Teeth grinding (sleep bruxism) and teeth clenching (awake bruxism) involve involuntary overactivity of the jaw muscles. Many people are unaware they grind until symptoms appear — worn teeth, jaw tightness, morning headaches or changes in the lower face. Sleep bruxism is linked with micro‑arousals during sleep, while awake bruxism is often associated with concentration, stress or habitual muscle tension.

Bruxism is more than a habit. Over time, it can affect teeth, muscles, joints and even facial contours. Common consequences include:

• Enamel wear and shortening of teeth
• Cracks or fractures in teeth and restorations
• Jaw muscle pain, tightness or fatigue
• Morning headaches or facial discomfort
• Sleep disturbance for you or your partner
• Contribution to TMJ symptoms
• Masseter hypertrophy, which can widen or square the lower face

Early assessment helps prevent long‑term structural changes and supports better oral and sleep health.

Dr Frances Ershad completes a detailed assessment of your teeth, bite, jaw joints and muscle patterns. This includes examining the intra‑oral soft tissues, which can reveal important clues about muscle activity and airway function. Findings such as tongue scalloping, linea alba, cheek impressions and frictional keratosis can indicate clenching, grinding or increased airway effort during sleep.

These observations help determine the type and severity of your bruxism and whether further investigation into sleep quality or breathing patterns may be appropriate.

A professionally fitted occlusal splint helps protect teeth from further wear and reduces strain on jaw muscles. These devices are custom‑made for comfort, stability and long‑term durability.

Chronic teeth grinding or clenching can lead to masseter hypertrophy, where the jaw muscles enlarge in response to repeated overactivity. This may widen or square the lower face and alter the definition of the jawline. Some patients notice a heavier or more prominent lower facial third, which can influence facial balance and overall appearance.

Addressing bruxism early helps protect not only teeth and joints, but also the long‑term harmony of facial proportions.

Teeth grinding is closely linked with sleep quality. Some people grind during brief sleep arousals, which may occur more frequently in conditions such as snoring or obstructive sleep apnoea (OSA).

While current evidence does not confirm a direct causal relationship between sleep bruxism and OSA, research shows they often coexist and may share underlying mechanisms such as airway resistance, micro‑arousals and increased sympathetic activity.

Dental findings such as enamel wear, tongue scalloping and jaw muscle tenderness can be early indicators of disrupted sleep or increased airway effort. When appropriate, Dr Ershad will discuss whether further medical evaluation may be beneficial.

For patients whose teeth grinding or clenching may be linked with disrupted sleep or airway‑related breathing patterns, a mandibular advancement splint (MAS) may be considered. These custom devices gently position the lower jaw forward during sleep, helping maintain airway patency and improve sleep quality.

MAS therapy is not suitable for everyone. Suitability is assessed carefully to ensure comfort, safety and long‑term dental health.

Orthodontic treatment is not a primary treatment for bruxism. Current evidence does not support the idea that straightening teeth alone resolves grinding or clenching.

However, orthodontic alignment may play a supportive role when:

• significant wear has altered the bite
• uneven load distribution affects restorative stability
• long‑term planning requires improved occlusal relationships

This is always considered as part of a broader, multidisciplinary plan.

Children may show:

• Audible grinding during sleep
• Flattened or worn primary teeth
• Cheek or tongue biting marks
• Morning jaw tiredness
• Restless sleep or frequent night waking
• Mouth breathing or snoring
• Bed wetting

Because primary teeth wear more easily, tooth wear alone is not a reliable indicator. Assessment focuses on a combination of parental reports, soft‑tissue findings, sleep behaviours and oral development.

Evidence shows a positive association between sleep bruxism and sleep‑related breathing disturbances in children. Micro‑arousals, airway resistance, enlarged tonsils or adenoids and habitual mouth breathing can all contribute to disrupted sleep and increased jaw muscle activity.

When a dental examination suggests possible sleep‑related breathing issues — such as snoring, mouth breathing, enlarged tonsils or soft‑tissue signs — Dr Ershad may recommend assessment by an Ear, Nose and Throat (ENT) specialist. This collaborative approach supports early identification of airway‑related concerns and ensures your child receives comprehensive care.

• Waking with jaw tightness, fatigue or headaches
• Clicking, popping or discomfort in the jaw
• Flattened, chipped or sensitive teeth
• Clenching during concentration or stress
• A partner hearing grinding sounds at night
• Difficulty opening the mouth fully in the morning

If any of these sound familiar, a dental assessment is recommended.

• A calm, thorough discussion about your symptoms and concerns
• A detailed examination of teeth, bite, jaw muscles and soft tissues
• Clear explanations in plain English
• A personalised plan to protect your teeth and relieve symptoms
• Transparent communication about treatment options before proceeding
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If you suspect you may be grinding or clenching your teeth, early care can prevent long‑term damage. Dental Garden provides gentle, modern, evidence‑based care to help protect your smile and support your overall wellbeing.