Teeth grinding (bruxism): symptoms, causes and treatment

The NHS is clear that treatment for teeth grinding is not always needed. For many people the first steps are self-care: working out what is driving the grinding and calming it down, while keeping an eye on your teeth through regular dental check-ups.

If your teeth are being worn or damaged, a dentist may recommend a mouth guard or mouth splint. The NHS describes these as worn at night to protect your teeth from damage, and says a dentist can make one that fits precisely over your upper or lower teeth. A guard protects the teeth; it does not on its own remove the reason you are grinding.

A GP can give advice and recommend treatments for reducing stress, and can help if you want to give up smoking, cut down on alcohol, or need advice about drug use. These are all things the NHS lists as possible contributors to grinding.

• Dentist: check for tooth wear, discuss a night-time mouth guard or splint.

• GP: help with stress and anxiety, smoking, alcohol, drug use and sleep problems.

• Self-care: relaxation, a regular bedtime routine, painkillers for jaw pain, and avoiding chewing gum or hard foods if your teeth or jaw hurt.

The NHS suggests several things that may help. None is guaranteed, and it can take a little while to find what suits you, but they are low risk.

• Find ways to relax, for example breathing exercises, listening to music and taking regular exercise.

• Improve your sleep: go to bed at the same time every night, relax before bedtime and keep your bedroom dark and quiet.

• Take paracetamol or ibuprofen if you have jaw pain or swelling.

• Hold an ice pack (or a bag of frozen peas) wrapped in a tea towel against a sore, swollen jaw for 20 to 30 minutes.

• Have regular dental check-ups.

• Do not smoke, and do not drink too much alcohol or caffeine.

• Do not chew gum or eat hard foods if you have tooth or jaw pain.

Many people do not know they grind. The NHS says the other symptoms to look for, besides the grinding and clenching itself, are a painful jaw, worn-down or broken teeth, headaches, earache and disturbed sleep.

A painful jaw can lead to a condition called temporomandibular disorder (TMD), which affects how the jaw moves. The NHS lists pain around the jaw, ear and temple, clicking, popping or grinding noises when you move your jaw, a headache around the temples, difficulty opening your mouth fully and the jaw locking. Worn or broken teeth can bring increased sensitivity and, in time, loss of teeth and fillings.

Because grinding often happens during sleep, a partner or someone sharing a room may notice it before you do. A dentist may also spot the signs during a check-up.

The NHS says it is not always clear what causes people to grind their teeth. It is often linked to the factors below, with stress and anxiety the most common.

The NHS lists sleep problems such as snoring and sleep apnoea as being linked to teeth grinding. Sleep apnoea is when breathing stops and starts during sleep; the NHS says symptoms include gasping, snorting or choking noises, waking up a lot, loud snoring, daytime tiredness, poor concentration and a headache on waking.

If those symptoms sound familiar, or someone has seen your breathing stop and start, tell your GP. The NHS says a GP may refer you to a specialist sleep clinic for tests, often done at home with devices worn overnight. Treating sleep apnoea, for example with a CPAP machine, is a separate pathway from treating the grinding itself.

The NHS includes children in its advice on when to see a dentist: if you are worried about your child grinding their teeth, ask a dentist. The dentist can look at the teeth and jaw and say whether anything needs doing.

The NHS says to see a dentist if you grind your teeth and have tooth damage or sensitive teeth, have pain in your jaw, face or ear, your partner says you grind your teeth in your sleep, or you are worried about your child grinding their teeth.

See a GP if you need help with some of the causes, such as stress, anxiety, smoking, drinking too much or taking drugs.

Jaw pain with other symptoms is sometimes something different. The NHS page on TMD says to ask for an urgent GP appointment or get help from NHS 111 if you cannot eat or drink, your jaw is locking or you cannot open your mouth fully, you have frequent severe headaches, pain or tenderness at the side of your head or on the scalp, or vision problems such as double vision or loss of vision in one or both eyes.

Teeth grinding is usually managed through dental care. You can see an NHS dentist or a private dentist; availability and charges differ between them, so ask the practice what is covered, particularly for a custom-made guard.

A GP appointment is the route for stress, anxiety, sleep or substance-use help. Private mental health, sleep and dental services also exist; check what is included, and keep your GP and dentist informed if you use them.