Why Do I Grind or Clench My Teeth – and What Can It Do to Them?
Many people clench or grind their teeth without realizing they are doing it.
Some notice themselves tightening their jaw while concentrating, driving, exercising, or dealing with stress. Others grind during sleep and may have no idea until a partner hears it or a dentist begins to see changes in the teeth.
Dentists use the term bruxism to describe grinding, clenching, or gnashing of the teeth. It can occur while awake or during sleep, and not every person who bruxes develops significant dental problems. But when the forces become frequent or intense enough, they can contribute to tooth wear, fractures, damaged restorations, muscle fatigue, and other symptoms. [1][2]
At Lagoon Dental, however, finding evidence of grinding is only the beginning of the conversation. We also want to understand what those forces are doing to your particular teeth.
Grinding and Clenching Are Not Exactly the Same
Although the terms are often used together, they describe slightly different behaviors.
Clenching generally involves pressing the teeth firmly together without much movement. Grinding involves movement of the teeth against one another. Both can generate significant forces.
Bruxism can occur while a person is awake or asleep. Awake clenching is often something a person can become more conscious of, while sleep bruxism is different because it occurs outside voluntary control. The causes of bruxism are complex, and current evidence does not support the old idea that simply having an imperfect bite is the primary cause of sleep bruxism. [1]
That distinction is important.
We do not want to look at worn teeth and simply say, “Your bite made you grind.” Instead, we ask: If significant forces are occurring, how are those forces interacting with your teeth, restorations, bite, and supporting structures?
What Can Grinding and Clenching Do to Teeth?
Flattened or Shortened Teeth
The biting edges and chewing surfaces can gradually become flatter. Front teeth may begin to look shorter than they once did.
In more advanced cases, the outer enamel can wear enough that the underlying dentin becomes increasingly involved.
Chipped or Fractured Teeth
Small chips may begin appearing along the edges of the teeth.
Teeth that already contain large fillings or other restorations may be particularly vulnerable because they have less intact natural tooth structure remaining.
Broken or Failing Dental Restorations
Crowns, fillings, veneers, and other restorations are designed to function under chewing forces, but no restorative material is indestructible.
Repeated mechanical stresses can contribute to microcracking, chipping, fracture, or other forms of restorative failure. [3]
Muscle Fatigue or Jaw Symptoms
Some people experience tightness, tired jaw muscles, headaches, or discomfort around the jaw. Others have very little discomfort even when considerable tooth wear is occurring. That is one reason symptoms alone do not always tell us how much damage is taking place. NIDCR notes that more severe bruxism can be associated with damaged teeth, jaw pain or fatigue, and headache. [2]
Tooth Wear Usually Deserves a Broader Evaluation
When I see worn teeth, I do not automatically assume that grinding explains everything. Tooth wear can be multifactorial.
For example, a patient may be grinding while also experiencing acid erosion. The acid can chemically soften and remove tooth structure, while mechanical forces act on an already compromised surface.
Another patient may have significant existing restorations, missing teeth, or tooth positions that cause forces to be concentrated differently throughout the mouth.
This is why the pattern matters. We look at where the wear is occurring, which teeth are affected, how the upper and lower teeth contact, whether restorations are failing, and whether chemical erosion or other factors appear to be contributing.
The goal is not simply to identify that the patient grinds. The goal is to understand why the teeth are changing.
Does Everyone Who Grinds Need a Night Guard?
No.
A night guard – or more accurately, an occlusal appliance – can be extremely useful for the right patient, but the appliance should be selected for a reason.
NIDCR identifies intraoral appliances as one option that can separate the teeth and help protect them from damage associated with grinding and clenching. [2]
Spear Education similarly emphasizes a diagnosis-first approach to occlusal splints: the appliance design and therapeutic goal should follow the diagnosis rather than beginning with a one-size-fits-all guard. [4]
An appliance does not magically eliminate every underlying contributor to tooth wear.
- The pattern and severity of tooth wear
- The condition of existing restorations
- The patient’s bite
- Jaw-joint and muscle findings
- Whether teeth are already structurally compromised
- Whether acid erosion may also be occurring
- Whether restorative treatment is planned or already present
For some patients, an appliance may primarily protect healthy natural teeth. For others, it becomes especially important after restorative treatment to help protect new dentistry from excessive forces. And for some patients, different or additional management may be appropriate.
What If My Teeth Are Already Worn Down?
Once significant tooth structure has been lost, simply stopping further wear does not necessarily correct what has already changed.
The next question becomes: Do the teeth actually need to be rebuilt – and if so, how conservatively can we do it?
Some patients may need little or no restorative treatment.
Others may benefit from conservative additive composite bonding.
More advanced cases may require a combination of bonding, veneers, partial-coverage restorations, crowns, or other restorative treatment.
The decision should depend on the amount of remaining tooth structure, the cause and pattern of wear, the bite, esthetic goals, and the condition of the mouth as a whole.
Full-mouth rehabilitation does not automatically mean crowning every worn tooth. Preserving healthy natural tooth structure remains an important part of the planning process.
How We Evaluate Grinding and Tooth Wear at Lagoon Dental
During a comprehensive evaluation, we do more than look for flat teeth.
Depending on the patient, our assessment may include detailed clinical photography, digital scans, evaluation of tooth-wear patterns, examination of existing restorations, bite and occlusal evaluation, jaw-joint and muscle examination, and discussion of sleep or airway findings when appropriate.
For more complicated cases, additional records may be necessary to understand the relationship between the teeth, jaw position, and proposed restorative treatment.
That information helps us determine whether we are looking at a relatively isolated problem – or one component of a larger pattern of dental breakdown.
The Takeaway
Grinding and clenching are common, but their effects are not the same for every patient.
The important questions are not simply: “Do I grind?” or “Do I need a night guard?”
The more useful questions are: How much force is occurring? Where is it going? What has already been damaged? What else may be contributing? And what can we do to protect the teeth long term?
If your teeth are becoming shorter, flatter, chipped, sensitive, or repeatedly breaking, a comprehensive evaluation can help identify the pattern before simply repairing another tooth.
Are Your Teeth Showing Signs of Wear?
At Lagoon Dental in Titusville, Dr. Jesse LeBrecht evaluates tooth wear as part of the larger picture – your teeth, bite, restorations, function, and long-term dental health.
Request a Comprehensive Evaluation
For patients with more extensive wear or multiple damaged teeth, learn more about our comprehensive approach to Full Mouth Rehabilitation & Reconstruction.
Clinical Sources & References
These references support the clinical statements in the article and can be retained by the website team as the editorial source record.
- Thomas DC, Manfredini D, et al. Sleep bruxism: The past, the present, and the future – evolution of a concept. Journal of the American Dental Association. 2024. Used for the contemporary understanding that dental occlusion is not considered a primary etiologic factor for sleep bruxism.
- National Institute of Dental and Craniofacial Research (NIDCR). Bruxism. https://www.nidcr.nih.gov/health-info/bruxism. Used for signs, symptoms, and conservative management concepts.
- American Dental Association Science & Research Institute. Self-healing dental composites / discussion of mechanical fatigue and microcracking under chewing and clenching forces. ADA research materials.
- Spear Education. The Diagnosis-First Approach to Occlusal Splints. https://www.speareducation.com/resources/spear-digest/the-diagnosis-first-approach-to-occlusal-splints/. Used for diagnosis-driven appliance selection rather than appliance-first treatment.
- Spear Education. Occlusal Stability in Restorative Dentistry: When Is It Safe to Treat? https://www.speareducation.com/resources/spear-digest/occlusal-stability-when-is-it-safe-to-treat/. Used for the broader system-based evaluation of teeth, muscles, joints, and function.