I think I’m grinding or clenching my teeth. Why? And can anything help?

Day or night, many of us grind or clench our teeth, and don’t even realise we’re doing it. Here are three questions to ask yourself.

At least once a week, do you:

• feel sore in your temple, face, jaw or near your ear?

• have pain when you open your mouth or chew?

• feel your jaw lock, click or become stuck?

If you answered “yes” at least once, you may be grinding or clenching your teeth (known as bruxism).

So why do we do it? And is there any way to stop? Let’s take a look.

What happens when you clench or grind?

Clenching or grinding your teeth is involuntary. We unconsciously activate our chewing muscles, tightening or thrusting the bottom jaw and clenching the teeth together or grinding them against one another.

Nearly one in six of us do this while sleeping, and one in four while awake.

Grinding your teeth while asleep makes a distinct noise. (If you share a bed, your partner might be able to tell you about it!)

Is it bad for you?

Mild, occasional grinding or clenching isn’t usually a problem.

But if you do it often or very forcefully, this habit can cause many tooth, jaw joint and muscle issues, interrupt sleep, and contribute to tension headaches or ear pain.

These issues can become painful and be expensive to manage.

Over time, it can also fracture and crack your teeth.

Read more: What happens to teeth as you age? And how can you extend the life of your smile?

Why do I clench or grind my teeth?

There is usually a mix of physical, mental and lifestyle factors.

You are more likely to clench and grind if you:

There is also a strong link with sleep apnoea, a condition which stops you breathing regularly while asleep and deprives your brain and body of oxygen.

Low oxygen triggers the release of stress hormones. These increase your heart rate and activate full body muscle spasms, which can also increase grinding and clenching.

Can my dentist tell from looking at my teeth?

Your dentist will usually review any health issues and medications. They may ask if you experience jaw pain, headaches, difficulty chewing or jaw locking. They may also ask about your sleep experience.

In your mouth, your dentist will look for teeth or fillings that have been chipped or worn down.

Teeth that are unusually worn down can also be a sign of acid reflux. This causes stomach acid to seep into the mouth, which softens the hard enamel that protects your tooth.

As a result, people who clench and grind their teeth and also suffer from reflux tend to chip and wear down their teeth a lot faster.

Another common sign is white ridges inside your cheeks and scallop-shaped indentations around your tongue. These are formed when the cheeks and tongue get caught against the teeth when you clench or grind them.

Other signs your dentist will look for include:

What can I do about it?

Clenching and grinding your teeth is highly manageable. Your health practitioner can help you identify the causes and manage symptoms.

Your doctor can review your medications and investigate potential underlying issues, such as reflux, arthritis in the jaw or sleep apnoea.

You can also ask your doctor to assess you for sleep apnoea to see if you need a polysomnograph test.

This test is the gold standard used to diagnose sleep disorders, including clenching and grinding your teeth.

To check if the test is required, your doctor will ask questions about your sleep experience, fatigue levels and whether you fall asleep while doing everyday activities.

A physiotherapist who specialises in jaw pain can help with joint locking, clicking or tension headaches with a combination of tailored exercises and stretching.

Pain-relieving medication can also help.

Your dentist may recommend a night guard or occlusal splint to protect your teeth from wear, reduce muscle tension and jaw clicking. These are acrylic or nylon appliances custom-made to fit over the teeth in your top jaw – like a sports mouth guard, but smaller.

When these options don’t relieve symptoms, some people may consider botox injections to block the signals that control specific jaw muscle movement, reducing clenching and associated pain.

However, botox is expensive and not effective for everyone. It is also short-acting, so will require frequent visits to a neurologist or specially trained dentist.

The bottom line

If you think you’re clenching and grinding your teeth, speaking to your doctor or dentist is the best place to start.

But remember, physiotherapy, night guards and painkillers treat the consequences of clenching and grinding, not its causes.

So it’s also worth thinking about ways to reduce your stress and develop good sleep habits.

Some simple adjustments to relax and unwind – such as drinking less caffeine and alcohol and keeping devices out of the bedroom at night – may improve your health and help avoid pain and expensive treatments.