Teeth · muscles · sleep
Bruxism is repetitive jaw-muscle activity involving clenching, grinding or bracing, while awake or during sleep.
Awake bruxism often involves unintentional clenching or jaw bracing, particularly during concentration or periods of stress. Sleep bruxism occurs during sleep and may be reported by a partner. Its presence does not always mean that treatment is needed.
Morning jaw tiredness or stiffness, tooth wear or sensitivity, repeated cracks, tongue or cheek markings, headaches, muscle pain or audible grinding may prompt assessment. These findings are not specific to bruxism, so a dental and clinical examination is still required.
Consultation reviews when symptoms occur, how they have changed, medical and dental history, medication, sleep quality and clenching habits. Examination includes teeth and restorations, muscles, jaw joints and mandibular movement. Imaging or sleep assessment is considered only when clinically indicated.
Stress, sleep quality, caffeine, alcohol or tobacco use, some medicines, snoring or signs of sleep apnoea, reflux and certain neurological conditions may be discussed according to context. Never stop prescribed medication without advice from the prescribing clinician.
Management is mainly considered when there is pain, dental damage or functional difficulty. It may combine explanation, awareness of awake habits, attention to contributing factors, dental monitoring and, in selected situations, a custom occlusal splint. A splint protects the teeth but does not guarantee that sleep bruxism will stop.
Bruxism does not necessarily cause a temporomandibular disorder, although it may aggravate existing muscle or joint symptoms. Management is therefore guided by symptoms and examination findings rather than clenching or grinding alone.
A fractured or cracked tooth, loss of a tooth fragment or restoration, acute tooth pain or persistent jaw locking warrants prompt assessment. Increasing muscle or joint pain, progressive restriction of mouth opening or accelerating tooth wear should also be evaluated.
Leeds Teaching Hospitals NHS Trust provides patient information on clenching and grinding, common signs, contributing factors and management. Read the NHS bruxism information
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