Bruxism is clenching and grinding of the teeth that happens involuntarily. In sleep bruxism, this forceful grinding happens while a person is asleep. Sleep bruxism is most common in children, adolescents, and young adults but can affect people of any age.
During sleep, people generally aren’t aware of their teeth grinding and can apply substantial pressure — up to 250 pounds of force — that can wear down the teeth, cause jaw and neck pain, induce headaches, and lead to long-term problems with the temporomandibular joint (TMJ).
While there is no cure to completely stop teeth grinding, treatment can reduce its frequency, decrease its impact, and relieve symptoms. In addition, home care tips can make it easier to cope with sleep bruxism.
If you have pain in your mouth, jaw, or neck from grinding your teeth, you should talk with your doctor or dentist. Sleep bruxism can cause serious harm to your oral and sleep health, and a health professional can help prevent more serious problems down the road.
A doctor or dentist can also identify if your teeth grinding occurs alongside other conditions, such as obstructive sleep apnea (OSA) or gastroesophageal reflux disease (GERD), which may require further testing or treatment.
While there are steps you can take at home to help with teeth grinding, it’s important to talk with your dentist or doctor who can recommend the optimal treatment in your specific situation.
Nighttime teeth clenching and grinding can put strain on the mouth and jaw and aggravate muscles in the neck. Decreasing this pain can be an important part of treatment for sleep bruxism.
Several home care tips can help prevent and address irritation of the teeth, jaw, and neck from sleep bruxism:
Several mouth exercises can help reduce pain and improve range of motion in the jaw.
One exercise that has been shown to relax the muscles involved in teeth grinding follows these steps:
Another exercise is designed to help with movement of the jaw:
A few minutes of these exercises several times per day may help relax and stretch the muscles involved in tooth grinding and clenching.
To develop a specific exercise routine, talk with your doctor or dentist. A referral to a physical therapist can provide an opportunity to work hands-on to create a regimen of mouth exercises. This can ensure that you do the exercises properly to avoid injury and get the maximum level of muscle relaxation.
Some patients benefit from head-and-neck massages to relieve muscle tension and pain points related to teeth grinding. A massage therapist or physical therapist may provide massage or demonstrate techniques that can be used at home to relax the jaw and nearby muscles.
Not everyone with sleep bruxism needs treatment, but when there are frequent symptoms of morning headaches and jaw pain, unrefreshing sleep, or risk for long-term damage to teeth, a number of treatment options may be considered.
Mouthguards, sometimes called night guards or dental splints, are worn during sleep to combat teeth grinding. These mouthpieces hold the jaw in a certain position and/or provide a barrier to minimize tooth damage from grinding. Some mouthguards also place the jaw in a slightly open position, allowing the masseter muscles (chewing muscles) to relax all night. Mouth guards may go over the full set of top or bottom teeth or in some cases just cover a smaller section of the patient’s mouth.
Another type of mouthpiece is a mandibular advancement device (MAD), which is best known for its use to reduce chronic snoring and mild obstructive sleep apnea. A MAD is held in place by the teeth and positions the lower jaw forward, helping to keep the airway open and in some cases limiting the extent of teeth grinding. This is typically used when bruxism is present with sleep apnea.
Some mouthguards and MADs are available over-the-counter and can be adjusted to fit your mouth, but many patients get custom mouthpieces that are molded by a dentist.
While they don’t cure sleep bruxism, mouthguards can decrease the impact of bruxism, reduce the wear-and-tear of teeth, reduce morning headaches, and improve sleep quality.
Stress is a common contributor to teeth grinding, so relaxation techniques are a natural approach to help. Employing relaxation methods can be a big part of sleep hygiene, and getting better sleep can empower a person to respond to stress in a healthier way.
In certain refractory and severe cases that persist despite conventional treatment, medications may be considered by a healthcare professional. Medications for bruxism may not be effective, and all have potential side effects. Several types of medications, including botox injections, may be considered when teeth grinding is severe. These medications work by trying to decrease activity in the facial muscles. Discuss the risks and benefits of bruxism treatment options with your healthcare provider prior to starting treatment.
Bed partners are often distracted by the noise of teeth grinding and have a hard time getting the sleep they need. Several steps may help avoid this disruption and sleep better: