Can teeth grinding be linked to stress? Read about the causes and signs of grinding your teeth in your sleep, and steps you can add to your evening routine.
One morning over breakfast your partner asks, half joking and half serious: "You were grinding your teeth again last night; the noise woke me up." You remember nothing. But over the last few weeks you have been waking with a tired jaw and aching temples; at your last check-up the dentist also mentioned wear on your back teeth. You have no control over something that happens while you are asleep; even so, most people notice that this period coincides with an intense time of stress in their lives. The link between teeth grinding and stress is something both dentists and psychologists come across often. In this article I look at what night-time teeth grinding is, how it connects with stress, which signs to watch for and what can be done before you go to sleep.
What Is Night-Time Teeth Grinding?
The condition known in medical language as bruxism is the involuntary pressing together or grinding of the teeth. It has two different forms. Daytime bruxism is mostly clenching the teeth while awake, when concentrating hard or in moments of tension. Sleep bruxism, on the other hand, happens during sleep without the person being aware of it, and sometimes makes a noise loud enough to wake the person lying next to you.
The focus of this article is the night. If you clench your teeth without noticing during the day, you can find detailed suggestions for the daytime in the article on teeth clenching and stress.
Grinding the teeth in sleep occurs together with brief arousal responses. During sleep the brain goes through light moments of wakefulness lasting a few seconds; in these moments the pulse speeds up, breathing changes and the jaw muscles can contract. The person does not remember these micro-arousals, but the jaw carries the load of these contractions all night. In other words, night-time teeth grinding is less a habit and more a response linked to arousal during sleep.
Is Teeth Grinding Caused by Stress? The Connection
There is no single cause of night-time teeth grinding; however, stress and anxiety are among the factors most often mentioned.
The body staying on alert at night
A body that has been under intense stress all day cannot fully relax when it falls asleep either. When the stress system stays switched on, sleep becomes shallower and micro-arousals become more frequent. Each arousal is a new opportunity for the jaw muscles to contract.
Suppressed tension
Words left unsaid during the day, objections swallowed and anger you try to keep under control can turn into a load the body tries to release in other ways at night. Many people describe waking with jaw pain during the very periods when they were "just about managing".
Anxious sleep
In people who fall asleep worrying, wake often at night or wake in the early hours and sink into thoughts, sleep is already fragmented. Fragmented sleep fits closely with the type of sleep in which night-time grinding occurs. This is why teeth grinding becomes more noticeable during periods of stress, especially in weeks when sleep is disrupted.
Personality traits
Research suggests that clenching and grinding may be more common in people who are perfectionistic, competitive or who feel the weight of responsibility intensely. This is not fate, but a clue to how the body carries its load.
Factors other than stress
Stress is not the only explanation. Pauses in breathing during sleep, alcohol taken in the evening, heavy caffeine use, smoking, some medications, bite problems and genetic predisposition also play a part. For this reason, the complementary perspectives of a dentist and a mental health professional matter in assessing night-time grinding.
How Can You Tell If You Grind Your Teeth at Night?
It is not easy to notice something that happens in your sleep. Most people find out either from someone close to them or from their dentist. The following signs can be clues:
- Tiredness and pain in the jaw, face or temples in the morning
- Tension-type pain at the sides of the head or the back of the neck on waking
- A clicking sound from the jaw or a feeling of locking when opening your mouth
- Wear, cracks or broken fillings in the teeth, or sensitivity to cold
- Tooth marks on the inside of the cheek or the edges of the tongue
- Pain or a feeling of fullness in front of the ear
- Waking unrefreshed even though you have slept long enough
- A grinding or scraping sound heard at night by the person you sleep with
Having some of these signs does not on its own amount to a diagnosis. But if several occur together and have been going on for weeks, a dental examination should be the first step.
Why Does Teeth Grinding Increase in Times of Stress? Examples from Everyday Life
Night-time grinding usually shares the same calendar as life's difficulties. Exam periods, changing jobs, moving house, a relative's illness, a divorce or financial hardship are high on the list. In Turkey, for many people, the rising cost of living, rent increases and worries about making ends meet can be quiet sources of the tension that builds up in the jaw at night.
Let's say someone working in an accountancy office does months of overtime every year during tax-return season. During these periods they get home late in the evening, keep their phone in their hand even while eating, and check client messages one last time before bed. Their partner notices that the grinding noise at night increases especially in these months. When the season ends, the noise also fades. In this example, the jaw keeps a kind of sound recording of how busy the calendar is.
Another common situation involves people who look calm during the day but whose minds never stop. When these people, who keep everything under control during the day and do not want to be a burden to anyone, surrender to sleep at night, their bodies voice the load carried during the day. This is why teeth grinding is sometimes the first stress symptom to be noticed. A person may say they do not feel tense, but their jaw may tell a different story; this clue is a good starting point for taking another look at the load they carry during the day.
Night-time grinding also has a relationship dimension. A partner sleeping in the same room can lose their own sleep to the scraping sound they hear every night. After a while, comments like "You've started again", arguments about sleeping in separate rooms or resentment caused by being woken at night come up. Yet the person grinding is not doing anything deliberately; instead of blaming, tackling the problem together, for example the partner who notices the sound sharing it calmly in the morning and the two of them planning a dental appointment together, is far more helpful. The same understanding applies to siblings and children who share a room in extended families or small homes.
The tiredness that follows night-time grinding can also create a cycle of its own. A person who wakes unrefreshed in the morning becomes more impatient, more tense and more sensitive to sources of stress during the day. This tension carries over into sleep in the evening, sleep stays shallow again and the jaw contracts again. It does not much matter at which point you enter the cycle; even a small intervention in sleep patterns, daytime stress or the evening routine can begin to loosen the whole chain.
An Evening Routine Against Night-Time Teeth Grinding
You cannot directly control a behaviour that happens in your sleep; but you can influence the body and mind you take into sleep. The steps below can be applied alongside the treatment your dentist recommends.
Create a ritual for ending the day
About an hour before bed, close down work, the news and contentious conversations. Writing tomorrow's to-do list on a piece of paper sends the mind the message "This can wait until tomorrow". The lighter the mind, the deeper the sleep.
Give your jaw and face some relaxation
Before getting into bed, gently relax your jaw muscles for a few minutes. With your lips closed, your teeth apart and your tongue resting on the roof of your mouth, take a few slow breaths. Make light circular touches with your fingertips on your temples and the corners of your jaw. A warm towel can also help the muscles relax.
Relax the whole body
Progressive muscle relaxation can help reduce the general tension that accompanies night-time grinding. Starting from the feet, tense each muscle group for a few seconds and then release it. Leave the face and jaw area until last and stay there a little longer.
Review evening alcohol, caffeine and smoking
Alcohol can increase night-time grinding by fragmenting the second half of sleep. Coffee, strong tea and energy drinks taken in the afternoon also make sleep shallower. Smoking before bed also increases arousal.
Protect your sleep pattern
Going to bed and getting up at roughly the same time every day helps make sleep deeper and less fragmented. Enough regular sleep can reduce the light-sleep moments in which night-time contractions occur.
Open an outlet for daytime stress
The load that builds up in the jaw at night may reflect tension that could not be released during the day. Regular walking, breathing exercises, talking to someone you trust or putting your feelings into writing can lighten this load. If you are looking for a broader framework for managing everyday tension, you can also read the article on stress management.
Keep up with your dentist's recommendations
A night guard is a commonly used way to protect the teeth from wear. The guard does not remove the cause of grinding but it protects the teeth. Psychological work, on the other hand, aims to ease the cause. The two are not alternatives to each other but complementary.
The jaw quietly carries at night what was left unsaid during the day; to lighten the load, sometimes you first need to look at the day.
When Should You Seek Professional Support?
In the following situations it is advisable to seek support from a dentist and, if necessary, a mental health professional:
- If morning jaw pain and headaches have been going on for weeks
- If you have noticed wear, breakage or sensitivity in your teeth
- If you have jaw locking, difficulty opening your mouth or pain in front of the ear
- If night-time grinding is accompanied by loud snoring, pauses in breathing during sleep or excessive daytime sleepiness
- If teeth grinding is part of a period involving intense anxiety, insomnia or low mood
If there are signs such as snoring and pauses in breathing, it is important to see a doctor for a sleep assessment. Decisions about medication should be made through the assessment of a doctor or psychiatrist.
How Are Teeth Grinding and Stress Addressed in Therapy?
Psychotherapy does not target night-time grinding itself, but the stress and sleep patterns that feed it. While the dentist protects the teeth, therapy works with questions such as: In which periods does it increase? What tensions are carried during the day? How fragmented is sleep?
In cognitive behavioural therapy, a personal map of stress is drawn up first. Thoughts that feed being constantly on alert, for example beliefs such as "I have to sort everything out myself" or "If I relax, something will go wrong", are examined. Relaxation skills, breathing exercises and behavioural steps for sleep patterns are learned. If there is suppressed anger or needs that cannot be expressed, work is done on voicing them in healthy ways.
One of the tools often used in therapy is a record kept for a few weeks. The severity of morning jaw pain, the previous day's stress level, what was done in the evening and how sleep went are tracked with short notes. This record often makes visible connections that even the person themselves had not noticed: the night after a contentious phone call, an evening spent working late, or a calmer morning that comes with the weekend's relaxation.
Night-time grinding is sometimes the physical face of generalised anxiety or a long-term burden. As this burden is addressed, sleep deepens and the jaw can rest a little more at night. You can find how individual work on anxiety and stress is carried out on the anxiety and panic page.
Frequently Asked Questions
Does teeth grinding ease by itself once the stress passes?
Night-time grinding that starts during stressful periods often eases when stress decreases. However, if it has become a habit or other factors are also present, it may continue. To protect your teeth, it is important to keep up with dental follow-up.
My child grinds their teeth in their sleep; should I worry?
Teeth grinding during sleep is quite common in children and often decreases with age. Even so, it is good to consult a paediatric dentist and, if snoring or restless sleep accompanies it, to let the paediatrician know too. If it started alongside changes at school or in the family, it is also helpful to look at the tension the child is experiencing.
If I wear a night guard, do I no longer need to deal with stress?
A guard protects the teeth from wear but does not change the arousal that sets off the grinding. When stress and sleep patterns are not addressed, jaw pain may continue even with a guard.
Can I do anything to keep my jaw relaxed while I sleep?
You cannot consciously manage your jaw during sleep. But going to sleep with a relaxed jaw and a calmer mind can reduce how often contractions happen at night. A few minutes of jaw and breathing work before bed is meaningful in this respect.
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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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