There’s nothing worse than waking up to my partner asking, “Do you have any teeth left?” and immediately noticing the jaw pain left in the wake of the grinding I must have been doing in my sleep. Even when I’m awake, there are moments I feel like I can’t unclench my jaw, no matter how hard I try. This is bruxism. In my case, the condition stems from a combination of stress and medication, but there is a range of reasons you might be gnashing your teeth. I talked to experts familiar with the face muscles and teeth to get to the bottom of the causes, side effects and solutions for bruxism. If you, too, experience bruxism, take a deep breath, unclench your jaw, and read on.
Featured experts
What is bruxism?
Bruxism is a condition where one grinds their teeth or clenches their jaw, says New York cosmetic dentist Jason Kasarsky, DDS. New York dermatologist Elaine Kung, MD, who experiences bruxism herself, says it’s a fairly common problem affecting about eight to 16 percent of adults. “Characterized by involuntary hyperactivity of the muscles responsible for jaw movement, bruxism can occur during wakefulness or sleep,” she notes.
What causes bruxism?
Stress
New York dermatologist Jody Levine, MD says stress is the most common culprit behind bruxism. Dr. Kasarsky points to distress, nervousness, depression, anxiety, anger and tension as possible causes. “Research suggests that there are many factors that can contribute to bruxism. Stress and anxiety are well-established contributors, with studies demonstrating increased electrical activity in the muscles of mastication during stressful periods,” says Dr. Kung. “I, myself, have awake and nighttime bruxism because of stress from my busy work schedule.”
Medication
“Neurotransmitters like dopamine and serotonin, involved in mood regulation, play a role in bruxism. Therefore, selective serotonin reuptake inhibitors (SSRIs) used for depression can have bruxism as a potential side effect,” notes Dr. Kung. Additionally, certain medications that treat ADHD and seizures may also increase the chances of grinding or clenching, says Dr. Kasarsky.
Medical or dental conditions
Dr. Levine notes that there are some medical conditions, such as sleep apnea, that might result in bruxism. Dr. Kasarsky notes that misaligned teeth can also cause nighttime bruxism. “There may be a genetic component as well,” he adds.
Alcohol, caffeine and smoking
Lifestyle choices can have a big impact on bruxism. Dr. Levine and Dr. Kasarsky note that consuming alcohol and caffeine, and smoking can cause bruxism.
Side effects of bruxism
The side effects of bruxism are plentiful, says Dr. Kasarsky, including worn and fractured teeth, TMJ, tooth abscess and pain. “Chronic bruxism can lead to a cascade of detrimental consequences. The constant friction from grinding can cause significant tooth wear, including flattening, chipping and increased teeth sensitivity,” says Dr. Kung. “The excessive pressure exerted on the jaw muscles can lead to pain and tenderness, such as temporal headaches, ear pain, neck pain, jawline muscle tenderness and temporomandibular joint pain.”
Solutions for bruxism
Address underlying conditions
Seeing a specialist to help identify the cause of your bruxism is the first step in addressing it as, depending on the cause, the solutions vary. For example, if the bruxism is due to sleep apnea or anxiety, those conditions should be addressed at the root in addition to alleviating the side effect of bruxism.
Wear a nightguard
“Fortunately, there are several effective treatment options available for bruxism. Oral appliances, commonly referred to as nightguards, remain a mainstay of therapy. These custom-made acrylic splints fit over the teeth and create a physical barrier, preventing the upper and lower jaw from coming into contact,” explains Dr. Kung. “Nightguards have been demonstrably effective in reducing tooth wear and alleviating jaw pain associated with bruxism.”
Neuromodulator injections
Dr. Kasarsky recommends trying Botox injections in the masseter muscles for those with bruxism. “Relaxing the masseter muscles with neuromodulator injections can be very helpful for patients with TMJ and who have pain in their jaw from excessive clenching,” says Dr. Levine.
“Studies have shown promising results with neurotoxin injections for bruxism, demonstrating reductions in pain, muscle activity and self-reported grinding episodes, says Dr. Kung. “I have injected myself periodically with neurotoxins over the last four years whenever I feel temporal headaches and jawline muscle pain. I have found this to be a very effective treatment for my own bruxism.”
Stress relief
Managing anxiety and stress can help alleviate bruxism for some, says Dr. Kasarsky. Dr. Kung notes that “for management of stress-related bruxism, relaxation techniques such as cognitive behavioral therapy and mindfulness meditation can be helpful.”
Lifestyle changes
Dr. Kasarsky says lifestyle changes, jaw exercises, avoiding chewing gum and talking to a doctor about muscle relaxants may prove beneficial. He adds that supplements like magnesium and vitamin B5 have shown promising results. Additionally, “avoiding stimulants like caffeine and alcohol before bed can promote better sleep quality and potentially reduce nighttime bruxism,” says Dr. Kung.