Are you a teeth grinder or a jaw clencher?  

You might not even realize that you’re doing it, especially while you’re sleeping. But your jaw can grit and grind with as much as 250 pounds of force. Ouch! 

Chronic, involuntary teeth grinding – technically called bruxism – can lead to all sorts of health problems. You could crack or fracture your teeth, which may require crowns or dental implants. You could also wear down the enamel on your teeth, leading to periodontal disease or lost teeth. 

Teeth grinding can cause chronic pain in your head, neck and ears. It can lead to migraines, noise sensitivity and tinnitus, said Navy Capt. (Dr.) Cecilia Brown, director of dental services at Naval Hospital, Jacksonville, Florida. 

In the most severe cases, you might need a total joint replacement for the hinge on your jaw. Surgeons can implant a titanium joint. That’s needed when bruxism wears down the jaw cartilage so that moving your mouth grinds bone against bone, Brown said. 

Bruxism, to varying degrees, is common. Up to 30% of people grind their teeth in some way, and estimates suggest that about 10% to 15% of adults suffer painful bruxing during sleep, according to Air Force Lt. Col. Preston Duffin, director of orofacial pain at the 59th Dental Training Squadron-Joint Base San Antonio-Lackland. 

“Most people have some degree of clenching, grinding, muscle guarding or other jaw activity during the day and night that is not associated with normal functioning like eating, talking, or swallowing,” Duffin said. 

Any “evidence of excessive tooth wear” could warrant some treatment, he said. 

Many people don’t fully understand how harmful teeth grinding can be. 

“It’s very difficult to manage, and difficult to get patients to understand” the possible consequences, Brown said. 

Bruxism as a Coping Mechanism 

“You can’t pinpoint one thing” that leads to bruxism behavior, Brown said. But teeth grinding and jaw clenching can be coping mechanisms for stress. Bruxism also shows up in patients with post-traumatic stress. 

Active duty service members on deployment can develop bruxism due to sleep deprivation, stress, or not eating properly. Some people clench their teeth to keep focused, Brown said. 

Teeth grinding can occur during the day and at night. 

“If you have this condition during the day when you’re ‘biting your tongue’” to keep your words in, it’s a coping mechanism that you will likely feel in your jaw muscles when you get home or off-duty and relax, Brown said. 

At night, bruxism occurs during periods of dreaming when your body has more muscle activity. “It’s involuntary and unconscious,” Brown said.  

If your facial muscles are working all the time, “like a body builder’s muscles, they get big, sore and inflamed,” she said.” Eventually, this can cause you to not be able to open your mouth fully. 

Those who have obstructive sleep apnea or fibromyalgia also are susceptible to bruxism. 

Night Guards and Other Treatments 

The first line of defense is to wear a night guard to protect your teeth while you sleep. But that may or may not work. “Some people grind right through the night guard,” Brown said. 

TRICARE covers night guards when medically necessary. 

Typically, “if you are aware of nighttime grinding and wake in the morning with jaw pain or tiredness, then there is a better chance you will be a good responder to night guard therapy,” Duffin said. 

Beyond a night guard, Brown said, there are a variety of treatment options that can reduce the frequency or harm caused by teeth grinding. They include: 

• Physical therapy such as massage, compresses and mouth stretching exercises 
• Yoga 
• Counseling 
• Treatment for acid reflux, which is a factor for bruxism development 
• Nonsteroidal anti-inflammatory drugs 
• Muscle relaxants 
• Botulinum toxin injections (Botox) 
• Anti-anxiety medications 
• A diet limited to soft, non-chew foods 
• Changing pillows if they are not firm enough 

Has the pandemic increased cases of bruxism? Duffin said he can “certainly say there is a greater tendency for patients to complain of higher levels of perceived stress and anxiety, which is likely influencing increased activities like bruxing, jaw pain, and tooth wear.” 

While many people who suffer from bruxism have mild symptoms, in some cases it can become a serious medical condition. 

“Bruxism is a real condition that’s very debilitating,” Brown said. “We need to make sure our medical practitioners can identify it and try to intervene earlier.”