The short answer: Teeth grinding (bruxism) means clenching or grinding your teeth, either while you sleep or while you’re awake, and about 1 in 5 people do it. In otherwise healthy people, experts now see it as a behavior rather than a disease, but it can wear down or crack teeth and cause jaw pain and headaches. Sleep grinding is driven mainly by the brain during brief arousals from sleep, while stress is linked mostly to daytime clenching; alcohol, smoking, heavy caffeine use and some antidepressants may add to the risk, and a misaligned bite plays little role. There is no cure, but a night guard made by your dentist protects the teeth, and becoming aware of daytime clenching may help. Botulinum toxin injections reduce jaw muscle activity, though the evidence is still limited.
Bruxism covers two related behaviors. Sleep bruxism is jaw muscle activity during sleep, which can be rhythmic grinding or sustained clenching, while awake bruxism involves repeated or sustained tooth contact or bracing or thrusting of the jaw while you’re awake (Lobbezoo et al., 2018). Both are common: a 2024 meta-analysis estimated that about 22% of people worldwide have bruxism, with sleep bruxism affecting about 21% and awake bruxism about 23% (Zieliński et al., 2024).
This guide explains what bruxism is, what causes it, the signs to look for, how it can damage your teeth and which treatments the research supports, from night guards to habit changes and injections.
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What is bruxism?
An international group of experts defines sleep and awake bruxism as activities of the chewing muscles that happen during sleep and wakefulness respectively. Importantly, they concluded that in otherwise healthy people, bruxism should be seen as a behavior rather than a disorder, one that can be a risk factor, or sometimes even a protective factor, for certain health consequences (Lobbezoo et al., 2018). That shifts the focus from “curing” bruxism to preventing the damage it can cause.
How common is teeth grinding?
Very. Beyond the 22% global estimate (Zieliński et al., 2024), a 2025 meta-analysis of 94 studies found that about 26% of adults in the general population report possible awake bruxism, and about 16% have probable awake bruxism based on a clinical examination. Awake bruxism was much more common in people with jaw joint and muscle disorders (temporomandibular disorders, or TMD), affecting about half of them (Stanisic et al., 2025).
What causes teeth grinding?
There is rarely a single cause. Bruxism appears to be regulated mainly by the brain rather than by the teeth (Lobbezoo & Naeije, 2001), and several factors seem to contribute.
Sleep arousals
Grinding during sleep is linked to brief arousals, short shifts toward lighter sleep. The role of breathing problems during sleep, such as obstructive sleep apnea, is still being studied (Lavigne et al., 2008).
Stress and anxiety
Stress and anxiety are linked mainly to clenching while awake, and there is no clear evidence linking them to grinding during sleep (Manfredini & Lobbezoo, 2009); awake bruxism is more strongly associated with psychological factors than sleep bruxism (Stanisic et al., 2025). Our guide to how stress affects your teeth and gums covers the wider picture.
Alcohol, smoking, caffeine and drugs
A systematic review linked alcohol use, smoking and very heavy coffee drinking (more than 8 cups a day) to a higher risk of sleep bruxism, although the evidence was limited (Bertazzo-Silveira et al., 2016). Normal coffee intake is a separate question; see is coffee bad for your teeth.
Medicines
Some antidepressants, including fluoxetine, sertraline and venlafaxine, have been reported to trigger teeth grinding as a side effect, although how often this happens is unknown (Garrett & Hawley, 2018). Don’t stop a prescribed medicine on your own; talk to your doctor if you notice grinding after starting one.
Your bite and your genes
Uneven or missing teeth were once thought to be a main cause of bruxism, but they are now thought to play only a small role, if any (Lobbezoo & Naeije, 2001). Family and twin studies suggest that bruxism is partly inherited and tends to run in families (Lobbezoo et al., 2014).
What are the signs of teeth grinding?
Sleep grinding often goes unnoticed until a partner hears it or a dentist spots the wear. The NHS lists these common signs (NHS, 2026):
- Jaw pain, which can develop into a temporomandibular disorder (TMD)
- Worn or broken teeth, which may become more sensitive
- Headaches
- Earache
- Disrupted sleep, for you or a partner who hears the grinding
Can teeth grinding damage your teeth?
Yes. Persistent grinding can damage the teeth and cause pain (Lavigne et al., 2008), and bruxism is associated with tooth wear and with fillings and other restorations failing (Stanisic et al., 2025). Worn teeth can also become more sensitive (NHS, 2026); see why teeth become sensitive.
Bruxism has also been linked to temporomandibular disorders, which cause jaw pain, clicking or locking, but studies that measured bruxism more precisely found a much weaker link than studies that relied on self-reports (Manfredini & Lobbezoo, 2010).
How is bruxism diagnosed?
Usually by a combination of what you report and what your dentist sees, such as wear patterns on the teeth. In research and in complex cases, instruments can measure jaw muscle activity directly, using electromyography or an overnight sleep study (polysomnography). Experts advise against applying a simple yes-or-no cut-off in otherwise healthy people and suggest assessing bruxism along a continuum instead (Lobbezoo et al., 2018).
How do you stop grinding your teeth?
There is no proven way to stop bruxism completely, so treatment aims to protect the teeth, ease symptoms and reduce triggers.
Night guards (occlusal splints)
A night guard is a plastic appliance worn over the teeth during sleep. A Cochrane review found too little evidence that splints stop sleep bruxism itself, although they may help limit tooth wear (Macedo et al., 2007), and a later review found that oral appliances tended to reduce grinding events, with no clear difference between splint types (Minakuchi et al., 2022). A 2026 meta-analysis of 36 studies found that splints and botulinum toxin injections relieved bruxism-related pain to a similar degree; splints mainly provide mechanical protection, and the authors concluded they are the preferred conservative option when protecting the teeth is the main goal (Aldosari et al., 2026). Your dentist can advise which type suits you.
Managing daytime clenching and stress
The NHS suggests relaxation techniques, good sleep habits and, for pain, over-the-counter painkillers (NHS, 2026). Because awake clenching is closely tied to stress (Manfredini & Lobbezoo, 2009), noticing when you clench and finding ways to manage stress are sensible first steps, although they haven’t been well tested. For sleep bruxism, the benefits of cognitive-behavioral therapy are not well supported, while biofeedback has reduced some measures of grinding in studies (Minakuchi et al., 2022).
Botulinum toxin injections
Injecting botulinum toxin into the chewing muscles consistently reduced jaw muscle activity measured by electromyography in a 2026 meta-analysis, but this didn’t reliably translate into less grinding when measured by questionnaires or sleep studies, and the review found no direct evidence of benefit for pain or function. Side effects were mild and short-lived (Val et al., 2026). Some studies report faster short-term pain relief than with splints (Aldosari et al., 2026), so injections are best seen as an option for people who don’t respond to conservative treatment.
Medicines
Some medicines, including clonazepam and clonidine, have reduced specific measures of sleep bruxism in studies, but side effects were reported, and larger, longer trials are needed (Minakuchi et al., 2022). They are not a routine treatment.
Lifestyle changes
Because sleep bruxism has been linked to alcohol, smoking and very heavy caffeine intake, cutting back on these may help, although this hasn’t been proven (Bertazzo-Silveira et al., 2016; NHS, 2026).
Bite correction
Adjusting the bite with braces or by reshaping teeth is unlikely to stop grinding on its own, since bite problems play little role in causing it (Lobbezoo & Naeije, 2001; Lavigne et al., 2008). Your dentist may still repair teeth damaged by grinding.
What it means for you
If your partner hears you grinding
Mention it at your next dental visit so your dentist can check for wear and discuss whether a night guard would help (Aldosari et al., 2026).
If you wake with a sore jaw or headache
These can be signs of sleep bruxism (NHS, 2026). A dentist can look for other signs, and simple pain relief and relaxation may ease symptoms in the meantime.
If you clench during the day
Notice when it happens, such as while concentrating or under stress, and try to relax your jaw. Awake clenching is closely linked to stress (Manfredini & Lobbezoo, 2009).
If you recently started an antidepressant
Tell your doctor if grinding started afterward; it is a reported side effect of some antidepressants (Garrett & Hawley, 2018).
Questions to ask your dentist
- Do my teeth show signs of grinding or clenching?
- Would a night guard help me, and what type?
- Is my jaw pain related to grinding?
- Do any of my teeth or fillings need repair because of wear?
- Should I be checked for a sleep problem?
When to see a dentist
Book a dental visit if:
- Your teeth look worn, chipped or flattened, or have become sensitive.
- Your jaw hurts, clicks or locks.
- You often wake with headaches or a sore jaw.
- A partner hears you grinding at night.
See your doctor if you need help with stress or anxiety (NHS, 2026). For severe pain, swelling or a broken tooth, see what to do in a dental emergency.
The bottom line
Teeth grinding is common, affecting about 1 in 5 people, and in healthy people it is now seen as a behavior rather than a disease. Sleep grinding is driven mainly by the brain, while daytime clenching is closely tied to stress; alcohol, smoking, heavy caffeine and some antidepressants may add to the risk, and the bite plays little role. There is no cure, but a night guard protects the teeth, habit awareness may help with daytime clenching, and botulinum toxin is an option when other treatments fail. See a dentist if you notice worn teeth, jaw pain or morning headaches.
References
Aldosari LIN, Chauhan E, Kaur K, Saini RS, Binduhayyim RIH, Asiri KA, et al. (2026). Occlusal splints versus botulinum toxin for the management of clinical sequelae associated with adult sleep bruxism: A systematic review and meta-analysis. Cranio. Advance online publication, 1–17. https://doi.org/10.1080/08869634.2026.2683509
Bertazzo-Silveira E, Kruger CM, Porto De Toledo I, Porporatti AL, Dick B, Flores-Mir C, et al. (2016). Association between sleep bruxism and alcohol, caffeine, tobacco, and drug abuse: A systematic review. Journal of the American Dental Association, 147(11), 859–866.e4. https://doi.org/10.1016/j.adaj.2016.06.014
Garrett AR, Hawley JS. (2018). SSRI-associated bruxism: A systematic review of published case reports. Neurology: Clinical Practice, 8(2), 135–141. https://doi.org/10.1212/CPJ.0000000000000433
Lavigne GJ, Khoury S, Abe S, Yamaguchi T, Raphael K. (2008). Bruxism physiology and pathology: An overview for clinicians. Journal of Oral Rehabilitation, 35(7), 476–494. https://doi.org/10.1111/j.1365-2842.2008.01881.x
Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. (2018). International consensus on the assessment of bruxism: Report of a work in progress. Journal of Oral Rehabilitation, 45(11), 837–844. https://doi.org/10.1111/joor.12663
Lobbezoo F, Naeije M. (2001). Bruxism is mainly regulated centrally, not peripherally. Journal of Oral Rehabilitation, 28(12), 1085–1091. https://doi.org/10.1046/j.1365-2842.2001.00839.x
Lobbezoo F, Visscher CM, Ahlberg J, Manfredini D. (2014). Bruxism and genetics: A review of the literature. Journal of Oral Rehabilitation, 41(9), 709–714. https://doi.org/10.1111/joor.12177
Macedo CR, Silva AB, Machado MA, Saconato H, Prado GF. (2007). Occlusal splints for treating sleep bruxism (tooth grinding). Cochrane Database of Systematic Reviews, 2007(4), CD005514. https://doi.org/10.1002/14651858.CD005514.pub2
Manfredini D, Lobbezoo F. (2009). Role of psychosocial factors in the etiology of bruxism. Journal of Orofacial Pain, 23(2), 153–166. https://pubmed.ncbi.nlm.nih.gov/19492540/
Manfredini D, Lobbezoo F. (2010). Relationship between bruxism and temporomandibular disorders: A systematic review of literature from 1998 to 2008. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 109(6), e26–e50. https://doi.org/10.1016/j.tripleo.2010.02.013
Minakuchi H, Fujisawa M, Abe Y, Iida T, Oki K, Okura K, et al. (2022). Managements of sleep bruxism in adult: A systematic review. Japanese Dental Science Review, 58, 124–136. https://doi.org/10.1016/j.jdsr.2022.02.004
NHS. (2026). Teeth grinding (bruxism). https://www.nhs.uk/conditions/teeth-grinding/
Stanisic N, Saracutu OI, Colonna A, Wu W, Manfredini D, Häggman-Henrikson B. (2025). Awake bruxism prevalence across populations: A systematic review and meta-analysis. Journal of Evidence-Based Dental Practice, 25(3), 102171. https://doi.org/10.1016/j.jebdp.2025.102171
Val M, Colonna A, Nykänen L, Pollis M. (2026). Effects of botulinum toxin injection on masticatory muscle activity in sleep bruxism: A systematic review and meta-analysis. Journal of Clinical Medicine, 15(18), 7179. https://doi.org/10.3390/jcm15187179
Zieliński G, Pająk A, Wójcicki M. (2024). Global prevalence of sleep bruxism and awake bruxism in pediatric and adult populations: A systematic review and meta-analysis. Journal of Clinical Medicine, 13(14), 4259. https://doi.org/10.3390/jcm13144259
References checked October 2026 · Editorial policy · Report a correction
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