Teeth Grinding

What Are the Signs?

• Flattened, worn or chipped teeth, or front teeth that look shorter and squarer than they used to
• A sore or tired jaw, aching temples, earache or a headache on waking
• Teeth that are sensitive to cold, from enamel worn thin
• A partner hearing you grind at night
• Broken fillings, chipped bonding, or crowns that keep coming loose
• Clicking or stiffness in the jaw joint, or difficulty opening wide first thing
• Indentations along the edge of your tongue, or a ridge on the inside of your cheeks where you've been pressing them against your teeth

Grinding, which dentists call bruxism, often shows on the teeth before you feel anything. At every examination we check your biting edges for wear, and we'll tell you if we see the pattern. Many people are surprised. Clenching in particular is silent, so there's no sound for anyone to hear.

What Causes It?

Stress and anxiety are the most common triggers, along with poor sleep, caffeine and alcohol in the evening, and smoking. Some medicines can increase grinding, and it's more common in people whose sleep is disturbed or who snore. Daytime clenching is often a habit that builds while you concentrate, drive or lift weights.

Many people grind or clench only while asleep, when the muscles that close the jaw can work at far greater force than during the day, and for longer, with nothing to tell you it's happening. That's why morning symptoms, a tight jaw and a headache on waking, are such a useful clue. An uneven bite or a filling that sits slightly high can also make clenching worse, which is something we can check and adjust.

What Grinding Does to Your Teeth

Enamel is hard, but it doesn't grow back. Years of grinding wear the biting edges flat, thin the enamel until the yellower dentine underneath shows through, and leave teeth sensitive to cold. Clenching puts enormous force through single points, which is how cusps crack, fillings break and crowns come loose. Cracked teeth can need onlays, crowns or root canal treatment, and a tooth that splits may be lost. The jaw muscles and joint suffer too, with tension headaches and a jaw that aches or clicks.

None of this happens overnight, which is why it's easy to ignore. The point of treating grinding early is to stop the slow damage before it needs expensive repair, and to protect any dental work you've already had.

How Does a Night Guard Help?

A night guard is a thin, custom-made guard that fits over your upper or lower teeth while you sleep. It doesn't stop you grinding, but it takes the force so your teeth and dental work don't. Instead of enamel wearing against enamel, the guard takes the wear, and it spreads the load across the whole arch rather than concentrating it on one cusp. Most people find their jaw feels looser in the morning too, because the muscles aren't working against a locked bite all night.

Ours are made from a digital iTero Lumina scan, with no putty impressions. A custom night guard is £210, or £189 for dental plan members.² It's especially important if you have bonding, veneers, crowns or implants, which don't have the natural give of a tooth and can chip or loosen under grinding. For heavy grinders, a harder occlusal splint is also available, and we'll recommend which suits you.

Getting a Night Guard

• Examination. We check your teeth for wear, feel your jaw muscles and joint, and look at your bite. If a high filling or an uneven contact is adding to the problem, it can be adjusted.
• Scan. Your teeth are scanned on our iTero Lumina in a few minutes. No trays, no putty.
• Fitting. The guard is made to fit your teeth exactly, then checked and adjusted so it's comfortable and your bite meets evenly on it.

Expect the first few nights to feel strange. Most people stop noticing it within a week or two. Clean it with cold water and a soft brush each morning, keep it in its case away from heat, and bring it to your dental examinations so we can check it for wear and make sure it still fits. If you've had Invisalign with us, tell us if you grind, and we'll advise whether your Vivera retainers are enough or you need a guard as well.

What Else Helps?

• Notice clenching in the day and relax your jaw: lips together, teeth apart, tongue resting on the roof of your mouth. Your teeth should only touch when you eat or swallow
• Cut down caffeine and alcohol in the evening, and don't smoke before bed
• Wind down before sleep: a regular bedtime, screens off, and something that helps you relax
• Warm compresses on tight jaw muscles, and gentle stretching, if your jaw is sore
• Avoid chewing gum and very chewy food while your jaw is aching. It's a workout for muscles that are already overworked
• Deal with stress where you can. Grinding is often the body's way of processing it

If your jaw is painful, clicks, locks, or you can't open wide, tell us. Jaw joint problems overlap with grinding, and we can assess them at an examination. If sleep is the issue, or you snore heavily, it's worth mentioning to your GP as well.

Grinding and Cosmetic Dentistry

If you're planning composite bonding, veneers, crowns or implants, grinding is one of the first things we check, because it's the most common reason cosmetic work chips or fails early. Composite edges are thin, porcelain is strong but brittle under repeated force, and implants have no ligament to cushion a clench. That's why we often recommend a night guard after cosmetic treatment, and why we'll be honest if your wear pattern suggests one is essential rather than optional. Our guide to caring for bonding has more, and the implant lifespan guide explains why implants need protecting too. A guard is a small cost next to the work it protects. See every fee.

Questions

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