Teeth grinding and jaw clenching, known together as bruxism, are among the most common things we find at checkups, and among the most commonly missed by the people who have them. Most grinding happens during sleep, and a lot of clenching happens during the day without you noticing. At Shield Dental Care in Burke, VA, we look for the signs, work out what is driving the problem, and protect your teeth and jaw with treatment that fits.

Signs you may be grinding or clenching

  • A sore, tired or tight jaw, especially when you wake up
  • Dull headaches that start at the temples
  • Teeth that look flat, short, chipped or worn
  • Teeth that have become sensitive to hot and cold
  • Cracked teeth, or fillings and crowns that keep breaking
  • A partner who hears you grinding at night
  • Ridges on the inside of the cheeks, or a scalloped edge to the tongue

What causes it

Often it is more than one thing. Stress and anxiety are the best-known triggers. Caffeine, alcohol and smoking can make grinding worse, and so can some medicines, including certain antidepressants. Sleep grinding is also linked with sleep problems. If you snore loudly, stop breathing during sleep, or wake up unrefreshed, mention it, because grinding and sleep apnea can occur together and sleep apnea should be assessed by a physician.

Treatment options

There is no single cure for bruxism, so treatment aims to protect the teeth, reduce the load on the muscles and joints, and deal with anything driving it. For most patients that means a combination of the following.

Custom night guards

A night guard made from impressions of your teeth is the first line of treatment. It does not stop grinding, but it takes the wear instead of your enamel and spreads the forces across the jaw. A custom guard fits better and is more comfortable than a store-bought one, which makes you more likely to wear it every night.

Botox for the jaw muscles

For patients with sore, overworked jaw muscles, or who keep waking sore despite a guard, Botox in the masseter muscles can reduce the force of clenching and grinding. It is an off-label use that we explain before treatment, and it works best alongside a guard, not instead of one.

Daytime habit changes

Daytime clenching responds well to awareness. The resting position of the jaw should be lips together, teeth apart, tongue resting on the roof of the mouth. Short reminders through the day, less caffeine late in the day, and managing stress can make a real difference.

TMJ care

If the jaw joint itself clicks, locks or hurts, we assess it separately. TMJ disorders overlap with bruxism but are not the same thing, and treatment is tailored to which part is involved.

Repairing the damage

Worn, chipped or cracked teeth can be rebuilt with bonding, crowns or other restorations. We plan this once the grinding is under control, so the new work is protected.

What happens at your visit

We examine your teeth for wear patterns and cracks, check your bite, and feel the jaw muscles and joints. Then we talk about your symptoms, sleep, stress and daytime habits. From there we will recommend a plan. For most people that starts with a custom night guard, and it can include Botox, TMJ treatment or restorative work where it will help.

Read more

If you want background first: Do you grind your teeth? explains the signs in more detail, TMJ disorder: why your jaw hurts covers the joint, and our TMJ and teeth grinding guide gathers everything we have written on the subject.

More on specific questions: daytime jaw clenching, teeth grinding and sleep apnea, teeth grinding in children, cracked tooth syndrome and Botox or a night guard?

FAQ

Frequently Asked Questions

Can teeth grinding be cured?+

Not usually cured, but it can be managed well. A custom night guard protects your teeth, habit changes reduce daytime clenching, and Botox can reduce the force of the jaw muscles in the right patients.

Is a store-bought guard good enough?+

It is better than nothing for a short time, but boil-and-bite guards fit loosely, can be bulky, and wear through faster. A custom guard fits your bite exactly and is more comfortable to wear every night.

Can grinding cause headaches?+

Yes. Overworked jaw muscles, particularly the temporalis at the side of the head, can cause tension-type headaches at the temples, often worst in the morning.

Should I be worried about sleep apnea?+

Grinding can occur alongside sleep-disordered breathing. If you snore loudly, have been told you stop breathing in your sleep, or feel exhausted during the day, tell us and talk to your physician about a sleep evaluation.