Teeth grinding is a subconscious act that involves grinding, gnashing, or clenching your teeth. Also called bruxism, it is a condition that can cause pain in the jaw, headaches and damage to your teeth.

While teeth grinding during the day is more common, teeth grinding at night can cause more harm as it is more likely to remain unnoticed for longer. It is estimated that up to 31% of adults experience teeth grinding, placing more stress on the teeth and jaw.

The Symptoms of Teeth Grinding

Unless spotted by a sleep partner, the signs of teeth grinding at night may only first be noticed by your dentist. Recognizing the symptoms of this condition offers the chance of an earlier diagnosis, reducing the risk of tooth damage from the effects of a longer period of bruxism.

The main symptoms of teeth grinding at night are:

• headaches
• jaw pain
• facial pain in the morning
• pain when eating
• tooth sensitivity
• worn tooth enamel
• cracked or damaged teeth

What Are the Causes?

Teeth grinding at night, also termed nocturnal bruxism, has many risk factors rather than one specific cause.

Risk factors linked to lifestyle and genetic disposition are classed as primary bruxism symptoms. These include:

• stress, anxiety and depression
• family history of teeth grinding
• lifestyle factors including smoking, alcohol and high levels of caffeine consumption
• age, with teeth grinding more common in children and younger adults
• personality traits, with a competitive or more aggressive personality placing you at more risk

Teeth grinding symptoms linked to underlying medical conditions and medications are classed as secondary bruxism symptoms. These include:

• certain medications, including antidepressants like Prozac, anti-anxiety and ADHD medications
• neurological conditions resulting from brain injuries, brain hemorrhage or a stroke
• imbalance in the chemicals in the brain that aid communication between cells

Another common condition linked to teeth grinding is sleep apnea. However, more research is required to establish whether this sleep disorder is a contributing risk factor.

Your healthcare provider will look at your medical history and inquire about your family history if they suspect you are displaying the symptoms of teeth grinding at night. Another method they may use for diagnosing the condition is a sleep study. This would involve an overnight stay where your sleep is monitored for signs of teeth grinding.

What Can Be the Consequences of Teeth Grinding?

While the occasional teeth grinding may not be something to be concerned about, the effects of long-term teeth grinding can be harmful.

A primary issue when teeth grinding is left without treatment is the damage it can do to your teeth. Enamel erosion and cracked or damaged teeth are potential consequences of long-term teeth grinding. Such dental issues can also increase the risk of gum disease and tooth decay.

Jaw pain is a symptom of nocturnal bruxism. The consequence of this can be a temporomandibular joint (TMJ) disorder. The TMJ connects the jaw to the skull and a disorder of this joint can cause further jaw pain, stiffness in the jaw, a popping sound, and even difficulty opening and closing your mouth.

Migraines may also become an issue when teeth grinding remains undiagnosed, as can chronic ear, neck, or shoulder pain.
Teeth Grinding at Night -- Treatment

When you experience teeth grinding and its contributing risk factors determine the treatment your healthcare provider may recommend.

A mouthguard may be recommended for someone who grinds their teeth at night. The mouthguard is custom-made to protect your teeth and gums as you sleep by keeping the upper and lower teeth apart.

A splint is another oral device that is sometimes used. This works by placing the jaw in a more favorable position overnight to help ease the strain on the jaw and the temporomandibular joint.

When lifestyle factors are a cause of teeth grinding, then changes such as quitting smoking or reducing consumption levels of alcohol and caffeine may help. Ensuring your bedroom is quiet, dark and set to a comfortable temperature will also promote better sleep.

Relaxation techniques including meditation, yoga, exercise and reading can also be beneficial. These may provide stress relief if stress and anxiety are factors in your nocturnal bruxism.

Advanced Treatments for Teeth Grinding

Grinding and clenching your teeth can be a hard habit to break, particularly when caused by stress, an underlying health condition or certain personality traits that make you more prone to it.

However, there are more advanced treatments that your healthcare provider may discuss with you to prevent any damaging long-term consequences of bruxism.

1. Medication
An anti-anxiety medication or an anti-depressant may be considered if stress is a factor. A muscle relaxer may also be discussed to help reduce teeth grinding as you sleep. Such medications are prescribed temporarily and are not usually considered a long-term solution.

2. Contingent Electrical Stimulation (CES)
CES uses a pulse of low-level electrical energy that helps relax the muscles in the mouth when a device detects the signs of teeth grinding as you sleep. You are less likely to grind your teeth as frequently when the muscles are relaxed.

3. Hypnosis
Hypnosis is another tool that can be used, and works by transforming your thoughts through the power of suggestion to help reduce and perhaps resolve teeth grinding.

4. Botox
Botox injections offer a temporary relaxation of the jaw muscles. You will need a repeat treatment every few months to continue to benefit from the results.

5. Biofeedback Sessions
Biofeedback helps treat nocturnal bruxism by detecting jaw movement as you sleep and waking you up when you start to grind your teeth. This is achieved using a device that sends you sensations to wake you.

Final thoughts

Teeth grinding at night can go unnoticed and can damage your teeth and result in facial pain. Understanding the factors causing your bruxism will help a healthcare provider recommend the most suitable treatment. This can range from a mouthguard worn overnight to lifestyle changes and more advanced methods such as contingent electrical stimulation.