Teeth Grinding Explained

Signs You Might Be Grinding

The clinical term is bruxism, and a dentist or a partner often picks it up well before the person who's doing it. Signs include:

• A jaw that feels tight, tired or sore on waking, or pain just in front of the ears
• Headaches around the temples in the morning that fade through the day
• Front teeth that have become shorter, flatter or more level, or have small chips along their edges
• Several teeth sensitive to cold because the enamel has thinned
• Fillings, crowns or composite bonding that break or loosen more often than they should
• A wavy edge along the sides of the tongue, or a pale line along the inside of the cheek
• Clicking, stiffness or trouble opening wide first thing
• A partner mentioning that they hear you grinding in your sleep

Clenching is completely silent, which is why it so often goes unnoticed. At every dental examination we look for patterns of wear on the teeth, and we'll let you know if we spot any.

What Sets It Off

It rarely comes down to one thing. Stress and anxiety are the main culprits, and grinding often gets worse during a difficult period at work or at home. Other things that can add to it:

• Caffeine in the afternoon or evening, alcohol and smoking
• Broken or poor-quality sleep, snoring and sleep apnoea
• Certain medicines, including some antidepressants
• Daytime clenching during intense concentration, driving or weight training
• An uneven bite, or a new filling sitting slightly high

During sleep the jaw muscles can bite down far harder than you ever would when eating, and keep it up for much longer. That explains how a few hours of grinding at night can do damage out of all proportion to anything you feel.

What Grinding Does to Teeth

Lost enamel never grows back. Over the years, grinding wears down the biting edges until the darker, softer dentine shows through, and that then wears away even faster. Clenching focuses force onto small points, which is how cusps break off, fillings fracture and crowns come loose. A cracked tooth may need an onlay, a crown or root canal treatment, and if the crack runs down into the root, the tooth sometimes can't be saved.

The jaw suffers as well. Overworked muscles lead to aching cheeks and tension headaches, and the jaw joint may become sore, click or now and then lock. If jaw pain is your main problem, our jaw pain page explains how we can help. The damage builds slowly, which is precisely why protecting your teeth early, before the repair bills mount up, makes sense.

What a Night Guard Does

A custom night guard is a slim, snug cover of tough plastic that fits over your upper or lower teeth while you sleep. It won't stop you grinding. Instead it sits between your teeth so the guard takes the wear rather than your enamel, and it spreads the load across every tooth instead of one or two cusps. Once they've got used to it, many people notice their jaw feels less tense in the morning.

We make each guard from a digital scan taken with our iTero scanner, so it fits precisely and you don't need a mouthful of impression putty. A custom night guard costs £210, or £189 for dental plan members. ¹ For heavy grinders, or anyone with jaw joint problems, a hard occlusal splint, from £620, can be the better choice, and we'll tell you which we'd recommend. Our night guards page has more on the choices.

Getting a Night Guard Made

1. Assessment. During your dental examination we check the wear on your teeth, feel the jaw muscles and joint and see how your teeth meet. If a filling is high or a contact is uneven, we can often adjust it at the same visit
2. Scan. Our iTero scanner records both arches in 3D in a few minutes
3. Fitting. Once the guard is back from the laboratory, we try it in, make sure it's secure but comfortable, and fine-tune it so your bite meets it evenly

Expect it to feel strange for the first few nights, and you might make extra saliva to begin with. Within a week or two, most people stop noticing it. Each morning, rinse it under cold water and brush it lightly, store it in its case away from radiators and hot water, and bring it with you whenever you come for a dental examination, so we can look at the wear marks. If you've finished Invisalign and wear retainers at night, tell us if you grind. Retainers aren't built to withstand that force, and a separate guard may be needed.

Everyday Habits That Help

• Lips closed, teeth apart. When your jaw is at rest, your teeth shouldn't be touching. If you notice yourself clenching in the day, let your jaw hang loose and rest the tip of your tongue on the roof of your mouth
• Drop caffeine in the evening, and avoid alcohol and smoking close to bedtime
• Look after your sleep: keep a regular bedtime, put screens away half an hour before, and keep the bedroom cool and dark
• Use heat and gentle stretches: a warm flannel held on tight jaw muscles and slow opening stretches ease soreness
• Rest the jaw: avoid chewing gum and very chewy foods while it aches
• Deal with stress where possible, through exercise, talking things over or a breathing exercise you can use when you feel tension building

If you snore loudly or wake feeling unrested, raise it with your GP too. Grinding and breathing problems during sleep are often linked.

Grinding and Cosmetic Dental Work

Grinding is hard on porcelain veneers, crowns, implant crowns and composite bonding alike. Thin composite edges can chip. Porcelain is very hard, yet it can fracture under constant loading. Implants are anchored straight into bone without the ligament that lets a natural tooth cushion pressure, so the crowns and screws absorb every bit of the force. Grinding is among the commonest reasons cosmetic work fails sooner than it should.

For that reason we look for wear before any cosmetic treatment begins, and the dentist planning your treatment may advise a night guard once your bonding, veneers or implants are complete. Where the wear is heavy, we'll be clear that the guard is essential. You'll find more in our guides to caring for bonding and how long implants last.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.