Why Do I Grind My Teeth at Night?

You wake up with a dull ache at your temples and a jaw that feels like you chewed a leather boot. Your dentist peers at your back molars and asks, casually, “Do you grind?” You didn’t know. Your partner was asleep, and so were you.

How to tell

The NHS¹ lists jaw pain, worn or broken teeth, headaches, earaches and disturbed sleep. In severe cases it can become a jaw-joint problem called temporomandibular disorder.

Cleveland Clinic² adds headaches or facial pain, especially in the morning, sore jaw muscles, worn tooth surfaces, ringing in the ears, and difficulty opening and closing your mouth.

It describes two types. Awake bruxism happens in the day, and you may not need treatment, especially if you can become more aware of it and reduce your stress. Sleep bruxism is the trickier type, because you don’t realize it’s happening, and people with it often need treatment.

Why it happens

The NHS¹ names stress and anxiety as the main culprits. The list continues with sleep disorders such as sleep apnea, certain medicines, smoking, and a lot of alcohol or caffeine.

Cleveland Clinic² names SSRIs, a common class of antidepressant, among the medicines. It also says there’s a correlation between sleep apnea and teeth grinding, and the NHS¹ lists sleep apnea as a cause.

That link is worth a second look if you’re a woman. The National Heart³, Lung, and Blood Institute (NHLBI) lists morning headaches, dry mouth and insomnia among sleep apnea symptoms, and says headache is more common in women. Our article on why you snore covers why women’s sleep apnea can go unrecognized.

What it does to your teeth

Left alone, Cleveland Clinic² says bruxism can cause tooth erosion, loose or cracked teeth, jaw-joint problems and facial pain. That’s the dentist’s reason for asking.

What helps

Cleveland Clinic² dentist Dr. Karyn Kahn lays out seven steps.

First, a custom night guard. A properly made guard protects your teeth from wear and fracture and helps reduce muscle tension and joint strain. She advises a hard resin guard from a dental provider rather than a drugstore boil-and-bite version, since a professional guard can be adjusted to your bite. The NHS¹ says dentists usually recommend a mouth guard or splint worn at night.

Second, stress management: meditation, journaling, talk therapy and breathing exercises to ease the day’s tension.

Third, less caffeine, alcohol and smoking. Cleveland Clinic⁴ says they can all affect your central nervous system, and cutting back helps it settle at night.

Fourth, a calmer bedtime: no screens for an hour before bed, soothing music, a warm compress on the jaw, and no heavy meals or stimulants.

Fifth, sleep position. Avoid sleeping on your stomach, which pulls your jaw out of line. Sleep on your back or side, and don’t rest your head on your hand.

Sixth, physical therapy. It won’t end the grinding, but it can relieve the muscle tension and pain, especially with jaw-joint trouble.

Seventh, Botox injections in some cases, to relax the muscles involved. Cleveland Clinic⁴ notes that Botox isn’t FDA-approved for this use.

The NHS¹ adds ice packs for pain, avoiding hard foods, and improving sleep habits.

Our take: ask your dentist about a custom guard before you buy the drugstore version. That’s the advice from Cleveland Clinic’s² dentist.

The play

Try this: the jaw check and the wind-down

Several times today, check your jaw. Are your teeth touching? If so, let them part.

Tonight, put screens away an hour before bed and lay a warm compress along your jaw.

At your next dental visit, ask directly whether your teeth show signs of grinding.

When to get checked

The NHS¹ says to see a dentist if you have tooth damage or sensitivity, jaw pain, or a partner who notices you grinding at night. Cleveland Clinic² says to see a provider if symptoms don’t go away, or if you have them more often than not. Its dentist’s guidance adds daily jaw pain, headaches or chipped teeth as reasons to book.

Book an appointment if any of these fit:

• You wake with a sore jaw or headache most mornings
• Your teeth are chipped, worn or more sensitive than they were
• Your jaw clicks, aches, or is hard to open
• Someone hears you grinding at night
• You also snore loudly, wake gasping, or stay exhausted after a full night

Next time the dentist asks “Do you grind?”, you’ll have an answer.