Teeth Clenching and Grinding: When Stress Settles in Your Jaw

Can teeth clenching be caused by stress? Learn why you wake with jaw pain, how to notice daytime clenching and what helps with grinding your teeth at night.

When you wake up in the morning your jaw is tired, as if you had been chewing something hard all night. A slight ache in your temples, a tension in front of your ear. At breakfast, as you open your mouth, a small click comes from your jaw. During the day, in traffic, at the computer or during a difficult phone call, you suddenly notice your teeth locked together. Teeth clenching under stress is one of the most common physical reactions to it, yet one of the last to be noticed. Most people only find out when the dentist says "there is wear on your teeth" or when their spouse describes the sound they hear at night. In this article I explain the link between clenching and grinding and stress, the signs, what can be done separately for the day and the night, and the place of therapy in this process.

What Are Teeth Clenching and Teeth Grinding?

In medicine this picture is generally called bruxism. It has two separate forms, and both can occur in the same person:

• Daytime clenching: While awake, the person presses their teeth together or locks their jaw, mostly without realising it. There is usually no grinding sound. It becomes more noticeable at moments of intense concentration, tension or anger.
• Night-time grinding or clenching: This is the rhythmic or sustained contraction of the jaw muscles during sleep. The person does not notice it; someone sleeping beside them may hear the grinding sound.

Normally, at rest, the upper and lower teeth do not touch; a small gap remains between them. The teeth only make contact briefly during chewing and swallowing. Even keeping the teeth resting against each other all day is a constant load on the jaw muscles.

Is Teeth Clenching Caused by Stress?

Teeth clenching does not have a single cause, but stress and anxiety are among the factors that most often accompany it. When the body perceives a threat, the muscles tense, and the jaw muscles take their share of that tension. It is no coincidence that the Turkish idiom "to clench one's teeth" means to endure, to put up with something. A person trying to get through a hard period without making a sound may, quite literally, be clenching their teeth.

Besides stress, there are other factors that can increase clenching:

• Intense concentration: While studying, doing fine detailed work or staring fixedly at a screen, the jaw can tense up of its own accord.
• Suppressed anger: Words left unsaid and objections swallowed often settle in the jaw. We have looked at ways of managing anger without suppressing it in the article on anger management.
• Caffeine, alcohol and smoking: Especially when taken in the evening, these can increase night-time grinding.
• Sleep problems: Snoring, pauses in breathing during sleep and broken sleep can occur together with night-time grinding.
• Certain medications: Teeth clenching can be among the side effects of some medicines; if you suspect this, talk to your doctor without stopping the medicine.
• Dental and bite problems: This is an area for your dentist to assess.

Signs: The Signals Your Jaw Is Sending You

Because clenching often goes on silently, the clues need to be sought in different parts of the body:

• Fatigue and pain in the jaw, face or temples in the mornings
• A headache that starts as soon as you wake up and eases during the day
• Earache or a feeling of fullness in the ear, although an ear examination is normal
• A clicking, catching or locking of the jaw joint when opening the mouth or chewing
• Sensitivity of the teeth to cold and heat, flattening at the tips, small chips, fillings falling out
• A white line inside the cheek bearing the imprint of the teeth, scalloped marks along the edges of the tongue
• A grinding sound heard at night by a spouse or someone sleeping in the same room
• Tension spreading to the neck and shoulders

As you read this article, you can try a small experiment: Are your teeth touching right now? Is your tongue pressing against the roof of your mouth? Have your shoulders crept up towards your ears? Many people, when they ask this question for the first time, notice that their jaw is tense even during a calm activity like reading. This realisation is the first step towards change.

Pains that start in the jaw and temples and spread to the sides of the head often overlap with tension-type headache. I have described this link separately in the article on stress headache.

Teeth Clenching and Stress: What Load Is Your Jaw Carrying During the Day?

To understand clenching, it is very instructive to look at the moments of the day when your jaw locks. Many people are surprised when they first pay attention: the jaw stays tense for much longer than they thought.

Let's say you work as a customer service representative at a bank branch. All day you have to respond with a smile to customers waiting for their queue number who are irritable and sometimes shouting. While your face smiles, your jaw clenches. On your way home in the evening, at the wheel in heavy traffic, your teeth lock together again. Before going to bed at night you glance at economic news and loan interest rates on your phone. In the morning you wake up with jaw pain. On this fictional day, the jaw has become the place where tension that cannot be expressed is hidden.

Many scenes of daily life in Turkey can add to this load:

• Traffic and long commutes: Waiting patiently and silently amid car horns, congested junctions and cars cutting in.
• Jobs that require emotional labour: Professions such as call centres, sales, healthcare and education, where you are expected to stay calm and smiling all the time.
• Exam periods: Young people preparing for the LGS or YKS (Turkey's national high-school and university entrance exams) may study at their desks for hours with their jaws tense. For a teenager complaining of morning jaw pain, this is one of the questions to ask.
• Things left unsaid: Being unable to stand up to family elders, unable to speak up about unfairness at work, unable to voice hurt in a relationship.
• Screen use late into the night: News and social media feeds lead to falling asleep with a tense mind.

The jaw is where unspoken words wait; loosening it sometimes begins with finding those words.

Noticing and Letting Go of Daytime Clenching

Daytime clenching is a habit that can be changed through awareness. The first step is to catch it.

Learn the resting position

Your lips should be closed, your teeth apart, and your tongue resting with its tip just behind your upper front teeth, lightly touching the roof of your mouth. This is the jaw's resting position. Practise taking up this position consciously several times a day.

Use reminders

Put a small sign on the edge of your computer screen, on your car's dashboard or on your phone's lock screen. Every time you see it, ask yourself: "Are my teeth touching right now?" If they are, part them, let your jaw drop slightly and breathe out. Setting an hourly vibrating reminder on your phone can also help.

Give your jaw muscles short breaks

Place your palms on your cheeks, in front of your earlobes, and gently massage your jaw muscles in small circles. Then slowly open and close your mouth. If there is pain or locking, do not force it; in that case, consult your dentist.

Cut down on habits that tire the jaw

Chewing gum all day, biting pens or nails and frequently eating very hard foods tire the jaw muscles even more. If you have these habits, try cutting down on them during periods when you are tense.

Relax the rest of your face too

The jaw rarely tenses on its own. Frowning, wrinkling your forehead, narrowing your eyes and raising your shoulders often accompany clenching. Every time you relax your jaw, smooth your forehead, let your eyebrows go and lower your shoulders. This small scan reduces tension across the whole face and neck together.

Name the tension

Every time you catch your teeth locked together, briefly note what you were going through at that moment: Which email were you reading, who were you talking to, what were you feeling? After a week, these notes offer a map of the emotions your jaw reacts to.

A Pre-Sleep Routine for Night-Time Grinding

It is not possible to control directly something that happens during sleep. But you can influence the physical and mental state in which you go to sleep.

• Calm the hour before sleep: Keep the news, work emails and contentious conversations outside this hour.
• Limit caffeine and alcohol: Cutting down on evening tea and coffee and not drinking alcohol before sleep may help with night-time grinding.
• Relax before bed: A lukewarm shower, a few minutes of breathing exercises or a relaxation exercise focusing on the face and jaw muscles can reduce muscle tension.
• Leave the next day's load on paper: Writing down the to-do list in your head before going to bed can reduce the mind's need to spend the night making plans.

If someone you live with hears the grinding sound at night, talking to them about it can also be helpful. You can ask them not to wake you, but to notice on which nights the sound is more noticeable. When you compare this with your own daily notes, you can see whether the nights when grinding increases coincide with tense days, late meals or coffee drunk in the evening.

A night guard, which your dentist may recommend, is an important tool for protecting the teeth against wear. However, a guard does not remove the cause of clenching; it absorbs the impact between the teeth and the jaw. That is why the stress load also needs to be addressed while using a guard. If there is snoring, pauses in breathing during sleep or excessive daytime sleepiness, see your doctor for a sleep assessment.

When Should You Seek Professional Help?

The first person to see about teeth clenching is the dentist. If there is wear, sensitivity or chipping in your teeth, or pain, noise or locking in the jaw joint, you need an assessment by your dentist and, if necessary, by a specialist experienced in jaw joint problems. If earache or headache is prominent, the relevant doctors may also become involved.

In addition, working with a mental health professional can be helpful in the following situations:

• If teeth clenching noticeably increases in stressful periods
• If you constantly feel tense, on alert and "wound up like a spring" during the day
• If you find it hard to voice your anger, hurt or needs
• If your sleep is broken by anxiety, racing thoughts or nightmares
• If clenching is accompanied by generalised anxiety, panic attacks or low mood

Whether medication is needed is decided by a psychiatrist.

How Are Teeth Clenching and Stress Addressed in Therapy?

The aim in therapy is to treat clenching not just as a "bad habit" on its own, but as a sign that reveals the person's relationship with stress.

Habit reversal: The situations in which daytime clenching appears are identified together. The person regularly practises noticing early that their jaw is tensing and moving into the resting position instead. This approach is often used for repetitive bodily habits.

Cognitive Behavioural Therapy (CBT): Thought patterns that keep tension constantly alive are examined: "I must keep everything under control", "If I make a mistake everything will be ruined", "If I say no they will be hurt." Working with these thoughts can reduce the body's need to stand constantly at attention.

Expressing emotions and setting boundaries: For a person who stays silent by clenching their teeth, one of the most important pieces of work is learning to voice anger and hurt in a safe and constructive way. Boundary-setting skills at work, in the family and in relationships are part of this work.

Relaxation and sleep work: Progressive muscle relaxation, breathing work and steps aimed at sleep routine are intended to reduce the general tension that can affect night-time grinding.

A schema-focused view: People who grew up with the belief "I must be strong, I must not be a burden to anyone" may have learned early in life to grit their teeth and endure difficulties. Understanding the origin of this pattern can be an important step towards lasting change.

Simple measures can be used to track progress throughout the process: the severity of morning jaw pain on a scale of 0 to 10, how many times during the day the teeth are noticed to be locked together, and the course of the wear at dental check-ups. These measures help you see that change is sometimes slow but real. The real goal is not for clenching to disappear completely, but for the person to notice their tension earlier and respond to it differently.

You can find the details of individual work with anxiety and tension on the anxiety and panic page.

Frequently Asked Questions

Does teeth clenching cause permanent damage to the teeth?

Clenching and grinding that continue for a long time can lead to wear on the teeth, chipping, and damage to fillings and crowns. That is why it is important to see your dentist when you notice the signs and to take the protective measures recommended.

Is a night guard enough on its own?

A night guard is an important tool for protecting the teeth, but it does not remove the cause of clenching. If stress, sleep routine and daytime habits are not addressed, clenching may continue. Combining dental follow-up with stress management is a more balanced approach.

Can teeth clenching cause earache?

Because the jaw joint sits just in front of the ear, strain on the jaw muscles and joint can create pain or a feeling of fullness in the ear area. If you have earache, other causes should first be ruled out with an ear, nose and throat assessment.

Is it possible to stop clenching completely?

Many people experience a marked reduction once they notice daytime clenching and make the resting position a habit. Night-time grinding, on the other hand, can fluctuate with stress and sleep routine. The aim is less to bring it down to zero than to reduce the load your jaw and teeth are carrying.

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• #teeth grinding
• #jaw pain
• #stress

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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