Bruxism Treatment: Causes, Night Guards and Other Approaches

• Bruxism: clenching or grinding the teeth, during the day (awake) or during sleep. In an otherwise healthy person, it is a behaviour that can become a risk factor for the teeth and jaw, rather than a disease in itself.
• The night guard: a device your dentist may offer to separate and protect the teeth. It does not eliminate bruxism, and it has not been demonstrated that it reduces tooth wear.
• Other approaches: noticing clenching during the day, managing stress and discussing biofeedback for sleep bruxism. Relaxing, relieving pain and reducing clenching are different goals; no cure has been established.
• The masseter injection: an injection that relaxes this muscle may reduce the intensity of its contractions. This does not mean eliminating episodes of bruxism; it is not an established treatment.
• When to seek care: jaw pain that persists, locking, teeth that wear down or break, headaches on waking, snoring with pauses in breathing: dentist or doctor.

You catch yourself clenching your teeth in front of the screen, or your partner hears you grinding at night. When you wake up, your jaw feels tense. You are looking for a bruxism treatment that works. But protecting the teeth, relieving jaw discomfort and stopping the clenching are three different goals. Your dentist examines any damage to the teeth and the sore areas before discussing options. Some may ease the clenching; no cure has been established to make bruxism itself go away.

Bruxism is repetitive activity of the muscles that move the jaw: you clench or grind your teeth, or tighten and push the jaw, without the teeth always touching. It occurs while awake or during sleep. Awake bruxism takes the form of repeated or prolonged tooth contact, or of jaw tightening. During sleep, muscle activity may or may not be rhythmic. These two forms do not necessarily have the same cause or the same management.

In an otherwise healthy person, bruxism is considered a behaviour that can become a risk factor, rather than a disease in itself. How it affects your teeth and jaw guides the decision on whether to treat it. Only a dentist or a doctor can make a diagnosis; it cannot be made online.

No single cause explains bruxism. For sleep bruxism, stress and other psychosocial factors, caffeine, alcohol and tobacco are associated with bruxism, with a moderate level of evidence. Association does not mean cause: reducing one of these factors will not necessarily make the clenching go away.

Some medications can also increase the likelihood of bruxism. If you think one of yours is responsible, talk to your prescriber: do not change how you take a medication without consulting them.

During the assessment, say whether you clench your teeth during the day or grind them at night. The dentist looks for damage to the teeth and sore areas. If you snore with pauses in breathing, also tell your doctor: sleep apnea requires its own assessment.

Severe bruxism can damage the teeth, cause jaw fatigue or pain and be accompanied by headaches. As for the teeth, the signs to have assessed are flattened, chipped, cracked or loose teeth, enamel wear, and tooth pain or sensitivity.

These signs are not enough to make a diagnosis: a headache or a sore jaw is not necessarily caused by bruxism. If you sleep poorly or wake up with a headache, tell the professional who examines you, without immediately attributing it to teeth clenching.

A night guard, also called an occlusal splint, is a device placed in the mouth that separates the teeth. Its purpose is to protect them; it may also reduce the muscle activity linked to clenching or grinding. It does not eliminate bruxism: it is worn to protect, not to cure.

Protecting the teeth, relieving symptoms and making bruxism go away are three different goals. It has not been demonstrated that a night guard reduces tooth wear: there is not enough evidence to draw a conclusion, which does not mean it is ineffective. For sleep bruxism, it is among the approaches with modest supporting evidence, although no cure has been established.

It is therefore an option to discuss with your dentist, who examines your teeth and the sore areas before suggesting it. Have your teeth assessed before choosing a night guard. CARE MD does not offer one.

For clenching while awake, the first step is to notice the habit: reminders can help you spot it and keep your teeth apart. This is practical advice, not a demonstrated cure.

Relaxing activities or support can help manage stress; this may reduce bruxism, with no guarantee. For sleep bruxism, biofeedback is among the options to discuss with your dentist. Before considering it, ask what it aims to change about the clenching and what you would have to do. There is no strong evidence supporting cognitive behavioural therapy for sleep bruxism in adults. If it is offered to you, ask which problem it targets in your situation. Caffeine, alcohol and tobacco are associated with sleep bruxism: talking about them with the dentist helps you examine your habits, without promising that changing them will make the clenching go away.

Reminders are for clenching during the day; biofeedback is an option to discuss for sleep bruxism. None of these options guarantees that bruxism will go away.

For nighttime bruxism, the first step is an assessment by a dentist, who looks for damage to the teeth and sore areas. The dentist may offer a night guard to protect the teeth. With the dentist, you can also discuss sleep-related and lifestyle factors (stress, caffeine, alcohol, tobacco) and biofeedback. None of these options is a cure.

If you are told that you snore loudly, with pauses in breathing, also tell a doctor: these signs may point to sleep apnea, a problem distinct from bruxism, for which a sleep study may be needed.

Hypnosis. Relaxing and reducing teeth clenching are not the same thing. If you are considering hypnosis, specify your goal: managing stress, relieving jaw discomfort or reducing episodes of bruxism. The dentist can examine your teeth and the sore areas; stress management may reduce bruxism, with no guarantee.

Homeopathy. If you take a homeopathic product for teeth clenching, tell your dentist or doctor. During the assessment, the dentist or doctor must distinguish between damage to the teeth, jaw pain and clenching activity; do not change how you take a medication without consulting your prescriber.

Essential oils. If you want to use them to relax, keep in mind the distinction between managing stress and treating bruxism. Work out with your dentist or doctor what you are trying to change, and mention the products you use.

Osteopathy. Relieving pain does not address bruxism: having less jaw pain does not necessarily mean you clench your teeth less. Before considering this approach, have persistent pain, locking or tooth wear examined. The dentist or doctor looks for the underlying cause of these signs.

The masseter is the muscle that closes the jaw; it is the one working when you clench your teeth. The injection may reduce the intensity of the masseter’s contractions. Reducing this intensity does not mean eliminating episodes of bruxism. Findings on bruxism itself are conflicting: this injection is therefore not an established treatment for bruxism, and no cure has been established.

Before any decision, ask the doctor what use they have in mind and which risks are relevant to you; no result is promised. CARE MD does not offer this injection as a treatment for bruxism. It is a neuromodulator injection: neuromodulators are medications that relax muscles in the face. It is given by a doctor, or by a nurse injector supervised by a doctor.

An injection into the masseter also carries risks. When it targets a large masseter, a temporary decrease in chewing strength, bruising, headaches, restricted ability to smile, muscle bulging, a hollow cheek or sagging skin are possible. Discuss these risks with the doctor before deciding.

If your question is about your jawline, the masseter injection is an aesthetic option offered by CARE MD, not a treatment for bruxism. The medical assessment comes before any decision; you can postpone the injection or decide against it.

A dentist or a doctor can identify the cause of pain in the masseter or jaw. Tension or pain in the masseter proves neither inflammation nor bruxism. Pain in the chewing muscles or in the joint, such as jaw stiffness, may also point to a disorder of the jaw joint, distinct from bruxism. Painless jaw clicking is common and does not require treatment.

CARE MD answers your questions about aesthetics. For bruxism, concerns about your teeth or jaw pain, contact your dentist or doctor.