People grind their teeth because of various underlying causes. Teeth grinding (bruxism) is a very common medical condition that may point to more serious problems.
Symptoms of bruxism include:
- Worn tooth enamel
- Tooth damage, in severe cases
- Tooth sensitivity
- Broken teeth
- Damage to dental restorations
- Facial pain
- Jaw pain and soreness
- Sore jaw joint (temporomandibular joint or TMJ), which can lead to
TMJ disorder (TMD)
The cause of bruxism depends on many factors, including whether you grind your teeth during the day or at night. The 2 types of teeth grinding are:
- Daytime grinding (awake bruxism) — Awake bruxism is usually stress-related. Jaw clenching is common in people who experience daily stress and anxiety.
- Nighttime grinding (sleep bruxism) — Sleep bruxism is often airway health-related. It is frequently caused by sleep apnea or another sleep disorder. Your brain initiates teeth grinding to wake you up and restart halted breathing.
Why do people grind their teeth?
The most common cause of awake teeth grinding is stress and anxiety. The most common cause of sleep teeth grinding is a sleep disorder like obstructive sleep apnea.
Researchers estimate 12-31% of adults grind their teeth at night, most of whom are undiagnosed. As many as 50% of children may suffer from teeth grinding. This is a treatable epidemic that we don’t have to be content just to live with.
Keep reading to learn about the 10 most common causes of bruxism, including in children.
1. Sleep Apnea
Many experts agree that the most common underlying causes of nighttime teeth grinding are sleep apnea and sleep-disordered breathing.
If you grind your teeth at night, it’s likely your brain signaling you to grind your teeth so you wake up just long enough to start breathing again.
Sleep apnea may be caused by poor airway health — when your tongue is too big for your oral cavity, obstructing the upper airway and resulting in halted breathing during sleep.
A number of grinders find success with the DNA oral appliance. By safely and painlessly increasing the space behind their teeth, the DNA (Daytime-Nighttime Appliance) expands the palate and allows space for the tongue in the oral cavity. This means the tongue won’t obstruct the airway, which causes grinding.
What does grinding your teeth in your sleep mean?
Grinding your teeth in your sleep may mean you suffer from sleep apnea, crooked teeth, or chronic stress.
How can you stop grinding your teeth in your sleep?
You can stop grinding your teeth in your sleep with effective, evidence-based treatment options, such as the DNA oral appliance, night guards, and mouthguards. I recommend the DNA oral appliance, as it is the only way to correct the root cause of grinding related to sleep apnea.
2. Chronic Stress
The most common cause of awake bruxism is chronic stress.
Chronic means constant, daily, or persistent. Chronic stress that can cause teeth grinding refers to daily stressors weighing down on you. Stress can come from work, school, home, etc.
Stress is known to cause people to clench their jaw muscles and grind their teeth. It is also linked to a mountain of other systemic health problems, but for now, let’s stick to talking about grinding.
If you’re experiencing daily stress, look for stress relief and relaxation techniques, such as:
- Taking a warm bath
- Spending time outdoors
- Getting plenty of sleep
Identify the stressors in your life, and try to avoid them as much as possible. This should improve your daytime grinding, as well as your overall health.
Anxiety and/or depression may be the cause of your bruxism, especially awake bruxism.
In scientific studies, anxiety is sometimes grouped with stress, and sometimes grouped with depression. In truth, an anxiety disorder is its own classification.
Either way, both anxiety and depression have been linked to teeth grinding, particularly daytime grinding.
To treat anxiety or depression disorders, doctors may prescribe medications or recommend psychotherapy.
One natural remedy for depression is St. John’s wort. A 2008 review revealed that St. John’s wort was as effective as antidepressants for treating mild to moderate depression, yet resulted in fewer adverse side effects.
Always consult your doctor before taking St. John’s wort or any new dietary supplement.
Besides anxiety, depression, and stress, other disorders in the brain may lead to bruxism, such as Huntington’s disease or Parkinson’s disease.
4. Tobacco and/or Alcohol Use
Tobacco use and excessive alcohol use are major risk factors for both teeth grinding and sleep apnea.
Nicotine dependence/addiction is linked to bruxism.
Exposure to secondhand smoke is associated with nighttime grinding in children.
Nighttime grinding in adults is positively associated with smoking tobacco, drinking caffeine, and consuming alcohol.
In order to reduce your risk of teeth grinding, quit smoking and avoid alcohol.
5. Hyperactivity (in Children)
Hyperactivity and ADHD have a proven correlation with bruxism. Some experts believe that bruxism causes hyperactivity, others believe hyperactivity causes bruxism. I believe both can be true.
Tips on how to stop a child from grinding their teeth at night:
- Have your child stretch when he/she wakes up and before bed.
- Decrease your child’s exposure to stressful situations, particularly right before bedtime.
- Help your child relax their muscles with a little massage.
- Give your child plenty of water to drink.
- Avoid caffeine in their diet, especially just before bed.
- Make sure your child is not exposed to secondhand smoke.
- Ask your dentist to watch your child’s teeth for early signs
of grinding or abnormal bite.
- Ask your child’s doctor about enlarged adenoids and tonsils. These may cause pediatric sleep apnea, which leads to nighttime grinding.
Parasitic infection can lead to grinding. Particularly in children, parasites may be a hidden cause of bruxism.
A 2010 article published in Dental Research Journal “suggests that pathogenic parasites may serve as the cause of initiation of bruxism habits among children.”
This is a controversial claim, and not all mainstream researchers agree. However, parasites seem to play a significant role in a limited number of cases.
Certain medications can cause bruxism.
Drug interactions or the adverse side effects of a single medication may lead to grinding. However, medications may also be used to treat grinding, which I would not recommend.
Types of medications used to treat teeth grinding include:
- Anti-anxiety meds
Yet, antidepressants like SSRIs and antipsychotic medications have been linked to increased risk of teeth grinding. Yes, you read that right, 2 of the types of medications that are supposed to treat bruxism can actually result in bruxism.
A 2018 systematic review reveals that 3 specific selective serotonin reuptake inhibitors (SSRIs, a type of antidepressant) most commonly resulted in bruxism: fluoxetine, sertraline, and venlafaxine.
Though not commonly thought of as a medication, nicotine is also a common cause of bruxism.
Teeth grinding seems to run in families. Bruxism involves hereditary and genetic factors.
A 2016 study published in Sleep supports the idea that sleep bruxism is inheritable, or genetic.
Knowing your family history can help prepare you for later in life. If you know you are at higher risk of bruxism due to genetics, you can eliminate other risk factors, like smoking, drinking, and daily stressors.
You can’t cure your genetics. However, you can influence your epigenetics, or the “layer” of alterable mechanisms that impact your gene expression.
Epigenetics don’t impact the underlying DNA you were born with, but by making positive lifestyle and dietary changes, you can actually influence your offsprings’ chances of developing genetically passed disorders.
9. Misaligned Teeth
Crooked or misaligned teeth are considered to be a leading cause of teeth grinding, especially at night. This is when your upper and lower teeth do not properly meet.
When your teeth are misaligned, you have an abnormal bite, also known as a “malocclusion”. This puts you at higher risk of teeth grinding during the day or at night.
Some experts claim that misaligned teeth are a major factor in bruxism, while others point out that bruxism is actually less prevalent in third world countries, where misaligned teeth are more common.
Treatment options for misaligned teeth may include:
- Reshaping the tooth
- Tooth extraction
- Wires or plates
10. Vitamin Deficiency
It seems strange, but in rare cases, a nutritional or vitamin deficiency may result in bruxism.
What vitamin deficiency causes teeth grinding?
The following nutritional and vitamin deficiencies may cause teeth grinding:
- Vitamin B5
Supplementing these nutrients may improve bruxism in certain cases. (Make sure you get enough vitamin D and vitamin K2 to properly absorb the calcium.)
When to See Your Dentist
You should see your dentist as soon as you recognize signs of teeth grinding, like morning headaches, pain in your jaw and facial muscles, or tooth sensitivity in the absence of tooth decay or gingivitis.
If you experience any symptoms of bruxism, seek medical advice right away — since grinding leads to long-term side effects that will reduce your quality of life.
A healthcare professional can discuss treatment options that are right for your specific situation.
How do I stop grinding my teeth?
Common treatments for teeth grinding include:
- DNA appliance
- CPAP therapy
- Stress relief
- Mouth taping
- Night guards, mouthguards, or occlusal splints
- Other oral appliances (MAD, TRD, etc.)
Did you know? A landmark 2006 study on 145,000 patients found up to a 21% reduction in healthcare costs associated with major diseases when oral health is improved.
Click here right away to set up your appointment with us. At Rejuvenation Dentistry, we empower our patients to take control of their overall health, including bruxism, airway health problems, and obstructive sleep apnea.
- Manfredini, D., Winocur, E., Guarda-Nardini, L., Paesani, D., & Lobbezoo, F. (2013). Epidemiology of bruxism in adults: a systematic review of the literature. J Orofac Pain, 27(2), 99-110. Full text: http://www.lucaguarda.it/articoli/159-Epidemiology.pdf
- Machado, E., Dal-Fabbro, C., Cunali, P. A., & Kaizer, O. B. (2014). Prevalence of sleep bruxism in children: a systematic review. Dental press journal of orthodontics, 19(6), 54-61. Full text: https://www.scielo.br/pdf/dpjo/v19n6/2176-9451-dpjo-19-06-00054.pdf
- Linde, K., Berner, M. M., & Kriston, L. (2008). St John’s wort for major depression. Cochrane database of Systematic reviews, (4). Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7032678/
- Rintakoski, K., Ahlberg, J., Hublin, C., Broms, U., Madden, P. A. F., Könönen, M., … & Kaprio, J. (2010). Bruxism is associated with nicotine dependence: a nationwide Finnish twin cohort study. Nicotine & tobacco research, 12(12), 1254-1260. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107617/
- Montaldo, L., Montaldo, P., Caredda, E., & D’Arco, A. (2012). Association between exposure to secondhand smoke and sleep bruxism in children: a randomised control study. Tobacco Control, 21(4), 392-395. Full text: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1031.9187&rep=rep1&type=pdf
- Bertazzo-Silveira, E., Kruger, C. M., De Toledo, I. P., Porporatti, A. L., Dick, B., Flores-Mir, C., & Canto, G. D. L. (2016). Association between sleep bruxism and alcohol, caffeine, tobacco, and drug abuse: a systematic review. The Journal of the American Dental Association, 147(11), 859-866. Abstract: https://pubmed.ncbi.nlm.nih.gov/27522154/
- Ghanizadeh, A. (2008). ADHD, bruxism and psychiatric disorders: does bruxism increase the chance of a comorbid psychiatric disorder in children with ADHD and their parents?. Sleep and Breathing, 12(4), 375-380. Abstract: https://pubmed.ncbi.nlm.nih.gov/18421490/
- Tehrani, M. H. N., Pestechian, N., Yousefi, H., Sekhavati, H., & Attarzadeh, H. (2010). The correlation between intestinal parasitic infections and bruxism among 3-6 year-old children in Isfahan. Dental research journal, 7(2), 51. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3177368/
- Teoh, L., Moses, G., Duma, S. R., & Fung, V. S. (2019). Drug-induced bruxism. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698238/
- Garrett, A. R., & Hawley, J. S. (2018). SSRI-associated bruxism: A systematic review of published case reports. Neurology: Clinical Practice, 8(2), 135-141. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5914744/
- Cruz‑Fierro, N., Martínez‑Fierro, M., Cerda‑Flores, R. M., Gómez‑Govea, M. A., Delgado‑Enciso, I., Martínez‑De‑Villarreal, L. E., … & Rodríguez‑Sánchez, I. P. (2018). The phenotype, psychotype and genotype of bruxism. Biomedical Reports, 8(3), 264-268. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867466/
- Khoury, S., Carra, M. C., Huynh, N., Montplaisir, J., & Lavigne, G. J. (2016). Sleep bruxism-tooth grinding prevalence, characteristics and familial aggregation: a large cross-sectional survey and polysomnographic validation. Sleep, 39(11), 2049-2056. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070759/
- Albert, D. A., Sadowsky, D., Papapanou, P., Conicella, M. L., & Ward, A. (2006). An examination of periodontal treatment and per member per month (PMPM) medical costs in an insured population. BMC Health Services Research, 6(1), 103. Full text: https://www.researchgate.net/publication/6873716_An_examination_of_periodontal_treatment_and_per_member_per_month_PMPM_medical_costs_in_an_insured_population