Short answer: Jaw clenching means pressing or bracing your teeth together, during the day or while you sleep. It is common, usually has more than one cause, and can contribute to a sore jaw, headache at the temples and tooth wear. Options include habit changes, a custom night guard and, for some people, muscle-relaxing injections into the jaw muscles. The right choice depends on an assessment.
What is jaw clenching?
Most of the day your teeth shouldn’t touch. When the jaw is at rest, the lips are together, the teeth are slightly apart and the muscles are relaxed. Clenching is when the teeth are pressed or held together and the chewing muscles stay working. Grinding is when the teeth move against each other under pressure. Dentists group clenching and grinding under one name: bruxism.
There are two main types:
- Awake bruxism. This is usually clenching or bracing rather than grinding. It often happens while concentrating, driving, lifting, working at a screen or feeling under pressure.
- Sleep bruxism. Clenching or grinding during sleep. Many people don’t know they do it until a partner hears it or a dentist notices wear on their teeth.
Some people do both. Clenching once in a while is normal. It becomes worth looking at when it is frequent, or when it comes with discomfort or changes to your teeth.
What causes jaw clenching?
There is rarely a single cause. Researchers and clinicians usually describe bruxism as having several contributing factors, and they differ from person to person. Common ones include:
- Stress and pressure. Many people notice they clench more during busy or demanding periods.
- Concentration habits. Bracing the jaw while focusing on a task is common, and often unconscious.
- Sleep-related factors. Sleep bruxism is linked to brief changes in sleep depth during the night. If you think you have a sleep problem, it’s a good idea to talk to your physician.
- Caffeine, alcohol and tobacco. These have been associated with more clenching and grinding in some people, especially later in the day.
- Some medications. Certain medications are associated with bruxism as a side effect. Don’t stop or change a medication on your own. If you’re concerned, talk to the prescriber.
- TMD. Temporomandibular disorders affect the jaw joint and chewing muscles. They often appear alongside clenching, though one doesn’t always cause the other.
Signs you may be clenching
Clenching often goes unnoticed, so these clues can help:
- a sore, stiff or tired jaw, especially first thing in the morning
- headache at the temples, often on waking
- teeth that look worn, flattened, chipped or cracked
- teeth that are more sensitive than before
- jaw muscles that feel tender or firm when you press on them
- clicking in the jaw joint, or a jaw that feels tight when you open wide
- a partner or family member hearing grinding at night
None of these on its own confirms bruxism, and some can have other causes. A dental exam can look at your teeth, jaw muscles and jaw joint together. Headache that is new, severe or changing should always be checked by a physician.
What can you do on your own?
For many people, the first step is noticing the habit. These simple strategies can help with daytime clenching:
- Learn the resting position. Lips together, teeth apart, tongue resting gently on the roof of the mouth, and jaw relaxed.
- Set reminders. A sticky note on your monitor, a reminder on your phone or a habit of checking your jaw at red lights can help you catch clenching.
- Look at evening habits. Some people notice a difference when they cut back on caffeine and alcohol later in the day.
- Manage stress in a way that works for you. That might be exercise, time outdoors, breathing exercises or support from a health professional.
If symptoms continue, or you see changes in your teeth, it makes sense to have an assessment.
Treatment options a dentist may discuss
Treatment depends on what the assessment finds. Not every option suits every person, and results vary. A general dentist will explain the risks and alternatives of each option, including choosing no treatment.
A custom night guard
A night guard, also called an occlusal splint, is a custom-fitted appliance worn while you sleep. It places a barrier between the upper and lower teeth to help protect them from wear. A night guard doesn’t stop the habit itself, but some people find it eases morning jaw tiredness. Your dentist checks the fit and adjusts it over time.
Habit guidance
Your dentist can help you build awareness of daytime clenching and habits that may strain your jaw muscles. This often works well alongside the steps above.
Physiotherapy and coordinated care
Jaw, neck and posture muscles work closely together. For some people, a physiotherapist who treats the jaw can help. Your dentist may also suggest coordinating with your physician, for example when sleep or medications may be involved.
Muscle-relaxing injections into the jaw muscles
For some patients, a prescription medication called a neuromodulator is injected into specific jaw muscles, such as the masseter, to reduce how strongly they contract. This is a therapeutic treatment for clenching and jaw-muscle pain. Before any decision, your dentist explains the following:
- Suitability. It depends on your assessment and health history, and it isn’t right for everyone.
- Possible side effects. These include tenderness, bruising or swelling where the injection is given, headache, and temporary weakness or tiredness when chewing. Less often, the medication can affect nearby muscles.
- How long it lasts. The effect is temporary, so repeat appointments may be discussed.
- Alternatives. A night guard, habit guidance, physiotherapy, or no treatment.
At Nabeta Dentistry, neuromodulator treatment is provided by Dr. Jared Nabeta and Dr. Kaitlin McCann, both general dentists.
How clenching relates to TMD and headaches
Clenching puts extra load on the chewing muscles and the jaw joint, so it often shows up alongside TMD. It can also contribute to headache felt at the temples, sometimes called headache related to TMD. Migraine is different: it is diagnosed by a physician. If you have physician-diagnosed migraine, our team coordinates any treatment with your physician. You can read more about this on our page on treatment for physician-diagnosed migraine, TMD and jaw pain.
When to book an assessment
Consider booking a visit if you:
- wake with jaw soreness or temple headaches more often than not
- notice your teeth wearing, chipping or becoming sensitive
- have jaw clicking, tightness or discomfort when chewing
- have been told you grind your teeth at night
No referral is needed for a clenching, grinding or TMD consultation. Learn more on our jaw clenching and teeth grinding page and our TMD and TMJ page.
Nabeta Dentistry is at Unit 3, 2202 Industrial St, Burlington, ON L7P 0N6, with parking on site, and sees patients from Oakville, Waterdown, Hamilton and Milton. Call 905-639-6701 to book a consultation.
This article is general information, not a diagnosis. Please see a dentist or physician about your own symptoms.