Teeth grinding—also called bruxism—can be one of those sneaky habits you don’t notice until it’s already causing problems. Maybe you wake up with a sore jaw, headaches that feel like they start at your temples, or teeth that suddenly seem more sensitive than they used to be. Or maybe a partner tells you you’re making a terrible grinding sound at night (not exactly the most romantic feedback, but very helpful).
Bruxism is common, and it can happen during sleep, while you’re awake, or both. The tricky part is that it isn’t always “just stress,” and it isn’t always harmless. Some people grind for years with minimal issues, while others develop cracked teeth, gum recession, jaw joint pain, or chronic headaches. The good news is that once you know the signs and what’s driving it, you can take practical steps to protect your teeth and feel better.
This guide walks through what bruxism looks like in real life, why it happens, what it can do to your teeth and jaw over time, and when it’s time to get professional help. If you’ve been wondering whether your symptoms “count,” you’ll get clarity—and a plan.
What bruxism really is (and why it’s not always obvious)
Bruxism is repetitive jaw-muscle activity that involves clenching, grinding, or bracing the jaw. Grinding usually means your teeth are moving against each other, often making noise. Clenching can be silent—your teeth may be pressed together hard without any movement—which is why many people don’t realize they do it.
There are two broad categories: sleep bruxism (happens during sleep and is considered a sleep-related movement issue) and awake bruxism (often linked to habits, posture, concentration, or emotional triggers). You can have one or the other, or both. And the symptoms can be different depending on which type you have.
One more important nuance: bruxism isn’t always a “problem” by itself; it becomes a problem when it causes pain, tooth damage, jaw dysfunction, or disrupts sleep. That’s why the goal isn’t necessarily to “stop it forever” (which can be unrealistic), but to reduce the intensity and protect your teeth and joints.
Signs you might be grinding or clenching (even if you’ve never heard it)
Morning clues: what your body tells you after sleep
Sleep bruxism often announces itself in the morning. A classic sign is waking up with jaw soreness, tightness in the cheeks, or fatigue in the muscles around the jaw. Some people describe it like they “worked out” their jaw overnight.
Headaches are another big one—especially dull, pressure-like headaches that sit at the temples or behind the eyes. These can be related to overworked temporalis muscles (the fan-shaped muscles on the sides of your head) that help you bite and clench.
You might also notice tooth sensitivity in the morning that improves as the day goes on. That can happen when grinding wears enamel or creates tiny cracks that make teeth more reactive to cold, heat, or sweetness.
Daytime hints: habits you may not realize you have
Awake bruxism can be surprisingly subtle. Many people clench while driving, working at a computer, lifting weights, or concentrating. If you catch yourself with your teeth touching when you’re not eating, that’s a clue. Ideally, at rest, your teeth should be slightly apart with lips closed and tongue resting gently on the palate.
Another hint is jaw “bracing”—holding tension in the jaw without fully clenching. It can show up as a tight jawline, facial fatigue, or a feeling that you can’t fully relax your mouth.
If you frequently chew gum, bite pens, or hold your phone between your shoulder and jaw, those habits can reinforce jaw muscle overuse and make clenching more likely.
What your teeth and gums may be showing
Dentists often spot bruxism before patients feel it. Flattened biting surfaces, tiny chips along the edges, enamel wear, and hairline cracks can all point to grinding. In some cases, teeth look shorter over time.
You might also notice gum recession or notches near the gumline (called abfraction lesions). These can be related to stress on the tooth from heavy biting forces, though brushing habits and gum health also play a role.
And if you’ve had dental work—like fillings or crowns—that seems to wear down or break sooner than expected, bruxism may be the reason. Restorations can only handle so much force, especially if clenching happens nightly.
Why bruxism happens: the most common causes and contributors
Stress, anxiety, and the “always on” nervous system
Stress is a frequent driver, but it’s helpful to think of it more broadly than “I feel stressed.” Bruxism can be linked to an overactive nervous system, high baseline tension, or difficulty shifting into a relaxed state—even if you’re functioning well on the outside.
Sleep bruxism may increase during stressful seasons, after major life changes, or when your sleep quality dips. Awake clenching can show up during focused tasks, conflict, or even excitement. The jaw becomes a place where the body stores tension.
Because stress is so common, it’s easy to dismiss bruxism as inevitable. But stress management isn’t just bubble baths—it can include sleep routines, counseling, exercise, breathing practices, and learning to notice jaw tension before it escalates.
Sleep disruption, snoring, and airway issues
Sleep bruxism is often associated with micro-arousals—tiny awakenings you may not remember. These can happen with snoring, sleep apnea, reflux, or nasal congestion. In some people, grinding appears around the same time the body briefly “wakes up” to adjust breathing or airway position.
This doesn’t mean everyone who grinds has sleep apnea, but it’s important not to ignore the possibility—especially if you also snore, wake up gasping, feel unrefreshed, or have daytime sleepiness. In those cases, addressing breathing and sleep quality can be a key piece of the puzzle.
If you suspect airway issues, talking with a dentist who screens for them or a sleep physician can be a smart move. Treating the underlying sleep disruption can reduce grinding intensity and improve overall health.
Bite alignment, jaw position, and orthodontic factors
There’s a lot of debate about how much “bite” causes bruxism. Bruxism is primarily driven by the brain and nervous system, but bite alignment can influence where forces land and how damaging those forces become. In other words, alignment may not be the root cause, but it can affect the fallout.
If your teeth don’t fit together comfortably, you may subconsciously search for a position that feels stable—especially at night. Some people also develop uneven wear patterns because the bite contacts are unbalanced, concentrating pressure on a few teeth.
Orthodontic evaluation can be helpful when bite issues are significant or when there are signs of progressive wear. For younger patients who show early wear, crowding, or bite discrepancies, options like two phase orthodontic treatment in SC may be part of a broader plan to guide jaw development and create a healthier bite foundation.
Medications, stimulants, and lifestyle triggers
Some medications can increase the likelihood of bruxism, including certain antidepressants and stimulant medications. This doesn’t mean you should stop anything on your own, but it’s worth mentioning to your prescribing provider if symptoms start after a medication change.
Caffeine, nicotine, and alcohol can also play a role. Caffeine and nicotine may increase muscle activity and arousal; alcohol can fragment sleep later in the night even if it helps you fall asleep faster. If you grind, experimenting with earlier caffeine cutoffs or reducing evening alcohol can be surprisingly impactful.
Finally, dehydration and electrolyte imbalance can contribute to muscle tension and cramps in some people. While they’re not primary causes, good hydration and balanced nutrition support muscle recovery and overall resilience.
How bruxism can affect your teeth, jaw, and daily life over time
Tooth wear, cracks, and sensitivity that creeps up slowly
One of the most common long-term outcomes is enamel wear. Enamel doesn’t grow back, so once it’s worn down, teeth may become more sensitive and more prone to decay along exposed areas.
Grinding can also cause micro-cracks that don’t show up on X-rays right away. Over time, those cracks can deepen, leading to fractured cusps (the biting points of molars) or even more serious cracks that require root canal treatment or extraction. If you’ve ever felt a sharp pain when biting on something hard and then couldn’t reproduce it reliably, that can be a crack clue.
Dental work can be affected too. Fillings can loosen, crowns can chip, and veneers can fracture. Protecting your teeth early can help you avoid a cycle of repairs.
Jaw joint irritation and TMJ-style symptoms
Bruxism can overload the temporomandibular joints (TMJs) and the muscles that control them. Some people develop clicking or popping, limited opening, or a jaw that feels like it “catches.” Others feel pain in front of the ears, especially when chewing or yawning.
It’s important to know that not all TMJ symptoms are caused by grinding, and not all grinding causes TMJ symptoms. But if you have jaw pain plus signs of clenching, it’s worth evaluating both the joint and the muscle patterns.
Early care often focuses on reducing inflammation and muscle load—things like a protective night guard, gentle stretching, avoiding chewy foods for a while, and addressing sleep or stress triggers.
Headaches, neck tension, and the “why do I always feel tight?” effect
The jaw doesn’t work alone. If you clench, you may also recruit neck and shoulder muscles, especially if posture is involved. That’s why some people with bruxism also deal with chronic neck tightness, upper back tension, or headaches that don’t respond well to typical treatments.
There’s also a feedback loop: pain and tension can make sleep worse, and poor sleep can make grinding worse. Breaking that cycle often takes a multi-pronged approach rather than a single quick fix.
If you’ve been chasing headaches with pain relievers and they keep returning, it may be worth asking whether jaw muscle overuse is part of the picture.
How dentists and orthodontists evaluate bruxism (what to expect at a visit)
The questions that actually matter
A good evaluation usually starts with your story: when symptoms happen, whether they’re worse in the morning or evening, if anyone has heard grinding, and what your stress and sleep have been like. You may also be asked about snoring, reflux, nasal congestion, and medications.
It’s helpful to mention any recent dental work, changes in your bite, or episodes of tooth pain. If you’ve cracked a tooth or broken a filling, bring that up—even if it happened months ago.
For kids and teens, parents may be asked about sleep habits, mouth breathing, allergies, and whether the child complains of jaw soreness or headaches.
What the clinical exam looks for
Clinicians look for wear facets (shiny flat spots), enamel fractures, gum recession patterns, and tenderness in the jaw muscles. They may check how your teeth fit together and whether any teeth hit too early when you bite.
They’ll often palpate (press on) the masseter and temporalis muscles to see if they’re sore. They may also evaluate the TMJ for clicking, deviation (jaw shifting to one side), or limited opening.
In some cases, X-rays or intraoral scans help document changes over time. Photos can also be useful—especially if the goal is to monitor whether wear is progressing.
When sleep screening becomes part of the conversation
If your symptoms suggest sleep-disordered breathing—snoring, gasping, dry mouth, morning headaches, daytime fatigue—your provider may recommend screening or referral for a sleep study. This can feel like a big leap if you came in “just for grinding,” but it can be a game-changer.
Why? Because if grinding is being triggered by repeated sleep disruptions, a night guard alone may protect teeth but won’t address the root pattern. Improving breathing and sleep stability can reduce the intensity of bruxism and improve energy, mood, and cardiovascular health.
Think of it as zooming out: sometimes the jaw is the messenger, not the main problem.
Practical ways to reduce damage and feel better
Night guards: what they do (and what they don’t)
A custom night guard (also called an occlusal guard or splint) is one of the most common tools for sleep bruxism. It creates a protective barrier between upper and lower teeth, reducing wear and lowering the risk of chips and cracks.
It’s important to know that a night guard doesn’t always “stop” grinding. Many people still clench or grind on the guard, but the guard takes the hit instead of your enamel and restorations. For a lot of patients, that’s a huge win.
Store-bought guards can help in a pinch, but they’re often bulky and may not fit well, which can irritate the jaw. If you’re using one and your jaw pain is worse, it’s a sign to get a proper evaluation.
Daytime unclenching: small habits that add up
If you clench during the day, the best strategy is awareness plus tiny resets. Set reminders on your phone or computer: “lips together, teeth apart.” It sounds simple, but it’s surprisingly effective when practiced consistently.
Try pairing jaw relaxation with routine moments—waiting for a page to load, stopping at a red light, or before answering a call. Let the tongue rest gently on the roof of the mouth, breathe through the nose if possible, and soften the jaw.
Also consider your workstation: screen height, chair support, and whether you crane your neck forward. Poor posture can recruit jaw and neck muscles and make clenching more likely.
Stress and sleep support that doesn’t feel like homework
Not everyone wants a long wellness checklist, so here are a few high-impact options: a consistent sleep and wake time, a caffeine cutoff (often 8 hours before bed is a good experiment), and a short wind-down routine that signals “we’re safe now.”
Breathing exercises can help reduce jaw tension quickly. Slow nasal breathing with a longer exhale (for example, inhale for 4 seconds, exhale for 6) can shift your nervous system toward a calmer state.
If your mind races at night, consider a “brain dump” note on paper before bed—just two minutes of writing what’s swirling around. It’s not fancy, but it can reduce the urge to clench through the night.
When orthodontics becomes part of the bruxism conversation
Alignment, crowding, and uneven force distribution
If your teeth are crowded or your bite is off, bruxism forces may concentrate on a few teeth instead of being spread out. That can accelerate wear in specific spots and make certain teeth feel sensitive or sore.
Orthodontic care isn’t a universal “cure” for grinding, but it can be a helpful part of a long-term plan—especially when bite issues are contributing to damage or discomfort. A more stable bite can make it easier for the jaw to settle into a comfortable position.
For teens and adults exploring clear aligners, it’s natural to wonder about budgeting and timing. If you’re weighing options, it can help to review the cost of invisalign so you can plan realistically and ask better questions at your consult.
Kids and teens: early wear deserves attention
It can be alarming to hear a child grinding at night. The good news is that some childhood grinding is temporary and linked to growth, teething, or airway issues like allergies. Still, if you notice flattened teeth, chips, or morning jaw complaints, it’s worth checking in.
Early orthodontic evaluation can identify bite patterns that may worsen wear over time. It can also flag habits like mouth breathing or tongue thrusting that affect jaw development and sleep quality.
Parents sometimes assume they should “wait until all the adult teeth are in,” but there are cases where earlier guidance is beneficial—especially when the goal is to reduce future complexity and protect developing teeth.
Retainers, aligners, and protective overlap
If you’ve had orthodontic treatment before, you may already wear a retainer at night. Some retainers can provide mild protection, but not all are designed to withstand heavy grinding. If your retainer keeps cracking or warping, that’s a clue that your bite forces are high.
Clear aligners can sometimes act like a thin protective layer, but they’re not the same as a dedicated night guard. If you grind heavily, your provider may recommend a specific approach to protect both your teeth and your orthodontic appliances.
The key is coordination: orthodontic goals, bite stability, and bruxism protection should work together rather than compete.
When it’s time to get help (and what “waiting too long” can look like)
Pain, broken dental work, or visible wear are clear signals
If you have jaw pain, frequent headaches, cracked teeth, or fillings that keep failing, it’s time to get evaluated. These are signs that your teeth and muscles are under more load than they can comfortably handle.
Also pay attention to changes that seem small but persistent: increasing tooth sensitivity, a new notch near the gumline, or a tooth that feels “different” when you bite. Bruxism damage often accumulates gradually until it suddenly becomes obvious.
Getting help early can mean simpler solutions—like a guard, a few habit changes, and monitoring—rather than major restorative dentistry later.
Sleep red flags shouldn’t be brushed off
If you grind and also snore loudly, wake up with a dry mouth, feel exhausted despite a full night in bed, or have a partner who notices breathing pauses, don’t chalk it up to “just stress.” Sleep quality is a health issue, not a luxury.
Bruxism can be one of the clues that your sleep is fragmented. Addressing airway and sleep stability can improve not only your teeth and jaw comfort, but also your mood, focus, and long-term health.
If you’re unsure whether your symptoms are “enough” to justify a visit, they probably are. A professional can help you sort out what’s normal, what’s risky, and what’s fixable.
How to choose the right next step
Start with a dental exam if your main concerns are tooth wear, sensitivity, or broken restorations. If jaw pain and muscle tension are front and center, look for a provider who evaluates TMJ and muscle function as part of the exam.
If bite issues, crowding, or orthodontic relapse are contributing to uneven contacts and wear, an orthodontic consult can add valuable perspective. And if sleep symptoms are present, ask about screening or referral for a sleep study.
If you’re ready to talk through your options with an orthodontic team and get personalized guidance, you can meet Dr. Washington today and discuss how bite alignment, protective strategies, and long-term planning can fit together.
Helpful self-checks you can do this week
A quick “jaw audit” during your day
Pick three times a day—morning, mid-afternoon, and evening—and check in with your jaw. Are your teeth touching? Are your lips pressed tight? Is your tongue jammed against your teeth? Just noticing patterns is often the first step toward change.
If you catch yourself clenching, don’t scold yourself. Instead, do a gentle reset: place the tip of your tongue behind your upper front teeth (not pushing), let your teeth separate slightly, and exhale slowly.
Over time, these tiny resets can reduce overall muscle load and make nighttime symptoms less intense.
A simple morning log that reveals patterns
For one week, jot down two things when you wake up: jaw soreness (0–10) and headache (0–10). Then note sleep quality (good/okay/poor) and any late caffeine or alcohol. You’re not trying to be perfect—just collecting clues.
Patterns often pop out quickly. You may notice soreness spikes after late-night work sessions, travel, alcohol, or poor sleep. That information helps you target the most effective changes rather than guessing.
Bring this log to your dental visit if you schedule one. It can help your provider tailor recommendations and track improvement.
Protect your teeth while you figure it out
If you suspect you grind and you’re waiting for an appointment, avoid chewing ice, hard candy, and very crunchy foods that can stress already-worn teeth. If a tooth feels cracked or painful, avoid chewing on that side and get evaluated promptly.
If you already have a night guard, wear it consistently. If you don’t, be cautious with over-the-counter options—some people do fine with them, but others feel worse. If you try one and your jaw pain increases, stop and get professional guidance.
And remember: bruxism is common, manageable, and not a personal failure. With the right mix of protection, habit changes, and targeted care, most people can reduce symptoms and prevent long-term damage.