Grinding your teeth, or bruxism, can cause headaches, jaw pain, tooth pain. Often it occurs at night while we are asleep – thats up to 9 hours of jaw clenching every night!

Unfortunately, we have no conscious control overnight, so it can be a very hard habit to break. Adults with night bruxism are three times as likely to have headaches or migraines during the day (1). This may be due to the tight bands of muscle forming in the neck, head and jaw.

Dentists worry about bruxism because it can have devastating effects on the teeth. Not only can the enamel be worn away, but teeth can be flattened, chipped or loosened.

Why do we clench our teeth?

It is not clear.

There are suggested links with stress, anxiety and disturbed sleep. There is growing evidence that bruxism can be caused by sleep apnoea (2).

How is night bruxism treated?

A 2015 systematic review (3) could not provide a gold-standard approach for the treatment of sleep bruxism. They evaluated and collated studies on pharmacological treatment, biofeedback, cognitive-behavioural treatment and TMJ mouthguard.

A summary of their findings:

  • Pharmacological approaches may reduce sleep bruxism. However, it is thought that the medication does not change the underlying cause.
  • Biofeedback devices and cognitive-behavioural approaches to bruxism were not found to not be effective. However, because these are non-harmful options they should still be incorporated in multimodal approaches to bruxism.
  • Any TMJ guard seems to be effective to reduce night bruxism. The guard may have a novelty effect which decreases muscle activity overnight. Intermittent use of oral appliances can be more effective than use every night.

Having a team on your side seems to work best, including a dentist, psychologist and a manual therapist. Chat to your osteopath today about the best way forward.


(1) De Luca Canto, G., Singh, V., Bigal, M.E., Major, P.W., & Flores-Mir, C. (2014). Association between tension-type headache and migraine with sleep bruxism: a systematic review. Headache, 52: 1460-1469. 

(2) Bender, S.D. (2016). Sleep bruxism and sleep-disordered breathing. Journal of Esthetic and Restorative Dentistry, 28(1): 67-71. 

(3) Manfredini, D., Ahlberg, J., Winocur, E., & Lobbezoo, F. (2015). Management of sleep bruxism in adults: a qualitative systemic literature review. Journal of Oral Rehabilitation, 42(11): 862-874. 

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