Jaw and tooth pain from grinding: signs, causes, and what helps

What’s probably going on

Grinding or clenching your teeth is called bruxism. It comes in two kinds, and many people don’t know they do either.

• Awake bruxism is clenching or grinding during the day without noticing. It often shows up when you’re stressed, angry, or concentrating hard.
• Sleep bruxism happens while you sleep. Often a sleep partner hears it, or a dentist spots the wear on your teeth.

Signs that often mean grinding:

• A sore, tight or tired jaw, often worst in the morning.
• A dull headache that starts at your temples.
• Teeth that are worn, flattened, chipped or loose.
• Tooth pain or sensitivity.
• Pain that feels like an earache, or soreness in your face or neck.
• A jaw that pops or clicks, or won’t open or close all the way.

What causes it

• Stress and anxiety. Anger and frustration can do it too.
• Caffeine, alcohol and tobacco. All three raise the risk.
• Some medicines, including some antidepressants. Don’t stop a medicine on your own; ask the doctor who prescribed it.
• Sleep problems. People who grind in their sleep are more likely to snore or have sleep apnea, where breathing pauses during sleep.

If you snore loudly, or someone has noticed you stop breathing in your sleep, talk to a doctor. Treating sleep apnea may help the grinding too.

Grinding can also crack teeth. If one tooth hurts sharply when you bite, see cracked tooth.

What to do tonight

These steps often ease sore jaw muscles.

1. Put heat or cold on the sore muscles. A warm, damp cloth or an ice pack on the side of your face can both help.
2. Massage the muscles of your jaw, face, neck and shoulders.
3. Take an over-the-counter pain reliever as the label directs. An anti-inflammatory such as ibuprofen can ease jaw pain. Ask a pharmacist first if you take other medicines, are pregnant, or have stomach, kidney or bleeding problems.
4. Eat soft foods while your jaw is sore. Skip nuts, hard candy and steak.
5. Skip caffeinated coffee and tea after dinner.

During the day, notice when you’re clenching, and relax your face and jaw. A reminder on your phone or a note on your screen can help you catch it.

What not to do

• Don’t use heat if your face is swollen. Use cold instead, and check the red box at the top of this page.
• Don’t chew gum or bite your nails. Cutting back on both can ease jaw pain.

How a dentist fixes it, and what it costs

A dentist looks for flattened or broken teeth and checks your jaw muscles and joints for tenderness. X-rays may be needed. If a sleep problem seems likely, you may be sent to a sleep specialist.

Mild grinding doesn’t always need treatment. When it does, the usual options are:

• A night guard. A guard of hard plastic or softer material keeps your top and bottom teeth apart while you sleep. That can help protect them from damage.
• Repairing damage. Badly worn teeth may be reshaped or covered with crowns.
• Treating the cause. That can mean stress management, practicing a relaxed jaw position, or treatment for sleep apnea.

Choosing a night guard

• Custom from your dentist. Made to fit your teeth exactly. It’s usually the most comfortable, protects best, and can last several years with care. It costs more than a store-bought guard.
• Custom from a direct-to-consumer lab. You take impressions at home and mail them in, and a lab makes the guard. You skip the office visit, but no dentist examines your teeth or checks the fit in person.
• Boil-and-bite from a drugstore. You soften it in hot water and bite into it. It costs less, but it doesn’t protect as well as a custom guard and may need replacing a few times a year.

Avoid any guard designed to permanently change your bite. If a guard causes pain, stop wearing it and see your dentist.

Ask your dentist for a written estimate. If you don’t have dental insurance, a dental savings plan (a discount membership, not insurance) can lower the price at participating dentists.

How to keep it from coming back

• Find a way to manage stress, such as exercise, meditation or yoga.
• Avoid caffeine and alcohol in the evening, and quit smoking if you smoke.
• Keep good sleep habits.
• Ask a sleep partner to tell you if they hear grinding or snoring.
• Wear your guard every night. Some people find the pain comes back when they stop.
• Rinse your guard in cool water after each use, and keep it out of hot water and direct sun.
• Get regular checkups, so a dentist can catch wear early.

Remi is another lab-made option that works the same way, from impressions you take at home.