Teeth Grinding Explained

Do You Grind Your Teeth? The Short Answer

Teeth grinding, or bruxism, means clenching your teeth together or sliding them against each other, usually without realising. It happens during sleep, during the day, or both. Many people grind now and then without harm. It becomes a problem when it causes wear, cracks, pain or headaches.

The usual treatment is protection rather than a cure. A custom-made night guard (£220) or hard splint (£640) takes the forces off your teeth while you sleep. Alongside that, we look at what might be driving the habit and track any wear over time.

As a general and family dentist in Edinburgh, I see grinding at every stage, from a few shiny wear spots in a teenager to adults who have cracked several back teeth. The earlier it's recognised, the less there is to repair.

What Are the Signs You Grind Your Teeth?

Because most grinding happens in sleep, the clues usually come from your teeth, your muscles or someone else.

In your teeth:

• front teeth that look shorter, flatter or more even in length than they used to
• small chips or a "see-through" look along the biting edges
• flat, shiny patches on the back teeth
• fillings or crowns that keep breaking
• cracked teeth, often felt as a sharp pain when biting and releasing
• sensitivity to cold, where wear has exposed the dentine underneath

In your jaw and head:

• aching or tired jaw muscles in the morning
• dull headaches at the temples on waking
• clicking or tenderness in front of the ears
• a scalloped edge to your tongue or a white line inside your cheeks

From other people: a partner who hears grinding at night, or a parent who notices it in a child.

None of these on its own proves grinding, and some have other causes, which is why an examination matters.

Why Do People Grind Their Teeth?

There's rarely a single cause. Grinding is now understood as something controlled mainly by the brain and nervous system rather than by how the teeth fit together. Things that are commonly associated with it include:

• stress and anxiety, including work pressure or concentration
• sleep disturbance, including snoring and sleep apnoea
• caffeine, alcohol and smoking, especially later in the day
• certain medicines, including some antidepressants
• daytime habits, such as clenching while at a screen, driving or exercising

If you snore loudly, stop breathing for spells at night, or feel exhausted during the day despite enough sleep, mention it to your GP as well as to us. A sleep problem may need looking at in its own right.

In children, grinding is common and usually fades as their adult teeth come in. We'll keep an eye on it at dental examinations, but children rarely need a guard.

How We Diagnose It, and Why iTero Scans Help

Diagnosis starts with a conversation about your symptoms, sleep and habits, followed by an examination of your teeth, gums, jaw muscles and jaw joints. We look at the pattern of wear: grinding tends to produce flat, matching facets on upper and lower teeth that line up when you slide your jaw.

Wear is slow, so the most useful question is whether it's still happening. That's where our iTero intraoral scanner earns its place. It builds an accurate 3D digital model of your teeth in a few minutes, with no impression putty. Taking a scan now and comparing it with another a year or so later shows whether your teeth are actually losing height and where.

This helps in two ways:

• it shows whether wear is active or historical, so we don't recommend treatment you don't need
• if you're wearing a guard, it shows whether the guard is doing its job

The same scans can be used to make your night guard or splint, so the fit is based on an accurate model of your teeth.

Night Guards Versus Hard Splints: Which Is Right for You?

Both are custom-made from a scan or impression of your teeth and worn at night. They differ in material, design and purpose.

Soft guards suit some people well, but in a few they encourage chewing and clenching on the guard. A properly adjusted hard splint gives a stable, even contact, which is why we often prefer it when there's muscle or joint pain.

Neither stops you grinding. They take the damage on themselves instead of your teeth, which is why they wear and need replacing every few years. Shop-bought "boil and bite" guards are bulky, can move the bite and rarely last, so they're not a substitute for a fitted appliance.

Our page on night guards and mouthguards explains the fitting process.

Protecting Bonding, Veneers and Crowns

If you've invested in cosmetic work, grinding is one of the biggest threats to it.

• Composite bonding is strong, but heavy grinding can chip or wear the edges much faster than normal.
• Porcelain veneers and crowns resist wear well, but can crack or debond under repeated heavy force. Porcelain can also wear down the natural teeth they bite against.
• Implant crowns have no natural shock absorber, so grinding loads them heavily.

Before planning composite bonding or veneers, we always look for signs of grinding. If we find them, we'll usually recommend wearing a guard or splint every night once the work is finished. That's part of looking after your treatment, in the same way as hygiene visits. Results and lifespan vary from person to person, and grinding is one of the main reasons.

Jaw Pain, Clicking and Headaches

Grinding and clenching overwork the chewing muscles, especially the large masseter muscle at the angle of the jaw. This can cause aching, stiffness and tension-type headaches, and contributes to problems with the jaw joints, often called TMJ or TMD.

Most jaw pain improves with simple measures:

• a soft diet for a while and avoiding chewing gum
• noticing and breaking daytime clenching: lips together, teeth apart, jaw relaxed
• warmth and gentle stretching of the jaw muscles
• a splint at night where appropriate

If your jaw locks, you can't open fully, or pain is severe, we'll assess it properly. There's more on our jaw pain and TMJ page.

What About Anti-Wrinkle Injections for Grinding?

Some patients ask about anti-wrinkle injections to the masseter muscle. These relax the muscle and can reduce the force of clenching for a few months at a time. They can also slim the lower face, which some people want and others don't.

This is an option that a clinician needs to assess individually. It isn't the first step for most people, and it doesn't replace protecting your teeth. Effects wear off and results vary. At Comely Bank Dental, Dr Miranda Paterson carries out assessments for facial aesthetics and can talk through whether it's suitable, the possible side effects and the alternatives.

Living with a Guard or Splint

Getting used to it. Most people adapt within a week or two. Extra saliva and a slightly odd feeling in the first few nights are normal.

Cleaning. Rinse it each morning, brush it gently with a soft brush and cold water (hot water can warp it), and keep it dry in its case.

Checks. Bring it to your dental examinations so we can look for wear, cracks and fit. A splint worn right through, or one that no longer sits firmly, needs replacing.

Keep an eye on symptoms. If your jaw feels worse, or your bite feels different in the morning and doesn't settle, stop wearing it and call us so we can adjust it.

Once a guard is part of the bedtime routine, most people barely think about it. If you're in Stockbridge, Inverleith or elsewhere in Edinburgh and suspect you grind, a dental examination is the place to start.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.