Bruxism (Teeth Grinding) Treatment

Bruxism is the involuntary habit of clenching the teeth or grinding them against each other. It can happen during the day or in sleep, and most people do not notice it themselves: either a partner hears the noise at night, or a dentist spots the worn teeth. The problem is less the habit itself than the load it puts on the teeth, the chewing muscles and the jaw joint.

When we talk about "bruxism treatment" we need to be honest: there is no single method that makes the habit disappear completely. What we do is protect the teeth and restorations, reduce the load on the muscles and find the triggers.

Is daytime clenching the same as night-time grinding?

No, and telling them apart changes the treatment.

Some medicines, particularly certain antidepressants, can increase night-time clenching. If it comes with snoring, pauses in breathing during sleep or waking up unrefreshed, you may also need to be assessed for sleep apnoea; in that case we refer you to the appropriate doctor.

How do I know if I clench or grind my teeth?

• Jaw fatigue in the morning, pain in the temples or just in front of the ears
• A headache that starts when you wake up and eases during the day
• Front teeth that look flattened, shortened or chipped along the edges
• Tooth sensitivity with no obvious cause, or fillings that keep breaking
• A white line on the inside of the cheek where the teeth meet, tooth marks along the edge of the tongue
• Enlarged, firm chewing muscles at the angle of the jaw

At the examination we look at the wear facets, cracks in the enamel and tenderness in the muscles. Some wear comes from an acidic diet or reflux instead; it looks similar, but the solution is different. We do not recommend a night guard until we have made that distinction.

Clenching also strains the jaw joint and the muscles around it. If your jaw clicks when you open your mouth, feels as if it catches, or will not open fully, the picture may not be bruxism alone, and jaw joint (TMJ) disorders need to be assessed separately. At our clinic in Bayraklı we look at both together at the first examination, because the two are managed in similar but not identical ways.

What a night guard does — and what it does not

At the heart of treatment is an occlusal splint, or night guard, made from hard acrylic to impressions of your teeth. It is usually made for one jaw, most often the upper. The guard stops the teeth rubbing directly against each other, so the wear happens on the guard, which can be replaced when needed, rather than on your teeth. Its surface is designed to be flat, so it spreads the force instead of concentrating it on a single tooth, and many patients find their morning jaw fatigue eases.

There is also something the guard does not do: in most cases it does not stop the clenching habit. That is why it is better thought of as protection than as a cure. Soft, ready-made guards sold in pharmacies can be a short-term stopgap, but because they are not fitted to you, in some people they can increase chewing activity and push the teeth in unwanted directions. We do not recommend them for long-term use.

What helps with daytime clenching?

For daytime clenching, changing the habit works better than a guard. At rest your lips should be closed, your teeth slightly apart and your tongue resting against the roof of your mouth; the teeth should only touch when you swallow and chew. Setting a small reminder on your phone and checking during the day, "are my teeth touching?", can noticeably reduce the habit within a few weeks. Giving up chewing gum, no longer biting pens and nails, and cutting down on caffeine and alcohol in the evening also lower the load on the muscles. If stress is a clear trigger, getting support with it will benefit your teeth too.

Is Botox an option?

If the chewing muscle is very strong and symptoms are not adequately controlled with a night guard, some patients are referred to the appropriate doctor for botulinum toxin injections into the muscle. This reduces the muscle's strength for a few months and has to be repeated to maintain the effect; it does not remove the cause of the habit. It is not necessary for everyone, and it is not a first step. We discuss whether it makes sense for you at the examination.

What if I have crowns, veneers or implants?

Bruxism is one of the common reasons ceramic restorations and implant-supported teeth fracture. If we see signs of clenching in a patient who is planning veneers, zirconia crowns or dental implants, we discuss it before treatment: the choice of material, the design of the bite and a night guard once the work is finished are built into the plan from the start. Cosmetic work handed over without a night guard to someone who clenches can be back in the chair within a few years.

If the wear is advanced and the teeth have become noticeably shorter, protection alone is not enough; the lost tooth structure has to be rebuilt. We explain how that is planned on the worn teeth restoration page. The right order is to bring the habit under control first, and then restore.

How does the process work?

At the first appointment we carry out an examination, take X-rays if needed, and take impressions or a digital scan. The guard is usually ready within a week; at the second appointment it is fitted and the bite is adjusted. It is normal for it to feel strange for the first few nights. We check it after a few weeks and reshape the surface if necessary. Guards wear too over time; we look at yours at routine check-ups and replace it when needed.

The cost depends on the type of guard and whether any additional treatment is needed. After the examination at our İzmir clinic you receive a written, itemised quote.