024 concludes that the literature no longer supports dental occlusion as a cause of sleep bruxism. The weight of evidence points to central factors instead: the autonomic nervous system, genetics and other health conditions (Sleep bruxism: the past, the present, and the future, JADA 2024).

Associated factors mentioned by the ADA include:

• Stress and anxiety. This is the best-known link.
• Sleep disorders. If you also snore, wake up tired or someone notices pauses in your breathing, tell your doctor. A sleep study can show what is happening at night.
• Tobacco, alcohol and coffee. According to the ADA, one study found that people who smoke or drink alcohol or coffee are twice as likely to grind their teeth.

In children, grinding is not usually caused by stress; it may be linked to irritation inside the mouth or to allergies that make breathing harder.

How it is managed

No treatment makes it go away for good. The aim is to protect your teeth and reduce whatever makes it worse.

A custom night guard

This is the most common measure for sleep bruxism. A night guard, also called an occlusal splint, is a rigid appliance that fits over your upper or lower teeth and takes the wear instead of your enamel. The ADA notes that a guard made from a mold of your teeth fits more closely and comfortably, and that guards sold online or in stores may not protect as well. It helps to be clear about what it does: a guard protects your teeth, but it does not stop you from clenching.

If you have veneers, crowns or implants

Grinding can wear, chip or fracture restorations. If you have veneers or dental implants, or are considering them, tell your dentist. A clinical assessment can check for signs of bruxism and whether a guard would help protect them.

Stress and daily habits

• Notice what you do during the day. Many people clench without realizing it at the computer or while driving. The resting position is lips together, teeth apart.
• Relaxation. The ADA mentions meditation, counseling, exercise, massage and deep breathing as ways to manage stress.
• Tobacco, alcohol and caffeine. Cutting back, especially in the afternoon and evening, helps you sleep better.

When jaw pain persists or a sleep disorder is suspected, care may involve your physician, a sleep specialist or a physical therapist.

Frequently asked questions

Can bruxism be cured? There is no single cure, because the factors behind it vary from person to person. What can be done is to protect your teeth, reduce what aggravates it and keep an eye on wear at your checkups.

Is it dangerous? Occasional clenching usually causes no problems. When it is frequent, it can wear down or fracture teeth and restorations and cause pain in the jaw, head or neck.

Does a drugstore night guard work? It can help as a stopgap, but the ADA cautions that guards sold online or in stores may not protect as well as a custom one.

What should I do if I think I grind? Bring it up at your next visit. Your dentist will look at the wear, the muscles and the joint, and that determines what makes sense for you.

Next steps

You can read more in the sources consulted: Teeth Grinding, ADA MouthHealthy, Sleep bruxism: the past, the present, and the future, JADA 2024 and Updating the Bruxism Definitions, J Oral Rehabil 2025.

If you wake up with a tired jaw, sore teeth or notice wear, you can schedule an individualized assessment. Together we can review your case and decide how best to protect your teeth.