Teeth Grinding

Bruxism is repetitive clenching or grinding of the teeth, either during sleep or while awake. Sleep bruxism is now understood mainly as a sleep arousal phenomenon rather than a bite problem, and it clusters with stress, anxiety, sleep apnea, reflux, smoking, alcohol, caffeine, and certain medications - SSRIs and stimulants in particular. Awake bruxism is more often a stress-related clenching habit. The consequences are what drive treatment: worn or cracked teeth, jaw muscle ache, morning headaches at the temples, and temporomandibular joint pain. A dentist-fitted occlusal splint does not stop the grinding but protects the teeth from it, and remains the mainstay. Behavioural approaches - stress management, daytime clenching awareness, reducing evening alcohol and caffeine - help a proportion of people, and treating coexisting sleep apnea or reflux can reduce episodes substantially. Botulinum toxin into the masseter muscles reduces muscle force in trials and is used selectively for severe cases. Supplement evidence is limited: magnesium is often suggested and may help muscle discomfort where intake is low, and there is no trial evidence that any supplement reduces grinding episodes.