Look in the mirror. Are all your teeth the same length, as if they’ve been worn down? Do you frequently wake up with a dull headache or pain in your face, jaw, or neck? Are your teeth always sensitive, or are the edges of your tongue scalloped?
If so, you might be a bruxer—someone who grinds their teeth. Anywhere from 5 to 95 percent of us grind our teeth while asleep.
Teeth grinding is an unpleasant habit, and it’s also a serious dental health problem. Forceful contact between your teeth wears on the enamel and damages the roots, causing sensitivity and pain and often calling for major dental repairs. Besides hurting the teeth, bruxism also damages the chewing muscles and jaw joint and can even affect your facial expressions over time.
But do you know what the biggest health concern there is with teeth grinding?
It’s that teeth grinding is a red flag for a sleep breathing–related issue.
One of my patients used to complain about a squeaking noise that disturbed him at night. His wife never heard it. Suspecting the problem, I asked his wife to come into my office, and sure enough, she was a teeth grinder. After I treated her mild sleep apnea, the squeaking noise disappeared, and they both slept much better.
Understanding the relationship between teeth grinding and sleep disorders is the key to ending both.
The True Cause of Teeth Grinding: It’s Not What You Think
Medical experts often point to stress and anxiety as common causes for teeth grinding at night. Another theory links teeth grinding with certain dietary deficiencies (such as magnesium).
While it’s true that stress causes many people to inadvertently clench their jaw or grind their teeth during the daytime, this is different from nighttime grinding, specifically, grinding during the deepest stages of sleep.
It’s also true that mineral deficiencies can contribute to symptoms of TMJ, including teeth clenching and grinding, but this is rarely the cause of night grinding.
So, what’s the root cause of nighttime teeth grinding?
Studies show that grinding your teeth can be a sign of an underlying sleep disorder, which endangers many aspects of health. This stems from an instinctive survival response to a constricted or blocked airway.
When you fall asleep, your muscles relax—including the muscles in your jaw and tongue. Both can obstruct the airway and cause you to stop breathing. Brain scans of sleeping people with blocked airways have shown that the body responds by grinding the teeth to reopen the airway.
Genetics plays a big part in the size and shape of your airway, and thus your risk of teeth grinding.
Stop Teeth Grinding by Treating the Source, Not the Symptoms
A common dentist-recommended treatment for teeth grinding at night is a mouth guard. It seems logical that protecting the teeth from the forces of grinding would help, but it often makes the problem worse. Mouth guards don’t open the airway, but make the muscles and teeth work even harder to open it, causing further damage to the teeth.
This is why I rarely prescribe a mouth guard as a treatment for teeth grinding.
Since a blocked airway and sleep apnea are, most commonly, the root causes of teeth grinding, keeping the airway open at night is the best way to treat teeth grinding.
The methods that are most successful at this?
- Oral appliances fitted by dentists, which keep the airway open at night so you can access deep-stage sleep without it being interrupted by grinding, snoring, tossing and turning, or other breathing difficulties.
- APAP or CPAP machines, which are prescribed by a physician based on the results of a sleep study. These tend to be prescribed for people at the far right of the sleep apnea spectrum (moderate to severe). If you start treating your sleep breathing difficulties early enough, you may never need to sleep with a machine.
If you’re grinding your teeth, I recommend the following course of action:
1. See a dentist who can screen for teeth grinding, check for signs of sleep apnea, and/or make an oral appliance for you. See localsleepdentist.com (run by the American Academy of Dental Sleep Medicine) for someone in your area.
2. Contact your physician to arrange a consultation and polysomnography sleep study so they can verify if you are on the sleep apnea spectrum (including upper airway resistance syndrome).
3. Read more about the link between sleep and dental health in my book: The 8-Hour Sleep Paradox: How We Are Sleeping Our Way to Fatigue, Disease and Unhappiness.