Bruxism is the habit of clenching and grinding the teeth. It usually occurs at night during sleep, but it may also occur during the day. Approximately one in four adults experiences it, but because it is an unconscious habit, most people are not aware of it until their teeth have been damaged.

While bruxism is typically associated with stress, anger, or anxiety, it may also be caused by abnormal occlusion (the way the upper and lower teeth fit together), or crooked or missing teeth.

Symptoms of bruxism include: dull headaches; sore and tired facial muscles; earaches; sensitive teeth; and locking, popping, and clicking of the jaw.

During a dental examination, a dentist may recognize damage resulting from bruxism, including: enamel loss from the chewing surfaces of teeth; flattened tooth surfaces; loosened teeth; and fractured teeth and fillings. Left untreated, bruxism may lead to tooth loss and jaw dysfunction.

Medical and dental histories and examinations are necessary to differentiate bruxism from other conditions that may cause similar pain, such as ear infections, dental infections, and temporomandibular joint (TMJ) dysfunction. However, uncommonly worn-down teeth strongly suggest a diagnosis of bruxism.

To prevent further damage to the teeth, bruxism is treated by placing a removable, custom-fitted plastic appliance called a night guard between the upper and lower teeth. Although the clenching and grinding behavior may continue, the teeth wear away the plastic instead of each other.

In some cases, abnormal occlusion may be adjusted and high spots removed so that the teeth fit together in a more comfortable position. Missing teeth may be replaced and crooked teeth may be straightened with orthodontic treatment to eliminate possible underlying causes of bruxism. In cases where jaw muscles are very tight, a dentist may prescribe muscle relaxants.

Stress management and behavior modification techniques may be useful to break the habit of clenching and teeth grinding. Tight jaw muscles may be relaxed by applying warm compresses to the sides of the face. Herbal muscle relaxants also can be helpful. Massage therapy and deep tissue realignment can assist in releasing the clenching pattern. This is a more permanent alternative treatment for bruxism.

Bruxism may cause permanent damage to teeth and chronic jaw pain unless properly diagnosed and promptly treated. However, the behavior may be eliminated if its underlying causes are found and addressed. Increased awareness in patients prone to anxiety, stress, or anger may prevent the habit of bruxism from developing.