Bruxism & Teeth Grinding

If you wake up with a tight jaw, a dull headache, or teeth that feel sensitive for no clear reason, bruxism—grinding or clenching, often during sleep—may be the cause. It's common, frequently overlooked, and very manageable once identified.

Bruxism is the involuntary grinding of teeth or clenching of the jaw, often happening during sleep without you realizing it. Over time, it can cause jaw pain and damage to teeth.

Signs of bruxism

• Disrupted sleep
• Morning headaches or facial pain
• Earaches
• Sore jaw muscles or pain when eating
• Painful or loose teeth

Bruxism doesn't have one single cause—it's usually a combination of factors. Common contributors include stress and anxiety, certain medications (particularly some antidepressants), alcohol, caffeine, and smoking, and sleep disorders—sleep apnea in particular is closely linked to nighttime grinding. Family history plays a role too; bruxism often runs in families.

Left unaddressed, bruxism can wear down or fracture teeth over time, sometimes requiring significant restorative dental work. It can also lead to enlarged jaw muscles, chronic jaw pain, and—over years—contribute to the development of TMJ disorders. And because grinding is often loudest and most active during sleep, it frequently disrupts rest for both the person grinding and anyone sharing a bed with them.

A standard night guard protects your teeth from the effects of grinding, but it doesn't address why you're grinding in the first place. As a board-certified orofacial pain specialist, Dr. Kruman evaluates whether your bruxism is being driven by airway issues, stress, or a combination—and builds a treatment plan around the actual cause, not just a mouthguard prescribed without that context.

Nighttime grinding is increasingly understood as the brain's response to a partially blocked airway during sleep—so bruxism and sleep apnea often travel together and are worth evaluating as a pair.

Clicking, popping, or a jaw that locks can signal something further along— TMJ disorders —and is worth an evaluation.

A standard night guard protects your teeth from grinding, but treating bruxism well means figuring out what's driving it first. Dr. Kruman's approach starts with that question, then builds a plan around the actual cause.

Custom oral appliances

Unlike an over-the-counter guard, a custom appliance is fitted to your bite and designed for the specific pattern of your grinding or clenching—it protects your teeth while also helping relax the muscles driving the problem. Because bruxism and airway issues are often connected, the same evaluation that identifies your bruxism pattern also screens for sleep-related contributors.

When injections make sense

For patients with significant muscle tension or jaw pain that an appliance alone doesn't fully resolve, therapeutic injections into the jaw muscles can reduce clenching intensity and ease pain. This is typically used alongside an appliance, not instead of one, and isn't the starting point for every patient.

If stress or airway issues are part of the picture

Because bruxism is rarely caused by one single thing, treatment sometimes involves more than a device—that might mean coordinating with your physician on an underlying sleep issue, or simply naming stress as a real contributing factor and adjusting the plan accordingly. The goal is addressing what's actually happening, not applying the same fix to every patient.

The first visit includes a full evaluation of your bite, jaw muscles, and any visible tooth wear, along with a conversation about your sleep, stress levels, and symptoms. If sleep apnea could be a contributing factor, Dr. Kruman will discuss whether a sleep study makes sense before finalizing a treatment plan.

You'll leave with a clear sense of what's driving your bruxism and a specific plan— whether that's a custom appliance, injections, coordination with another provider, or some combination. Questions about cost are welcome at this visit; see our Fees & Insurance page for how billing works as an out-of-network practice.

Will a store-bought night guard work?

It can protect your teeth from wear, which matters. But it doesn't address why you're grinding, so symptoms like jaw pain or headaches often persist. A custom appliance, fitted after an evaluation, tends to do more for the underlying problem.

Is bruxism always related to stress?

Stress is a common contributor, but not the only one. Sleep-disordered breathing, certain medications, and family history all play a role—which is why treatment starts with figuring out your specific mix of causes rather than assuming stress is the whole story.

Can bruxism damage my teeth permanently?

Left untreated over years, yes—grinding can wear down enamel, crack teeth, and in severe cases require restorative dental work. Treating the underlying cause early is the best way to avoid that.