Nighttime tooth grinding can have serious dental consequences, including jaw pain, tooth damage and destroyed dental work. And many people who grind their teeth don’t even realize they do it.
Clues that you might be grinding your teeth at night—in addition to a partner reporting the noise—include chronically waking with jaw pain and/or headaches. Your dentist also might see new signs of substantial tooth wear.
If you are grinding your teeth, consider these options…
Bite splint. Commonly called a “mouth guard” by patients, you wear this plastic device over your upper or lower teeth at night. It won’t stop the grinding, but it can reduce further tooth damage. Important: Obtaining a bite splint through a dentist costs several hundred dollars. Dental insurance probably will cover much of this cost—but typically only for the first bite splint.
Caution: If your dentist suggests an “advanced” bite splint that covers only some of your upper or lower teeth, ask for a more traditional full-coverage splint if your dentist makes these. There’s no evidence that the advanced splints are more protective than standard splints that cover all of the upper or lower teeth, but there is evidence that they can create future bite or tooth problems.
Also avoid over-the-counter splints and guards that are available without going to a dentist. These are significantly less expensive than dentist-supplied bite splints, but their use has been linked to long-term bite and tooth problems.
Exercise and massage. If tooth grinding causes jaw pain, try the jaw-muscle exercises and facial massages described on the website of the American Academy of Dental Sleep Medicine. (On AADSM.org, select “OAT Patient Resources” from the “For Patients” menu, then scroll down to find the video.) This video technically is for people who are using bite splints for sleep apnea, but the same techniques work for tooth grinding.
Botox injections. In extreme cases, injecting Botox into the jaw muscles can reduce the force exerted during tooth grinding, greatly decreasing the odds of tooth damage, jaw-muscle soreness and headaches. But: Botox injections can cost $500 to $1,000 or more per session and are unlikely to be covered by dental insurance. And the benefit lasts only a few months, at which point additional Botox injections will be required to prevent the problem from returning.
Other potential options: Acupuncture, electrical stimulation and cognitive behavior therapy to treat the underlying anxiety. Each of these could be worth trying if nothing else provides relief—but there is no evidence that they work.
Note: Daytime tooth grinding is less common than nighttime grinding and doesn’t necessarily mean that you need to sleep with a bite splint. Most people who grind their teeth do so while asleep or while awake, not both. Discuss daytime grinding with your medical doctor or dentist—it may be a symptom of stress or could indicate a neurological issue such as a stroke.
