The Teeth-Grinding Problem You Might Be Sleeping Through

You may not realise you are doing it, but a sore jaw, tight neck, dull headache, tooth sensitivity, or small indentations along the edge of your tongue can all be clues.

You could be grinding your teeth or clenching your jaw, often while asleep. You may also do it during the day without noticing, especially when stressed, focused, or tense.

The medical term is bruxism. It is common, and it can be easy to miss until symptoms start showing up. But if it continues, it can damage teeth and contribute to other problems.

“At rest, most people maintain a small gap between their upper and lower teeth. Teeth are not meant to be forcefully in contact with each other unless you’re eating or swallowing,” says Sercan Akyalcin, D.D.S., head of orthodontics.

That is exactly what happens with bruxism. Teeth grinding involves moving the jaw back and forth, or side to side. Clenching involves pressing the upper and lower teeth together tightly.

Over time, these habits can wear down tooth enamel, cause cracks or fractures and trigger tooth sensitivity, which may indirectly increase the risk of decay. Bruxism may also contribute to temporomandibular disorders, or TMDs, in some people. These conditions affect the jaw joint, muscles and surrounding areas, and can cause pain, clicking, stiffness, or trouble opening the mouth comfortably.

Experts still do not know the exact cause of bruxism, but stress and anxiety are common triggers. Certain medicines, including amphetamines and some antidepressants, can also have bruxism as a possible side effect.

Alcohol before bed may play a role too, as it can disrupt normal sleep cycles and affect muscle activity during sleep. Research also suggests a link between sleep disorders, such as obstructive sleep apnoea, and teeth grinding.

Most people with bruxism do not know they have it until symptoms appear, or a dentist notices worn teeth, cracked fillings, or damaged crowns.

“Other early indicators are a scalloped tongue with teeth indentations, or raised lines from biting on the insides of cheeks,” says Nojan Bakhtiari, D.D.S., a TMJ and orofacial pain specialist.

If any of this sounds familiar, do not ignore it. Bruxism can be managed, but the right approach depends on whether you are clenching during the day, grinding at night, dealing with stress, having sleep issues, or protecting teeth that are already showing signs of wear.

Below, experts share the steps that may help ease tension and protect your teeth.

Here's how to manage bruxism

Bruxism can happen during the day, overnight, or both. The best strategy depends on when it shows up.

If you clench during the day

Start by noticing when it happens.

“Becoming aware of this behavior is the first step toward alleviating it,” says Akyalcin.

Many people clench when they are concentrating, driving, working at a computer, stressed, or rushing through the day. If you notice a pattern, use a visual cue. Put a sticky note on your laptop, phone, steering wheel, or desk that reminds you to relax your jaw.

A simple reset can help: lips together, teeth apart, tongue resting gently on the roof of the mouth. Your teeth should not be touching unless you are eating or swallowing.

It also helps to keep a stress-release tool within reach. Bakhtiari suggests taking a quick walking break, squeezing a stress ball, or using a fidget tool to redirect tension. Cutting back on caffeine may also help some people, as the stimulant effect may make clenching more likely.

If you grind or clench at night

Night-time bruxism can be harder to control because you are not conscious when it happens. Start with sleep hygiene, since disrupted sleep may make grinding and clenching more likely.

Build a wind-down routine before bed. Keep the bedroom quiet, cool and dark. Try to go to bed and wake up at roughly the same time each day. Avoid alcohol close to bedtime, and give your jaw a break from chewing gum, hard foods, or late-night snacking if your jaw already feels tight.

If you have a strong sleep routine but still wake with jaw pain, headaches, or tooth sensitivity, speak with your dentist or GP. They may check for tooth wear, jaw tenderness, bite issues, medication side effects, or signs of sleep apnoea.

In some cases, your doctor or dentist may discuss whether a short-term muscle relaxant before bed is appropriate. This may help reduce muscle activity, including in the jaw, but it is not something to start without medical advice.

If you cannot stop clenching

For daytime bruxism, practise keeping your lips together and your teeth apart. This helps keep the jaw in a more relaxed resting position.

If you cannot open your mouth wide because of pain or stiffness, or if your jaw clicks, locks, or feels stuck, ask your GP, dentist, or physiotherapist about jaw exercises that may help loosen the muscles safely.

For ongoing day or night bruxism, a dentist may also recommend a custom mouthguard or splint to protect your teeth while you sleep. This will not always stop the grinding, but it can reduce tooth damage.

If other strategies do not help, your doctor may discuss injections into the masseter muscles at the jaw.

“This can decrease clenching for up to four months,” says Bakhtiari.

This option is not for everyone. It may reduce jaw muscle activity, but repeated treatment can weaken jaw muscles and joints over time. Ask about risks, benefits and whether it suits the cause of your bruxism before going ahead.

The main point: do not wait until a tooth cracks or your jaw pain becomes daily. Bruxism is common, but it is easier to manage when you catch it early.

Should you get a mouth guard?

If you grind or clench your teeth while you sleep, a mouthguard can be one of the best ways to protect your teeth from damage.

But experts recommend avoiding over-the-counter options where possible. They may be cheaper, but they can fit poorly and create other problems.

Bakhtiari says over-the-counter guards can “move your teeth and mess up your bite and could ultimately cause issues such as jaw locking.”

A custom mouthguard is usually the better option. These are made from durable plastic or acrylic and moulded to fit your teeth properly.

A few things to know:

• Custom guards can be expensive. Dentist-made options may cost several hundred dollars or more, although some private health insurance extras may cover part of the cost.
• A mouthguard that fits over the upper teeth usually will not stop grinding altogether. Instead, it acts as a protective barrier to help reduce tooth wear, damage and discomfort.
• It can also create slight separation between the jaw and socket, which helps prevent a full biting movement, Bakhtiari says.
• With proper care, a custom mouthguard may last around two to five years, depending on the material, your grinding pattern and how well you maintain it.

Clean your mouthguard gently after each use with a soft toothbrush, mild unscented soap and cool water. Avoid abrasive toothpastes, which may damage the surface. Let it dry before storing it in its protective case.

If your mouthguard starts to feel loose, cracks, smells, changes shape, or your jaw pain worsens, book a dental review. Bruxism can change over time, and your guard may need adjusting or replacing.