How do you sleep? More importantly, how do you wake up? When you awake after what may seem like a good night’s sleep, do you have a dull headache? Do you have neck pain, facial pain, or jaw pain? Do you get earaches, or do you have a generalized pain in the area below the ears? If the answer to any of these questions is yes, it’s possible you suffer from sleep bruxism. 

Sleep bruxism is more commonly known as teeth grinding, and it’s fairly common, especially in children. The problem is, it’s often difficult to know if you’re a teeth grinder unless someone tells you. Sometimes, the only way to know is by symptoms experienced while you’re awake. 

Besides what’s been previously mentioned, here are other signs you may be grinding your teeth in  your sleep:

  • Do you have a clicking sound in your jaw?
  • Do all of your front teeth look like they’re the same length or appear flat?
  • Are your parents or siblings teeth grinders?
  • Does anyone else hear you grinding your teeth at night?
  • Are any of your teeth loose?
  • Do you have tooth sensitivity?
  • Do you have a white line on the inside of your cheek?
  • Are the edges of your tongue scalloped?

According to Steven Bender, DDS, director of the Center for Facial Pain and Sleep Medicine, “About 60 percent of the population will have a rhythmic movement of the jaws while they sleep, but that doesn’t always consist of teeth contact, which accounts for about eight percent of the population’s tendencies.” In children, the number can go as high as 20 to 30 percent, although most outgrow it. However, there is also awake bruxism, which about 20 percent of the population will do from time to time. What causes bruxism? Is it dangerous? Are there ways to treat bruxism? 

It was once believed that bruxism was exclusively a stress response, which is still mainly true, even in children. Stress, anxiety, anger, or frustration, whether at work or at school, often need a release, which often occurs while sleeping by clenching one’s jaw or grinding one’s teeth.  

Children most often outgrow the reasons for grinding, as they learn or create coping strategies for dealing with stressors. Adults should examine their sources of stress, and try to reduce chronic stress through stress management and relaxation techniques. The effects of stress include other dangerous health problems including heart disease. 

Factors other than stress can affect bruxism. According to the Mayo Clinic, additional risk factors include:

  • Personality type. Having a personality type that’s aggressive, competitive or hyperactive can increase your risk of bruxism.
  • Medications and other substances. Bruxism may be an uncommon side effect of some psychiatric medications, such as certain antidepressants. Smoking tobacco, drinking caffeinated beverages or alcohol, or using recreational drugs may increase the risk of bruxism.
  • Family members with bruxism. Sleep bruxism tends to occur in families. If you have bruxism, other members of your family also may have bruxism or a history of it.

Of the factors listed, some researchers have determined that sleep apnea may be one of the biggest culprits in causing bruxism. 

Sleep apnea is defined as a condition in which a person temporarily stops breathing during sleep. During very deep sleep, the soft tissues of the mouth and tongue become so relaxed that they block one’s airway, making breathing difficult. This blockage can lead to an interruption in breathing for several seconds at a time. 

Researchers found that, once patients stopped breathing, they were able to reopen their airway if they began grinding their teeth. When sleep-study participants were given something to keep airways open all night, the sleep apnea stopped and so did the grinding. The researchers concluded that grinding is the body’s natural reflex to force the airway open when breathing is hampered. 

While bruxism seems relatively harmless, it can cause major issues. The force exerted by the jaw when grinding can be up to 10 times greater than during regular chewing. This pressure can crack teeth, or cause hairline cracks to become larger, resulting in broken teeth. Additionally, the grinding motion can wear away the enamel, leaving the tooth unprotected and subject to decay. 

Even more extreme damage can include loose teeth; fractured teeth; jawbone malformations, TMJ (temporomandibular joint dysfunction), which shares many of the same symptoms and may be caused by bruxism; and damaged dental work on crowns or bridges. 

According to WebMD, those with bruxism can try the following behavioral changes:

  • Avoid caffeine 
  • Avoid alcohol
  • Avoid or reduce the dose of medications containing amphetamines
  • Avoid chewing gum
  • Avoid chewing on pencils, ice, or any other non-food item
  • Train yourself not to clench or grind during the day
  • Relax jaw muscles before sleep by holding a warm cloth against the cheek, in front of the earlobe

Most importantly, since bruxism does so much damage to teeth, see your dentist. Over-the-counter, one-size-fits-all dental appliances that claim to stop bruxism can do more harm than good. Your dentist can help. The dentist will look at prior restorations such as implants, veneers, crowns, or bridges. Only your dentist will provide, or suggest a resource for, a custom-made mouth guard, fit for your mouth. 

If you grind your teeth at night, or suspect that you do, get in touch with the office of 

Dr. Robert Brei, DDS. He is Tucson’s premier cosmetic and family dentist.

You can email the office at, call 520-325-9000, or click here to book online and schedule an appointment directly. Let Dr. Brei provide a course of action that will stop bruxism, and give you a good night’s sleep.