Teeth-grinding could signal sleep problems
December 6th, 2011
07:53 AM ET

Teeth-grinding could signal sleep problems

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

Zach was a life-long teeth grinder.

“It seemed that as soon as his teeth came in, he started grinding," his mother told me.

It was so loud and frequent that Zach was given his own room because his little brother couldn't get any sleep when they shared. For years he had slept at the end of the hall far from his parents’ and his brother’s room, so one suspected that the grinding was getting worse.

When a dentist noticed a progressive worsening of wear on his patient's teeth, he discussed his concerns about a possible underlying sleep disorder with both Zach and his mother. They then came to me.

Sleep-related bruxism is the official term for grinding your teeth during sleep. It occurs in approximately 14% to 17% of children, although these rates decrease with age. Bruxism does show a familial pattern but no genes have been identified. It affects both sexes equally.

Nocturnal grinding can cause not only extensive wear on your teeth, but also jaw and facial pain, headaches, and when it is severe, it can cause sleep disruption that results in daytime drowsiness.

There are two types of bruxism. If there's no clear cause, bruxism is termed "primary." Secondary sleep-related bruxism has been associated with various other disorders, as well as the use of psychoactive medications and recreational drugs.

An overnight sleep test is not always necessary. However, a careful evaluation by a sleep specialist is warranted if, as in this case, the grinding is becoming worse rather than better with age. Bruxism must be distinguished from partial complex seizure, facio-mandibular myoclonus and sleep disordered breathing.

Often, grinding can be an accompanying feature of obstructive sleep apnea and confusional arousals, and it can improve with treatment of the underlying sleep disturbance.

Even in the absence of a clear psychiatric or medical cause, sleep specialists often note heightened stress and anxiety as a predisposing factor. Some specialists have found an association with a Type A personality or someone who is hyper-vigilant and easily aroused from sleep.

In Zach’s case, we figured out that he did have a lot if increased stress due to his busy academic and extra-curricular schedule. He was also worried about getting into a good college and was working around the clock to assure his success. He was stressed in the daytime and it carried over into his sleep. We ruled out any other sleep or medical problems. His dentist made him a bite guard to protect his teeth at night.

He and his parents worked on simplifying his schedule, ensuring adequate time for sleep. They also talked a lot more about his college application process which, Zach admitted, really made him feel less alone and less anxious about the outcome.

If you are - or suspect you are - a grinder, see your dentist to evaluate if there is any damage to your teeth. A visit to a sleep specialist is warranted if there are other symptoms.

soundoff (60 Responses)
  1. Bubba

    I grind my teeth whenever I see a news story about Donald Trump.

    December 6, 2011 at 09:54 | Report abuse | Reply
  2. tamara reina

    Well according to research that may be true, but it depends on what stage of sleep a person is in. There are several stages before that can appear there are some control there under a doctor supevise care.

    December 6, 2011 at 10:25 | Report abuse | Reply
    • bella01

      wow. i grind my teeth as well. 🙁

      December 16, 2011 at 15:25 | Report abuse |
  3. Fellow tooth grinder

    You can get an occlusal guard from your dentist to help protect your teeth. They make a mold to fit your mouth and it's quite comfortable.

    My grinding was related to stress. Once I alleviated some of that the grinding subsided.

    December 6, 2011 at 11:29 | Report abuse | Reply
    • Barbara olminsky

      Mini Comfort makes a Clench Guard that is soft, flexible, virtually invisible, does not interfere with speech and can be worn during the day at work and social situations. http://www.originalminicomfort.com

      February 17, 2014 at 10:42 | Report abuse |
  4. Lynn

    How can they contribute it to stress if he has done it every since his teeth came in? He didn't have those same fears, stresses, and concerns of college, and accomplishments at the age of 2 or 3. Seems to me that possibly more needs to be researched.

    December 6, 2011 at 11:59 | Report abuse | Reply
  5. Amber

    My husband has been grinding his teeth since he was a small child. His is related to his Turrets Syndrome. Bruxism is also a part of that diagnosis as well. He has worn a mouth guard to bed as long as we've been married because I can not sleep from the sound he makes and his teeth were disappearing.

    December 6, 2011 at 12:50 | Report abuse | Reply
  6. Leaf on the Wind

    ". . . sleep specialists often note heightened stress and anxiety as a predisposing factor." In other breaking news, water is wet.

    December 6, 2011 at 12:52 | Report abuse | Reply
  7. Muktuk Wolfsbreath, Hard-boiled Tribal Shaman

    I grind my teeth in a pestle, adding dried lizards and frogs, then dump them on the fire during the incantation.

    December 6, 2011 at 14:50 | Report abuse | Reply
  8. wendy5

    i grind and clench; i broke a bone ; get a mouth guard everyone should have one it instantly worked for me ; neck stiffness anxiety;everything; since i was little i was grinding; dentists every 6 months and i would tell them and not one ever suggested a mouth gaurd ;and still didnt recommend one after my bone cracked ;all they want to do is xray you; more greedy medical idiots;

    December 6, 2011 at 16:38 | Report abuse | Reply
    • shimsdoc

      Glad to read your blog from 2011. Hope you are still doing well with your night guard. I am a general dentist and I believe everybody grinds some more obvious than others. Please check out our site http://www.getshims.com and read our testimonials. Hope you can relay others to us that we can help.

      January 29, 2013 at 09:43 | Report abuse |
  9. Jo

    I used to repeat to myself 10 times each night: "I will relax my jaw instead of grinding my teeth". I trained myself to stop grinding in just a few months. I also trained myself to stop tensing up my upper and lower body muscles 24×7. It's not rocket science.

    December 6, 2011 at 18:21 | Report abuse | Reply
  10. BEE

    i have been grinding my teeth since i can remember i dont not have the pain that comes with it. i go to the dentist and asked if there was any signs or future problems if i continued to grind my teeth he said there was no damage and if there is no pain i should be fine...
    so what does that mean?
    i tried to wear a mouth guard but the next morning from using it i was very sore in my jaw and teeth along with stiffness can anyone explain this?

    December 6, 2011 at 19:23 | Report abuse | Reply
    • queen bee

      You've been lucky so far.
      I've fractured teeth due to clenching and grinding. All required root canals and crowns. Some required repeat root canals. I'm wearing braces for the third time, although getting back that "perfect bite" would require breaking my jaw and I'm not going to that extreme.
      I have TMJ, jaw soreness now and then, difficulty opening and also biting into certain foods.
      Although I'm wearing Invisaligns, they aren't stopping me from grinding my front teeth. Woke myself up the other night doing just that. Noticed the next morning that there is enamel loss on some of my lower teeth. 🙁
      Can't wait for orthodontia to be complete so the dentist can make a nightguard.

      December 7, 2011 at 04:06 | Report abuse |
    • shimsdoc

      Research shows that everybody grinds their teeth. Some more obvious than others. It is very important to wear a night guard every night to protect your teeth and to relax your jaw. Go to http://www.getshims.com to read our testimonials to see how we were able to help a lot of people. I am a general dentist and I am a severe grinder too.

      January 29, 2013 at 09:46 | Report abuse |
  11. Helen

    I read an intelligent article last year about nighttime teeth grinding. One of the main suggestions was to completely stop drinking coffee and all forms of caffeine, including chocolate. I went cold turkey and had to take a pain reliever for a week for the caffeine headaches. Before 10 days were up, my headaches were gone, my eyes were clear, AND I stopped grinding my teeth!! I was fine until fall came and cold weather. I starting drinking coffee again and now I'm waking up grinding again. I don't like decaff or green tea. But I will suggest to someone who really wants to stop the grinding to quit caffeine 100%.

    December 6, 2011 at 20:59 | Report abuse | Reply
    • BJ

      Thank you!

      January 7, 2012 at 12:52 | Report abuse |
    • Daniela

      bravoo.............st.george we win it! oh bunna plasee try to be our compitative.long live ethiopia!!!!!!!!long live st. george!!!!

      February 1, 2012 at 01:53 | Report abuse |
    • Chikhaoui

      I work in a busy office in Anchorage, and most of the tniteaps I see have tried some sort of whitening. OTC or in office. I have worked in this office for 8 1/2 yrs and we had an in office bleaching system when I started and we became unhappy with it, the results just were not there. We tried differant ways to do it and found nothing changed. We did a promotion ,at one point with NP, they recieved a free set of bleach trays wit the first syringe of bleach gel. we have tried to find a in office bleaching system without using a light, and have been insuccessful. I see 8-9 tniteaps a day and almost half have tried Crest strips. They are the only OTC product we recommend. I have seen great results with that, so for the $ and for the time invested it seems more tniteaps are going for the inexpensive strips, and they are satisfied with the results. We also do Invisalign in our office and they can use their aligners for bleach trays, so that is a double bonus for them. I bleached my teeth years ago, I have veneers and do not need to any longer, but I remember alot of sensitivity. I do think that we are missing out in our practice by not promoting the bleach trays or some sort of in office bleaching system. We have just changed owners of the practice, so hopefully we will see some more interest in finding one we like.

      April 8, 2012 at 04:28 | Report abuse |
  12. Kim

    I've ground my teeth ever since I was little and I don't think it had anything to do with stress. Finally, at 29, I got a night guard from my dentist because he said I had the molar wear of a person in their 60s! And I know I still grind my teeth, because a few nights I didn't wear it and the next morning I noticed that I had chipped the corners of my lower teeth. I'm still mad at myself about that!

    I don't chew gum, the only caffeine I have is one cup of coffee in the morning. I limit my total sugar intake (both from natural sugars like fructose from fruit, as well as added sugars), have never had a cavity or any dental work other than braces. I don't know what else to do about my bruxism, except continue wearing my night guard :/

    December 6, 2011 at 21:05 | Report abuse | Reply
  13. Susan

    I was a grinder for years. I used a night guard and ground it down until it had to be built-up several times. I was finally diagnosed as having Restless Legs Syndrome (RLS). Once I began medication for my legs, my sleep was more restful, and I stopped grinding. I wonder if anyone else has made this connection?

    December 6, 2011 at 21:19 | Report abuse | Reply
  14. fred gray

    i used to grind my teeth when i was a teenager. afraid of damaging my teeth i would fold up the corner of my sheet and put it in my mouth to soften the grinding. i should have talked to a doctor about it but fortunately i outgrew it. that was 30 years ago and my teeth are fine now.

    December 6, 2011 at 21:21 | Report abuse | Reply
    • Oetriz

      You don't even want to get me sttraed with my dentist stories. My mouth has been a basket case since I was a young boy. I once had 13 cavities in one visit! My parents were about ready to trade me in. Over the years, I have had more crowns, root canals, bridges, you name it, than I can even remember – even if I wanted to. I think I must have put several dentists' kids through college and paid for a couple of cruises too. The one good thing is that I have had pretty much all of it before, so nothing scares me about the dentist anymore. This is nice, because I used to lie awake at night worrying about going to the dentist. But the only thing I worry about now is how am I going to pay for it. Good luck with your dental issues.

      February 1, 2012 at 05:27 | Report abuse |
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      February 3, 2012 at 06:20 | Report abuse |
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      February 4, 2012 at 05:28 | Report abuse |
  15. Tooth Fairy

    I grind up the teeth I collect so they don't take up so much space.

    December 7, 2011 at 13:36 | Report abuse | Reply
  16. Birmingham Chiropractor

    Here at Birmingham Chiropractic we find that many people grind their teeth due to stress. Birmingham back pain sufferers with high amounts of stress have these symptoms! We find that regular Chiro adjustments can relieve some stress and rid you of horrindous teeth grinding!!!

    December 7, 2011 at 15:17 | Report abuse | Reply
  17. Bmore

    If you want to give yourself a case of bruxism, go to law school. The stress I'm under right now during finals is unreal, and the constant headache I have from developing stress-related bruxism doesn't help at all.

    December 8, 2011 at 12:13 | Report abuse | Reply
  18. Mark

    I started doing it after graduate school. I went back to school for social work and I have been grinding ever since. I think it has to be stress related in my case. I wonder if I got a job as a flourist if it would go away.

    December 11, 2011 at 22:48 | Report abuse | Reply
  19. Rachel

    TMJ Mouth Guard

    December 15, 2011 at 13:50 | Report abuse | Reply
  20. The Ronbot Hunter

    The symptom doctor will not tell you to take a calcium and a B Complex vitamin to permanently solve your sleep problems.

    You are very deficient in these nutrients and he will not make another dime on you if he admits the truth.

    The U.S. Federal Corporation has blocked the real cure for many illnesses.


    December 20, 2011 at 17:13 | Report abuse | Reply
  21. iwearglasses

    I can solve my problem give me 3.2 million dollars an i bet i will stip haha

    December 21, 2011 at 17:44 | Report abuse | Reply
  22. epeck

    Magnesium deficiency can cause bruxism. Many people understand the need to supplement calcium (which helps muscles contract), but many fewer understand that they also need ample magnesium in the diet to help muscles relax.

    January 3, 2012 at 11:10 | Report abuse | Reply
  23. bruxer

    I know from experience SSRIs can cause major bruxism for some people.

    January 5, 2012 at 22:55 | Report abuse | Reply
  24. Tom

    I never ground my teeth until i started going to a Catholic School.

    January 10, 2012 at 06:29 | Report abuse | Reply
  25. BA

    TMJ can be hereditary, a poor bite, as well as caused by stress. This is a very poorly reported and written article. It is missing a lot of scientific evidence, and should have talked to more experts about the condition.

    January 14, 2012 at 00:33 | Report abuse | Reply
  26. Samuel Bogale Calgary Alberta

    My son used to be a grinder but I was very happy when he grew out of it!

    January 19, 2012 at 14:40 | Report abuse | Reply
    • Ali

      Appropriate pic of day Trixie looks like the towering oatmic baby again. It's like you took a psych eval test where you draw your family. Here, you, Ben are very small, and Trixie is big and scary. And she thinks it's amusing she's drunk with power. Baby is boss. Perhaps we should charge Trixie w/abuse of her parents and send her to baby court for an adjudication. Baby court was a brainchild borne of similar frustations with Sophie.p.s. on a more practical note, could it be teething? Nevermind, why bother wasting the energy w/the why s, just accept your powerlessness

      April 8, 2012 at 13:22 | Report abuse |
  27. Wendy

    Often times, bruxism (tooth grinding) is controlled by your central nervous system. In Other words, your brain tells you to grind. Stress can make it worse, but is not the initial cause of the grinding. Since you can't completely stop the grinding, wearing a mouth guard can keep you from causing irreversible damage to your teeth!

    January 31, 2012 at 10:40 | Report abuse | Reply
    • shimsdoc

      please go to http://www.getshims.com and read our testimonials. Our skinny shims have helped many and hope you can direct others too.

      January 29, 2013 at 09:52 | Report abuse |
  28. Sun Lee

    I've been suffering from bruxism for a lot of time now. Teeth grinding in one major discomfort.. It also affected sleep and then the doctor recommended a light dosage of sleeping pills. I also took muscle relaxers for quite a while. It has been a few months since I am better but it is still not fully cured.
    I have been reading up a lot. Ex. http://teethgrindinginsleep.com/ The information you mentioned is quite helpful. Thanks for posting for all of us

    April 28, 2012 at 17:24 | Report abuse | Reply
    • shimsdoc

      go to http://www.getshims.com and read our testimonials. Hopefully we can help you too.

      January 29, 2013 at 09:54 | Report abuse |
  29. Brisbane Dentist

    I know of someone who had this kind of bruxism that even when they are not asleep, they still grind. And I do not know if what kind of stress was that. But thanks for sharing this matter to us and More power!


    April 29, 2012 at 00:19 | Report abuse | Reply
  30. ametepe thomas

    hi to work on smoking

    April 30, 2012 at 15:21 | Report abuse | Reply
  31. Ari Sevin

    Nightguards protect enamel but they don't stop the clenching behavior – in fact, my nightguard actually stimulates it, causing even more pain. The only thing I have found that is lessening my clenching behavior is a biofeedback headband called the SleepGuard System. It's not a medical device, it simply beeps when you start clenching, signaling you to stop. The only way to stop clenching is to become aware of it, and that's exactly what biofeedback does. It has completely improved my quality of life, I can't say enough about it.

    June 4, 2012 at 17:47 | Report abuse | Reply
  32. katestwins

    As a dental hygienist, I see so many people daily that struggle with grinding at night, or bruxism. Many times it can be stressed induced but that's not always the case, especially if they have been grinding their teeth at night for a long time, some since childhood. I will recommend a night guard, which doesn't stop the grinding but then they're grinding the guard and not their actual teeth. I'll also recommend they try journaling to see when they might grind more frequently. Some have said by journaling, they noticed they grind more when it's their monthly meeting at work, or whenever their kids/husband are stressed, or even when the inlaws come to visit! Not kidding! That could be weekly or a few times a year depending on how close they live of course. It really can be something simple that happens at different times in your life.

    I found this link that made some really valid points about bruxism. A gentleman explains how he has struggled with severe bruxism since childhood, to the point of wearing through an actual sports mouthguard in ONE night- holes and all. Now that is severe. He has found different everyday techniques that can totally stop the bruxism. I was intrigued myself and thought I would share the link with any of you that may be interested. I would love to hear your thoughts on it and any other information you learn on bruxism, as it helps me help my patients! Here is the link,

    Click Here!

    December 8, 2012 at 15:08 | Report abuse | Reply
    • shimsdoc

      Pls. go to http://www.getshims.com and direct other people that you know that we may be able to help too.

      January 29, 2013 at 09:56 | Report abuse |
  33. katestwins

    Click Here!

    December 8, 2012 at 15:11 | Report abuse | Reply
  34. katestwins

    Not sure why the link wont post. Im going to try it again.
    Click Here!

    December 8, 2012 at 15:14 | Report abuse | Reply
  35. katestwins


    December 8, 2012 at 16:33 | Report abuse | Reply
  36. Kenny Porter

    Very informative article. This is an alternative to high priced dental night guards. http://sentinelmouthguards.com/about-night-guards/
    Hope this helps!

    September 3, 2013 at 05:30 | Report abuse | Reply
  37. Brenda Harris

    My father use to grind his teeth whenever he is sleeping. My mother is really concerned and bothered by how my father sleeps. So I look for a site who can explain what are the causes my father grind his teeth. I just bumped to placidway.com and I just found out that he also has a sleeping disorder. I immediately told it to my mother and make sure dad would see a doctor. And after that he had minimized his teeth-grinding motion whenever he sleeps.

    May 21, 2014 at 22:40 | Report abuse | Reply
  38. sociallisterine

    This is serious problem you should always take care of your kid and try to help him out to get rid of this habit . To know more about teeth grinding and cause watch this video

    September 15, 2014 at 02:06 | Report abuse | Reply
  39. Lakeshl

    Once i got my teeth gums taken off from thier place , whenever i am eating i feel always pain , because the smaller particles will settle in the gap which creates a lot of pain. And the another which i was facing is i feel my teeth facing outwards. I feel uncomfortable to have a teeth like that . I thought of consulting a dentist. I heared that Srdh dentist hospital is good(http://www.srdh.co.in/best-dentist-in-chennai.html) is it so?..please suggest

    January 14, 2015 at 03:46 | Report abuse | Reply
  40. Shenu Patel

    Grinding teeth is the common problem in the age of teenage. However there are solution for it. But I consulted Dental Clinic In Delhi, they have asked me to do some basic mouth exercises. In few months I get the positive result.

    January 23, 2015 at 01:46 | Report abuse | Reply
  41. M Irfan ASif

    i face problem during sleep. i grind my teeth in sleep soo loudly. please somebody advised me the reason of it and solution. i am already use albanda tablets for this purpose consutate my doctor. i am so worry about it so and in want to release from it.cell No.0092 346 7700392

    March 14, 2015 at 03:09 | Report abuse | Reply
  42. M Irfan ASif

    i face problem during sleep. i grind my teeth in sleep soo loudly. please somebody advised me the reason of it and solution. i am already use tablets for this purpose advised my doctor. i am so worry about it and i want to releasing from it.cell No.0092 346 7700392

    March 14, 2015 at 03:14 | Report abuse | Reply
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