One night last year, after a long day at a work conference, I got back to my hotel room to eat dinner and discovered, to my horror, that I couldn’t open my mouth. It just… wouldn’t open. Fortunately, this bizarre episode didn’t last long—the evening ended with me managing to painfully pry my jaw open about half an inch, which was enough to force-feed myself a plate of room-service pasta… glamorous #BusinessTripLife, right?
To my surprise, I later learned that the symptoms were caused by grinding my teeth in my sleep—something I didn’t even know I had been doing. Teeth grinding, also called bruxism, is startlingly common: Some metrics estimate that this repetitive, involuntary movement, a clenching of the jaw muscles, can affect up to 16 percent of the population. Some people grind their teeth during the day, but many do so in their sleep—often without even realizing it’s happening.
While there are different medical explanations as to why bruxism happens, and each case is different, most experts trace the majority of their clients’ cases back to either a bite imbalance or stress. “Grinding one’s teeth is a way your body is coping with stress,” says Kruti Patel, D.M.D. “It releases an endorphin in your brain, which makes your brain feel good, and you continue to grind.”
How bad is grinding your teeth, really?
Since teeth grinding is so common, it’s easy to assume that it’s nothing more than a minor annoyance. Sure, there are those wild cases of people forced into dentures at 50, you might tell yourself, but for most people, it doesn’t really matter, right? Well, kind of. The extreme cases are rare, but according to the experts, grinding on a regular basis is definitely not ideal.
Extreme cases are called “extreme” for a reason—they don’t happen to everyone. If you only grind your teeth occasionally, you may never develop any dental issues from it. Even regular grinders aren’t necessarily doomed to early dentures, but consistent grinding over time can lead to pretty intense dental wear and tear. You could experience tooth cracking, bone loss around the roots of your teeth, and sometimes even loss of the teeth themselves. “Excessive force on your teeth can cause cracks in your teeth,” Patel says. “Depending on the crack, you may need anywhere from a filling to an extraction.”
You may also experience enamel loss. “Once enamel is lost, it is lost forever,” says Robert C. Rawdin, D.D.S., co-owner of Gallery 57 Dental in Manhattan. “It can only be restored through the restoration of the teeth.” Restoration involves the use of methods like bonding, porcelain crowns, or veneers.
Tooth grinding can also lead to pain in the joints around your jaw, as well as migraines caused by the exertion of your jaw muscles. Ron Rosenthal, D.D.S., a retired dentist and dental educator, explains the migraine-bruxism connection by comparing the experience to a leg cramp—only way worse.
“The chewing muscles are the strongest in the body,” Rosenthal says. “They are far more powerful than the calf muscle in your leg. If you’re like most of us, you’ve had a leg cramp at some time or other. It felt kind of like someone stabbed you in the calf muscle with an ice pick, right? Remember, the calf muscle is nowhere near as powerful as the chewing muscles—now, imagine that same kind of spasm in the chewing muscles on the side of your head.”
Oof. Is your jaw hurting yet?
When it comes to treatment, lots of dentists recommend custom-made night guards to wear when you sleep, which can buffer your teeth from the damage of the grinding. You can also buy night guards off the rack at a store, but they haven’t been fitted to your individual bite, so you might not see the same results. That said, there are some dentists who feel that the results of night guards aren’t worth the trouble, and if your bruxism is triggered by a bite problem rather than stress, they might opt to focus on dental intervention that can correct an unbalanced bite.
“The jaw muscles want to be in a comfortable orientation,” says Benjamin Lawlor, D.D.S., of Maine Cosmetic Dentistry. “When this doesn’t happen, the muscles will uneasily shift back and forth trying to find that comfortable position.” As you can imagine, this leads to grinding and pain—so if your dentist can get to the root of the problem by helping you adjust your bite, it’s probably worthwhile.
There are other potential solutions—if you’ve got an open mind.
When it comes to bruxism that’s triggered by stress, there are all kinds of wacky remedies that have been tried to varying success. Some of these options are backed by solid research, while others are just beginning to be explored, although there’s reason to believe they can work. Here are a handful of promising solutions for teeth grinding—and info about the current research surrounding each.
Yep, really! While Botox won’t “cure” grinding, it can drastically reduce the symptoms for some patients, and each treatment lasts for several months. It’s not a fit for everyone, and it’s a bit divisive among experts, but some bruxism sufferers have described Botox as life-changing. The solution can paralyze or slow the activity of some of the muscles around your jaw—which can lead to a whole lot less pain from clenching or grinding.
“For nocturnal teeth grinding, I inject a small amount of Botox into the masseter muscle—the big round muscle under the ears at the angle of the jaw you can feel when you bite down with your mouth closed,” explains Charles Crutchfield, M.D., clinical professor of dermatology and medical director at Crutchfield Dermatology. “It does not work for everyone,” he says. “But in my experience, it gives significant relief to about three-quarters of those who suffer from teeth grinding during sleep and wake up with sore jaws and headaches.”
Plenty of professionals are recommending Botox these days, but others aren’t convinced. One dentist even laughed when I asked him if he’d ever recommend the treatment. Early research isn’t very substantial on either side of the debate just yet, but it’s worth noting that two small studies pointed to Botox as a positive option, with one noting that Botox “effectively and safely improved sleep bruxism.”
On the other hand, another small study found that Botox led to bone density loss in rabbits. (Reminder: You are not a rabbit, and non-human studies should be taken with a small bucket of salt.) All in all, just be sure to consult with a dentist or medical professional before you try it.
2. Cognitive Behavioral Therapy
Cognitive behavioral therapy is a form of short-term talk therapy that explores the thoughts behind your behaviors and feelings. CBT helps you build healthier habits and thought associations to empower you to ditch negative patterns in your life.
Initial research has hinted that CBT could help with treating bruxism, but more data is needed to find a conclusive and clear connection. “CBT may help treat underlying anxiety that causes bruxism, but a night guard definitely helps protect against the consequences,” says psychiatrist Sandip Buch, M.D. CBT, founder of Skypiatrist.
This form of therapy can be incredibly effective when it comes to managing stress and breaking unwanted habits, so as you can imagine, it has the potential to be a good fit for stress-fueled bruxism.
According to the Bruxism Association, research has indicated that hypnosis has had a positive impact on some bruxism suffers for more than two years after treatment. Like other treatments, hypnosis might not work for everyone, but if you’re down to “get sleepy… very sleepy,” it could be worth a shot. You can undergo hypnosis in person—or, if you’re looking for something more low-key, you can download or buy hypnosis recordings created especially for bruxism.
Tapping, also known as the Emotional Freedom Technique (EFT), is a therapeutic method of “psychological acupressure” that takes its cue from certain key facets of acupuncture. Instead of acupuncture needles, the treatment involves tapping with your fingers on designated pressure points on your body. Many bruxism sufferers have said it works wonders, but there’s not much research on the topic. Research has found, however, that EFT is beneficial in treating PTSD, so there’s certainly a possibility that it could help with stress-related habits as well.
5. General De-Stressing
Because teeth grinding can be driven by stress, both physicians and more holistic-leaning practitioners have suggested relaxing at night. “Find ways to relax and de-stress before bed, such as getting a massage, using a warm compress, and avoiding alcohol and caffeine,” says certified personal trainer Caleb Backe of Maple Holistics. Yoga, stretching, meditation, or any kind of self-care routine you’d usually use to de-stress is a good bet.
Claire Hannum is an NYC-based writer, editor, and traveler.