Are you grinding your teeth at night?

You may not know you grind your teeth. Most sleep bruxism is unconscious, patients are unaware of it unless a partner hears the grinding or a dentist notices the telltale wear patterns. But the damage is cumulative, and by the time it becomes obvious, years of enamel have been lost.

Quick answer

Bruxism is a repetitive jaw-muscle activity, grinding, clenching, or bracing, that the international consensus now distinguishes into sleep and awake forms because their causes differ ^[1]. The best-supported management for sleep bruxism is a custom-fitted stabilisation splint made from hard acrylic, adjusted for even bilateral contact ^[3][4]. But the splint manages the damage, understanding what drives the bruxism is equally important ^[2].

What bruxism actually is

Bruxism is not simply a bad habit. The international consensus by Lobbezoo and colleagues defined it as a repetitive jaw-muscle activity and drew a clear distinction between sleep bruxism and awake bruxism ^[1]. Sleep bruxism is now understood as a centrally mediated motor behaviour linked to micro-arousals during sleep, not a response to an imperfect bite. This matters because adjusting the occlusion does not stop sleep bruxism; protection is the primary strategy.

Why it matters more than most patients realise

The consequences are cumulative rather than sudden: flattened biting surfaces, cracked enamel, fractured restorations, jaw stiffness, temple headaches. Over years, the damage can be severe. And it is not just about stress. Kuang and colleagues found that sleep bruxism is associated with other sleep-related disorders including obstructive sleep apnoea ^[6], suggesting that for some patients the grinding is a symptom of a broader sleep problem.

The association between psychological stress and bruxism is well-established. Chemelo and colleagues' systematic review confirmed stress as a significant, modifiable risk factor ^[5].

Which type of night guard actually works

Not all guards are equal. The most comprehensive evidence review. Riley and colleagues' Health Technology Assessment, confirmed that stabilisation splints (flat-plane, full-coverage, hard acrylic, adjusted for even bilateral contact) are the best-supported design ^[3].

Ainoosah and colleagues compared different splint designs and found that while several can reduce symptoms, the full-coverage stabilisation splint remains the most predictable ^[4]. Soft splints and pharmacy guards have less evidence and can sometimes increase muscle activity rather than reducing it.

This is why I use laboratory-fabricated, hard acrylic splints adjusted to the patient's bite, the evidence supports this design.

Beyond the splint

A splint is essential but rarely the complete management. Minakuchi and colleagues' systematic review confirmed that effective care usually combines the splint with investigation of contributing factors ^[2]. For stress-related bruxism, stress management and possibly referral to a psychologist may be indicated. For grinding associated with sleep-disordered breathing, a sleep study may be more important than the guard itself.

Frequently asked questions

How do I know if I grind at night?

Common signs include flattened biting surfaces, jaw stiffness on waking, temple headaches, and a history of cracked restorations. I look for these at every examination.

Will a pharmacy night guard work?

Prefabricated guards are a compromise. They lack the precise fit needed for even force distribution and can alter the bite in undesirable ways. A custom splint is more predictable.

Can bruxism be cured?

Sleep bruxism is managed rather than cured. The splint protects the teeth while the contributing factors are addressed.

Does grinding damage fillings and crowns?

Yes. Bruxism is one of the leading causes of restoration fracture. A night guard protects both natural teeth and dental work.

Can children grind their teeth?

Yes, but childhood bruxism often resolves naturally and is usually monitored rather than treated with a splint.

When to see Dr. Khalid

If you suspect you grind your teeth, or if a partner has told you, a comprehensive examination can assess the extent of the wear and identify contributing factors. A well-fitted night guard is one of the highest-value investments in preventive dentistry.