When teeth grinding is frequent and severe, it can cause tooth wear, cracks and fractures, damage to fillings and crowns, and pain in the chewing muscles. However, mild grinding that happens only occasionally does not always cause lasting harm. Treatment is planned according to the type of damage to the teeth and the factors that make grinding worse.
Are Teeth Grinding and Teeth Clenching the Same Thing?
Teeth grinding and teeth clenching are two different forms of a condition known medically as bruxism. In grinding, the lower and upper teeth move while rubbing against each other. In clenching, the teeth are pressed firmly together without moving. Both can occur together during sleep, while clenching is more common during the day.
Most people do not notice for themselves that they grind their teeth at night. It is usually discovered through a sound heard by someone close to them or through signs of wear seen during a dental examination. Why grinding occurs and which symptoms it causes are covered in detail in the article What Causes Teeth Clenching (Bruxism)? What Are the Symptoms?
How Does Teeth Grinding Damage the Teeth?
During grinding, the teeth come into contact outside of chewing and without any food between them. Repeated over a long period, this contact can cause different types of damage to the teeth and surrounding structures.
Wear on Tooth Surfaces
Wear caused by grinding is known medically as attrition. The chewing surfaces of the back teeth can become flattened and the biting edges of the front teeth can become shorter. Flat, shiny wear surfaces that match each other can form on opposing teeth. As the enamel thins, the dentine underneath becomes exposed and sensitivity to hot and cold can develop.
Not all tooth wear is caused by grinding. Erosion caused by acidic foods and drinks or stomach acid also leads to enamel loss. The two can occur together in the same person; enamel softened by acid can wear more easily through grinding. For this reason, the cause of the wear is identified before treatment.
Cracks and Fractures
Repeated high forces can cause cracks in the teeth or fractures of the chewing points known as cusps. Teeth with large fillings or teeth that have had root canal treatment may be more vulnerable. Cracks are not always visible; sudden pain when biting or sensitivity in a single tooth may be the first sign.
Not every crack carries the same level of risk. Which cracks only need monitoring and which require treatment is explained in the article How Can You Tell If a Tooth Is Cracked?
Damage to Fillings, Crowns and Implants
Grinding puts as much strain on restorations as on natural teeth. Fillings can break, porcelain can chip off crowns and crowns can loosen. Implant-supported restorations may also be more likely to develop technical problems such as screw loosening or porcelain fracture. For this reason, a grinding habit is also taken into account when a new restoration is planned, and the choice of material and the need for a protective guard can be decided accordingly.
Strain on the Jaw Muscles and Jaw Joint
Frequent and severe grinding can be accompanied by pain and fatigue in the chewing muscles, tension-type headaches around the temples and disorders of the jaw joint (temporomandibular joint). However, not everyone with jaw pain has bruxism as the cause. The source of the pain is assessed separately with an examination of the muscles and joint.
| Type of damage | Possible findings | Approach that may be considered |
|---|---|---|
| Enamel wear | Flattened chewing surfaces, shortened front teeth, sensitivity | Monitoring the wear, a night guard, repair with fillings or crowns where needed |
| Crack or fracture | Sudden pain when biting, sensitivity in one tooth, a broken-off piece of tooth | Treatment planned according to the type and depth of the crack |
| Damage to restorations | Broken filling, chipped porcelain, loose crown or implant-supported restoration | Repair or replacement, a guard to protect the restoration |
| Muscle and joint complaints | Jaw fatigue in the morning, pain when opening the mouth, sounds from the joint | Muscle and joint assessment, a night guard, supportive approaches |
This table is not intended for diagnosis; it shows that different types of damage may require different approaches.
Does All Teeth Grinding Need Treatment?
No. Mild, occasional grinding may not cause noticeable damage to the teeth, and in this case treatment may not be needed. The dentist can follow the signs of wear over several check-ups to assess whether the changes are progressing.
Treatment is usually considered when there is progressive wear, fractures or problems with restorations, or when muscle and joint pain affects daily life. Teeth grinding is common in children and often decreases as they grow. Even so, if a child has noticeable tooth wear, pain or sleep problems, a dental assessment is needed.
Which Treatments Are Used for Teeth Grinding?
There is no single treatment that completely stops grinding in every case. Treatment plans therefore often have more than one aim: protecting the teeth, repairing damage that has already occurred and reducing the factors that may make grinding worse.
A Night Guard to Protect the Teeth
The most common approach for grinding during sleep is a custom-made night guard. Also called an occlusal splint, this appliance aims to reduce the likelihood of wear and fractures by preventing direct contact between the upper and lower teeth during sleep. Research shows that a guard can help protect the teeth but does not permanently stop the grinding behaviour.
Whether the guard is made from a hard or soft material depends on its purpose and the person's teeth. Types of guards, how they are made and how to care for them are covered in detail in the article What Is a Night Guard? What Does It Do?
If there are complaints suggesting sleep apnoea, such as snoring or pauses in breathing during sleep, this should be shared with the dentist before a guard is planned. Some guard designs can affect breathing in people with sleep apnoea.
Repairing Worn or Broken Teeth
If the damage affects the function, appearance or sensitivity of a tooth, restorative treatment can be planned. Small fractures and wear can be repaired with composite fillings. For teeth with extensive loss of structure, an onlay or crown may be considered. When advanced wear affects many teeth, the bite is also assessed and a comprehensive treatment plan is prepared.
Repair does not remove the cause of grinding. As long as grinding continues, new restorations are exposed to the same forces, so a protective guard may be planned alongside the repair. Which signs mean a crown needs replacing is explained in the article When Should a Dental Crown Be Replaced?
Addressing Factors That May Increase Grinding
Stress and anxiety, sleep problems such as snoring and sleep apnoea, smoking, heavy alcohol and caffeine consumption, and some medicines are associated with teeth grinding. The following steps aimed at these factors may help reduce grinding:
- Managing stress with relaxation techniques, regular exercise and psychological support where needed
- Reducing caffeine and alcohol in the evening and stopping smoking
- Keeping a regular bedtime and a calm sleeping environment
- Being assessed for sleep disorders if sleep apnoea is suspected
- If a medicine is thought to be increasing grinding, speaking to the prescribing doctor rather than stopping it on your own
For people who clench their teeth during the day, becoming aware of the habit is important. When the lips are closed, the teeth should not touch and the jaw should be kept relaxed. Reminders set during the day can help people notice this habit.
Botox and Medicines
Botulinum toxin injected into the chewing muscles temporarily reduces the strength of muscle contractions. Some studies have reported reductions in pain and bite force. However, the systematic reviews on this subject have limited methodological quality, and no definitive conclusion has been reached about how effective botox is for bruxism. Because its effect lasts a few months, the injections may need to be repeated. Botox is generally a supportive option considered in selected cases where other methods have not given an adequate response.
Muscle relaxants may be recommended for a short period in some cases. However, the effectiveness of medicines for bruxism is generally limited. Which medicine is used and for how long is decided by the doctor according to the person's situation.
When Should You See a Dentist?
A dental assessment is recommended in the following situations:
- You notice wear, shortening or increasing sensitivity in your teeth
- Fillings or crowns frequently break or loosen
- You wake up with jaw pain or fatigue in the morning
- People close to you say they hear grinding sounds while you sleep
- Your child grinds their teeth and has pain or tooth wear
Assessment should not be delayed if the mouth cannot be opened or closed, if a piece of tooth has broken off with sharp pain when biting, or if there is swelling and pain that starts on its own. These symptoms do not always require advanced treatment; the cause must be identified first.
Frequently Asked Questions
Does enamel worn away by grinding grow back?
No. Once enamel has worn away, it cannot regenerate. The aim of treatment is to slow the progression of wear and to repair the tooth if the damage affects function or appearance.
Can teeth grinding make teeth loose?
Grinding alone does not cause gum disease. However, in teeth whose gum and bone support has been reduced, excessive forces can increase tooth mobility. A loose tooth also requires the condition of the gums and bone to be examined.
Can worn teeth be repaired without crowns?
Small areas of wear and fractures can often be repaired with composite fillings. Crowns or onlays are considered for teeth with more extensive loss of structure. The choice is made according to the remaining tooth tissue and the bite.
Can someone who grinds their teeth have dental implants?
Grinding does not rule out implant treatment on its own. However, because it may increase the likelihood of technical problems with implant-supported restorations, it is taken into account during planning. The design of the restoration and the use of a night guard can be decided based on this assessment.
Does botox stop teeth grinding permanently?
No. The effect of botox on the muscles is temporary and wears off within a few months. Evidence on its effectiveness for bruxism is also still limited.
Does teeth grinding go away on its own?
In children, grinding often decreases with growth. In adults, it can increase and decrease depending on factors such as stress and sleep patterns. Even if grinding decreases, wear that has already occurred does not heal on its own, so regular dental check-ups are important.
Does clenching your teeth while awake also damage them?
Keeping the teeth clenched for long periods during the day can cause fatigue and pain, particularly in the jaw muscles. The teeth and restorations can also be affected by these forces. Noticing and reducing this habit is important, independently of protective methods such as a night guard.
In teeth grinding, the treatment decision is based not on the presence of grinding itself but on the findings in the teeth, restorations and jaw structures. The degree of wear, whether there are cracks or fractures, muscle and joint complaints and accompanying conditions such as sleep apnoea are assessed together to plan approaches for protection, repair and the triggering factors.
-NHS – Teeth grinding (bruxism)
-Mayo Clinic – Bruxism: Diagnosis and treatment
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