Bruxism and Teeth Grinding
Bruxism — the habitual grinding or clenching of teeth — affects a significant proportion of adults, many of whom are completely unaware they do it. This guide explains what it is, why it happens, what it does to teeth over time, and what can be done about it.
Note
This guide is for general information only. Bruxism can only be properly diagnosed through clinical examination. If you suspect you grind your teeth, speak to a dentist.
What is bruxism?
Bruxism refers to the repeated, involuntary grinding, gnashing, or clenching of teeth. It can occur during sleep (sleep bruxism) — by far the most common type — or while awake (awake bruxism, which tends to be clenching rather than grinding).
Because sleep bruxism happens unconsciously, many people are unaware of it until a dentist spots the characteristic wear patterns, or until a partner notices the grinding sound. Some people grind quite intensely for years without realising.
What causes it?
The exact causes aren't fully understood, but bruxism is associated with a combination of factors:
Stress and anxiety
The most commonly cited trigger. Many people clench or grind during periods of stress — often without realising.
Sleep disorders
Bruxism is significantly more common in people with sleep apnoea, insomnia, or other disrupted sleep patterns.
Certain medications
SSRIs (a common class of antidepressants) and some other medications are associated with increased bruxism.
Caffeine and alcohol
Both are linked to more intense bruxism episodes, particularly if consumed in the evening.
Bite issues
Misalignment of teeth can contribute, though this is debated in the literature.
What does bruxism do to teeth?
The forces generated by grinding can be considerable — significantly higher than those during normal eating. Over time, the effects accumulate:
• Tooth enamel gradually wears away, making teeth shorter and the biting surfaces flatter • Teeth become more sensitive as the protective enamel layer thins • Cusps chip and fracture — sometimes requiring crowns or other restorations • Existing fillings and restorations wear faster and fail sooner • Jaw muscles become overdeveloped, changing the shape of the lower face in severe cases • The jaw joint (TMJ) is placed under repeated stress, leading to clicking, discomfort, or restricted movement • Chronic headaches, particularly across the forehead, are very common
The damage is cumulative — it builds gradually over years. This is why early identification and management matters.
Treatment options
Custom night guard (occlusal splint)
First-line treatment. A custom-fitted hard acrylic appliance worn over the upper or lower teeth during sleep. It doesn't stop grinding, but it protects teeth by absorbing and redistributing the forces. Properly made, a night guard is comfortable and highly effective at preventing wear. Over-the-counter versions are significantly less effective. Indicative cost: £300–£500.
Botulinum toxin (Botox) for bruxism
For moderate-severe cases. Small injections of botulinum toxin into the masseter (jaw) muscles temporarily weaken them, reducing the force of grinding significantly. Results last 4–6 months, after which re-treatment is needed. Also visually slims the jawline as a secondary effect. Indicative cost: £300–£450 per treatment.
Bite adjustment / equilibration
Where bite is contributing. In some cases, reshaping specific teeth to improve how they meet can reduce the bruxing trigger. This is selective — not appropriate for everyone — and is typically used alongside other treatments rather than in isolation.
Restorative treatment
For existing damage. Teeth that have been significantly worn or damaged may require crowns, veneers, or composite bonding to restore their original height and appearance. This is treatment for the damage already done, not a solution for the bruxism itself — protection should run alongside any restorative work.
Questions to ask your dentist
Do I show signs of bruxism, and how significant is the wear?
Understanding the extent of existing damage helps prioritise treatment.
Would a night guard be sufficient, or is more intervention needed?
The right treatment depends on severity — a clinician can advise.
Is Botox for bruxism something you offer, and would it be appropriate for me?
Botulinum toxin injections are increasingly used for moderate to severe cases.
Are any of my existing teeth or restorations at risk of fracture?
Identifying vulnerable teeth early can prevent costly repairs.
Should I see my GP about potential sleep apnoea or stress as a contributing factor?
Addressing underlying causes can significantly improve outcomes.