Teeth grinding at night: what helps and when to see a dentist

Teeth grinding (bruxism) can happen while you are awake or asleep, the NHS says, and it is often linked to stress or anxiety. As well as grinding and jaw clenching, it can cause a painful jaw, worn-down or broken teeth (and with them sensitivity), headaches, earache and disturbed sleep. You may not know you do it in your sleep — which is why the NHS lists a partner noticing it among the reasons to see a dentist. (NHS — Teeth grinding)

This article is a practical guide; it is not a diagnosis or a treatment.

What is actually happening at night

In 2018 an international group of experts described sleep bruxism as activity of the chewing muscles during sleep — rhythmic or non-rhythmic. In otherwise healthy people they do not consider it a sleep disorder or a movement disorder, but a behaviour that can be a risk (possibly even protective — the evidence is still inconclusive) factor. In some people, however, it can be a sign of another condition, such as obstructive sleep apnoea. (Lobbezoo et al., J Oral Rehabil 2018)

What triggers grinding is not always clear, according to the NHS. It is most often linked to stress and anxiety, and also to snoring and sleep apnoea, some medicines for sleep problems, depression or anxiety, smoking, and drinking lots of alcohol or caffeine. (NHS — Teeth grinding) Never stop a medicine on your own — talk to your doctor.

What you can try yourself

1. Find what relaxes you: breathing exercises, music, regular exercise. (NHS — Teeth grinding)
2. Regular sleep: go to bed at the same time, wind down before bed, and keep your bedroom dark and quiet. (NHS — Teeth grinding)
3. Less alcohol and caffeine, and don't smoke. (NHS — Teeth grinding)
4. When your jaw hurts: hold an ice pack (or a bag of frozen peas) wrapped in a tea towel against it; common painkillers, used as the leaflet says, may also help. (NHS — Teeth grinding)
5. Go easy on your jaw during the day: when it hurts, avoid chewing gum and hard foods (NHS — Teeth grinding) and don't clench — apart from when you eat, your teeth should be apart. (NHS — Temporomandibular disorder)

A mouth guard from the dentist

• Treatment is not always needed, the NHS says. A dentist may recommend a mouth guard or splint worn at night to protect your teeth from damage; it is made to fit your upper or lower teeth. (NHS — Teeth grinding)
• The US NIDCR notes that such devices protect the teeth, but there is not a lot of evidence that they improve pain from jaw-joint disorders. A splint should not permanently change your bite; if it causes pain, stop using it and talk to your dentist. (NIDCR — TMD)
• Treatments that permanently change the bite (grinding down teeth, crowns, orthodontics) do not have enough evidence for jaw-joint disorders, according to the NIDCR, and sometimes make things worse. (NIDCR — TMD)

When to see a dentist or doctor

• See a dentist if you have damaged or sensitive teeth, pain in your jaw, face or ear, your partner has noticed you grinding in your sleep, or you are worried about a child grinding their teeth. (NHS — Teeth grinding)
• See a GP if you need help with the causes — stress, anxiety, smoking, alcohol or drugs. (NHS — Teeth grinding)
• If you snore loudly in your sleep, your breathing stops or you gasp for breath, or you always feel very tired during the day, tell a doctor — it could be sleep apnoea. (NHS — Sleep apnoea)
• Get an urgent GP appointment or contact NHS 111 the same day if you cannot eat or drink, your jaw locks or will not open, you have frequent severe headaches, pain or tenderness at the side of your head or on your scalp, or problems with your vision. (NHS — Temporomandibular disorder)
• An AI health check is not a medical review. This article is not medical advice.

Takeaways

1. In otherwise healthy people, experts do not consider grinding in sleep a disease — but it can damage teeth and cause pain.
2. It is most often linked to stress and anxiety; snoring, sleep apnoea, alcohol, caffeine, smoking and some medicines can play a part.
3. Calmer evenings, regular sleep, less alcohol and caffeine, and not clenching during the day all help.
4. A dentist's mouth guard protects your teeth; it should not change your bite.
5. Damaged teeth or pain → dentist; snoring with pauses in breathing → doctor; jaw locking or unable to eat → see a doctor the same day.

Grinding may not disappear completely, but your teeth and your sleep can be protected.