Solutions for Bruxism: A Guide to Treatment Options

Written by Dr. Febin Mary George, BDS | Medically Reviewed by Dr. Shaista Salam, BDS, Dr. Zein El Hammouz, DDS, MFD/RCSI

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Table of Contents

1. What does bruxism mean, and when does it occur?

2. Common causes and symptoms of bruxism

3. Bruxism solutions: effective treatments and tips

4. Bruxism and other dental problems

5. Useful tips from our orthodontic experts

Teeth grinding with aligners: It is difficult to imagine the success of your orthodontic treatment when you have clear aligners and bruxism in a single frame. This article is aimed at giving you clarity about clear aligners treatment if you grind or clench your teeth.

What does bruxism mean and when does it occur?

Bruxism is a condition where you grind or clench your teeth excessively without conscious control. This can happen during the day while you are awake or at night while sleeping (sleep bruxism). (1)

Some individuals may not even know they are experiencing it until their bed partner or family member reveals it.

Most instances of sleep bruxism occur in the initial stages of the sleep cycle, specifically during non-REM (rapid eye movement) sleep stages 1 and 2. However, a small fraction of cases can also happen during REM sleep.

Clenching vs. bruxism


In bruxism, an individual moves the jaw from side to side while the teeth are tightly clenched, resulting in worn down and flattened teeth surfaces. On the other hand, an individual, while clenching, keeps the teeth in close contact with each other without moving them.

Common causes and symptoms of bruxism


Although the exact cause of bruxism remains unknown, here is a list of the possible causes and risk factors of bruxism:(2)

  1. Stress- Bruxism is often linked to stress, and people experiencing high levels of stress and anxiety may be more likely to grind their teeth. (3)
  2. Sleep disorders: Sleep apnea, snoring, or other sleep-related breathing disorders can trigger bruxism. (7)
  3. Abnormal bite: A misaligned bite can cause the jaw muscles to work harder, leading to bruxism. (4)
  4. Lifestyle factors: Consuming large amounts of caffeine or alcohol, smoking, and using recreational drugs can increase the risk of bruxism. (5, 2)
  5. Medications & Medical conditions:: Certain medications and medical conditions can cause bruxism as a side effect. (2)
  6. Medical conditions: Bruxism can be associated with neurological conditions such as Parkinson's or epilepsy. (2)

Signs and Symptoms

Finding out the underlying cause is essential in coming up with a suitable treatment plan for managing bruxism.


The signs and symptoms may differ from individual to individual and can include:

  • Abraded teeth, cracked or chipped teeth
  • Swollen or receding gums
  • Wear facets: They are the flattened, shiny surfaces on the teeth that indicate the wearing down of enamel on the biting surfaces of the teeth due to bruxism.
  • Teeth grinding or clenching sounds that may disturb a sleeping partner
  • Tooth sensitivity due to the wearing away of the enamel layer of teeth
  • Jaw pain, stiffness, or soreness
  • Clicking sound while opening or closing the mouth
  • Headaches, especially in the mornings
  • Facial pain or discomfort
  • Pain and tightness in the neck and shoulders

If you notice any of the above-mentioned signs and symptoms, you should consult your doctor to confirm the condition that you have.

Who diagnoses it?

When you visit your dentist for a routine dental check-up, your dentist will thoroughly inspect your teeth and gums. If there are signs like wear facets or chipped or cracked teeth that suggest bruxism, your dentist may ask you a few questions to confirm the diagnosis. Once established, your dentist will prepare a customized treatment plan to manage your condition. If required, he may refer you to a specialist (maxillofacial surgeon) for confirmation and assistance in the diagnosis and treatment planning, especially if you have TMJ symptoms.

Bruxism solutions: effective treatments and tips

If you are keen on understanding how to alleviate bruxism, this section is meant for you.

1. Clear aligners and bruxism

The popular belief is that invisible aligners and bruxism cannot go hand in hand. But that’s far from the truth! When subconsciously teeth grinding with aligners on, your teeth will undergo extensively less damage than without aligners.

The aligners form a protective layer between the teeth, similar to a nightguard. They could potentially work as a habit breaker because the patient will be reminded to stop the habit when he feels there’s something new in his mouth.

A preventive approach can be considered to minimize the risk of damage to your aligners from bruxism. Aim to live a stress-free lifestyle, with reduced consumption of alcohol and stimulants like caffeine.

2. Jaw exercises

To enhance the range of motion of the jaw and alleviate pain, one can practice jaw exercises. Your dentist /maxillofacial surgeon will prescribe several exercises depending on the severity of your case.

3. Medications

Based on their evaluation, your dentist may choose to prescribe some medications for a short period of time. These may help relax and control your jaw movements.

4. Mouthguard

Your dentist will ask you to wear a customized plastic mouthguard overnight or during the day if needed. The mouthguard will absorb the excessive biting force and protect your teeth from further damage.


5. Medication

Certain medicines can alter the activity of neurotransmitters, thereby reducing the grinding activity. If the underlying cause of bruxism is diagnosed as an antidepressant, it can be replaced with another to get relief. (6)

6. Biofeedback

This is an effective technique to address daytime bruxism. Biofeedback involves using electronic gadgets that gauges the activity of jaw muscles. The gadget indicates to the individual if the muscle activity is abnormally high so that the individual can alter his behavior accordingly.

Teeth grinding dental problems

Bruxism can lead to several dental issues, and the most common are listed below:

  • It can cause toothache, headache, and earache even though your ears are fine.
  • It can affect your TMJ causing a clicking sound each time you open your mouth or limiting your range of motion.
  • It can cause soreness of jaw muscles and stiffness when you wake up.
  • Prolonged and untreated bruxism results in wear facets, and shiny surfaces on biting surfaces of teeth that indicate the loss of the protective enamel layer, exposing the yellow dentine.

Teeth grinding with aligners on can reduce the above-mentioned dental problems in some cases as the teeth stay protected underneath the aligners during the grinding activity.

Useful tips from our experts

Practice these self-care tips to help clear aligners and bruxism go hand in hand.

  • Reduce stress- Choose any activity that calms you from within and relaxes your mind. It could be listening to music, an aerobic exercise routine, or gardening. Low-stress levels can improve teeth-grinding activity.
  • Say NO to stimulants- Too much caffeinated coffee or alcohol consumption can worsen your condition. So avoid having such stimulants before going to bed.
  • Adopt sound sleep practices- Focus on getting a good night’s sleep by avoiding screens two hours before bed. Take professional help if you are having sleep-related issues.



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