Teeth Grinding and Clenching: Signs, Damage and Treatment

Most people who grind their teeth have no idea they do it, because it mostly happens while they are asleep. The damage is cumulative and largely silent, and by the time it is obvious it is expensive to put right.

The short answer

Bruxism is grinding or clenching outside of normal chewing, and it happens in two distinct forms: at night, which is involuntary and linked to sleep, and during the day, which is usually a stress-related clenching habit. The forces involved are far higher than chewing forces. There is no cure, but the damage is very largely preventable with a night guard, which is the single most cost-effective thing you can do if you grind.

How to know you do it

• Waking with a tight, aching jaw, or a dull headache in the temples first thing that eases through the morning.
• Flattened, shiny wear facets on the biting surfaces, particularly the canines and front teeth. This is what your dentist notices first and it is very hard to miss.
• Teeth becoming shorter, or front teeth chipping at the edges.
• Generalised sensitivity with nothing obviously wrong. Enamel worn thin exposes dentine. See sensitive teeth.
• Notching at the gumline, where teeth flex under load, often alongside recession.
• Fillings and crowns that keep failing. If several restorations have come loose or fractured, grinding is high on the list of reasons. See when a filling falls out.
• Clicking or locking of the jaw joint, or a partner telling you they can hear it at night.
• Ridging along the inside of your cheeks, or a scalloped edge to your tongue, from pressing against the teeth.

Why it happens

Night grinding is now understood as a sleep-related phenomenon rather than a dental one, and it is associated with sleep arousals, snoring and sleep apnoea. Stress and anxiety are strongly linked, as are caffeine, alcohol, smoking and recreational stimulants. Some medications, including certain antidepressants, list it. Daytime clenching is more straightforwardly behavioural and typically shows up at a desk, in traffic, or during concentration.

Worth knowing: an untreated snoring or apnoea problem can be the real driver, and treating that sometimes reduces the grinding. If you snore heavily, wake unrefreshed, or your partner has noticed you stop breathing, mention it, because that is a conversation for your GP as well as us.

What can be done

• A night guard. A hard acrylic splint made from impressions of your own teeth, worn overnight. It does not stop you grinding, it absorbs the load so your teeth do not. This is the mainstay of treatment, and it is far cheaper than replacing worn teeth. Ask us for the current price and we will tell you before you commit to anything.
• Avoid the boil-and-bite kind from a chemist for long-term use. They are soft, which can encourage more chewing, and a poor fit can load individual teeth unevenly.
• Daytime awareness. Genuinely effective for clenchers. Teeth should be apart at rest, with lips together and tongue on the palate. Phone reminders work better than willpower.
• Cut evening caffeine and alcohol, both of which fragment sleep and worsen night grinding.
• Address the stress side however works for you. It is not the whole cause, but it is a lever.
• Repair the damage where it has gone too far. Worn or chipped edges can be rebuilt with composite bonding from £175 per tooth, and heavily worn teeth may need crowns at £600 to £620. Any of that is wasted money without a guard to protect it afterwards.
• Botulinum injections into the jaw muscles are used for severe cases by some clinicians. If that is genuinely relevant to you we would discuss it and refer rather than improvise.

What it costs to get assessed

A new patient examination is £89 including X-rays, or £60 if you are already with us. Grinding is one of the things a dentist can diagnose confidently from the wear pattern, so it is a short conversation. Night guards are priced individually depending on the design needed. Everything we publish is on the fees page.

Frequently asked questions

Can teeth grinding be cured?

Not reliably, no, because the night-time form is not a habit you can decide to stop. What you can do is protect the teeth from the consequences and reduce the triggers. In practice a guard plus attention to sleep, caffeine and alcohol handles it well.

Is a shop-bought mouthguard good enough?

For a few weeks, possibly. Long term, no. They are usually soft, which can increase muscle activity rather than reduce it, and a guard that does not fit precisely concentrates force on whichever teeth touch first. That is the opposite of what you want.

Will grinding make me lose teeth?

Rarely on its own, but it wears them down, cracks them, and repeatedly destroys fillings and crowns. Combined with gum disease it accelerates the loss of teeth that are already compromised. The usual outcome of ignoring it is a large restorative bill rather than extractions.

My jaw clicks and aches. Is that the same thing?

Related but not identical. Jaw joint problems and grinding often occur together and a guard frequently helps both. If your jaw locks, or you cannot open fully, tell us, because that needs assessing in its own right.

Grinding is also a common reason teeth chip at the edges, and our guide to a chipped or cracked tooth covers repairing that damage.

If you wake with an aching jaw or your fillings keep failing, it is worth twenty minutes to find out. Call us on 01625 574609.

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