Dra. Cléo Salustiano In this article
SummaryWhat are the signs of bruxism and what does it do to your teeth?How is bruxism treated?FAQRead nextBruxism: signs, effects on your teeth and treatment options
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Bruxism is the habit of grinding or clenching the teeth, asleep or awake. The most common signs are worn, short or chipped teeth, sensitivity, a tired jaw and morning headaches. It can wear down enamel, crack teeth and raise the risk of chipping or debonding veneers, crowns and fillings. Treatment combines a custom-made occlusal splint, habit and stress management, a sleep assessment when there is snoring or apnea and, once the teeth are protected, restoring the wear. Bruxism does not rule out veneers, but it must be in the plan from the start. Dr. Cléo Salustiano (CRO-SP 170844) sees patients in Mooca, São Paulo, Monday to Sunday, 8 a.m. to 10 p.m., in Portuguese, English and Spanish.
Bruxism is the habit of grinding or clenching your teeth, during sleep, while awake or both. There is no single cure, but it can be managed: the most common treatments are a custom-made occlusal splint (night guard), habit and stress management, a sleep assessment when there are signs of snoring or sleep apnea and, once the teeth are protected, restoring the worn teeth.
Many people only find out about bruxism when someone mentions hearing the noise at night, or when the dentist points out teeth that are shorter, chipped or sensitive. In clinical practice, it is common for people not to notice that they clench during the day, in traffic, at the computer or at the gym. Because the force involved can be much greater than in normal chewing, the effects show up in the teeth, the restorations and the muscles.
In this article, Dr. Cléo Salustiano (CRO-SP 170844), who provides general dentistry with a focus on cosmetic dentistry in Mooca, explains the signs of bruxism, what it can do to teeth, veneers and crowns, which treatments exist and how it relates to cosmetic work. If your question is specifically about getting veneers when you grind your teeth, there is a dedicated article: can I get composite veneers if I grind my teeth?.
This article comes from Dr. Cléo Salustiano's dental office in Mooca, São Paulo (care in English, Portuguese and Spanish). See the general dentistry page to learn how the treatment is done here and book your assessment.
What are the signs of bruxism and what does it do to your teeth?
The most common signs of bruxism are teeth with flat or shorter edges, small chips along the edges, cracks in the enamel, sensitivity to cold, a tired or sore jaw on waking, headaches at the temples in the morning and grinding noises noticed by whoever sleeps next to you. There may also be tooth marks along the sides of the tongue, a whitish line inside the cheek and enlarged jaw muscles.
There are two main types. Sleep bruxism happens involuntarily during sleep and usually involves both grinding and clenching. Awake bruxism happens during the day, almost always as silent clenching linked to concentration, tension or stress. The causes vary and tend to add up: stress and anxiety, sleep disturbances, caffeine, alcohol and smoking, some medications and individual traits. Today we understand that the bite, on its own, rarely explains bruxism.
In natural teeth, the most visible consequence is wear. Over time, teeth become shorter and flatter, the enamel thins and the dentin, which is more yellow and more sensitive, becomes exposed. Chips, cracks and, in more intense cases, fractures can appear. It is also common to see small notches near the gumline and sensitivity without cavities. When wear is extensive, the case may reach the point of needing rehabilitation, the subject of the article on worn-down teeth and oral rehabilitation.
On veneers, crowns and fillings, bruxism raises the risk of chipping, fracturing and debonding. Composite veneers can chip at the edges and wear faster. Porcelain veneers and crowns resist wear well, but they can fracture under excessive force and, if not properly adjusted, can wear down the opposing teeth. Implants also suffer from overload, which can loosen screws and break the upper part. That is why bruxism is not a reason to give up on cosmetic treatment, but it is a factor that must be in the plan from the start.
The muscles and the jaw joint feel it too. Frequent clenching overloads the chewing muscles and can contribute to pain in the jaw, the ear and the head, a picture that overlaps with TMJ disorder. Not every case of bruxism causes pain, and not every jaw pain comes from bruxism, which is why the exam is what tells them apart.
| Treatment | What it is for | Note |
|---|---|---|
| Custom occlusal splint | Protects teeth, veneers and crowns and spreads the force | Does not stop the habit; needs adjustment and check-ups |
| Habit control | Reduces daytime clenching | Lips together, teeth apart, tongue relaxed |
| Stress and sleep management | Addresses factors that drive bruxism | Exercise, relaxation and psychological support when indicated |
| Sleep assessment | Investigates associated snoring and apnea | Done by a physician when there are signs of a sleep disorder |
| Physical therapy | Eases muscle and joint pain | Indicated when there is pain or limited movement |
| Restoring the wear | Rebuilds tooth shape and function | Comes after the teeth are protected |
How is bruxism treated?
Bruxism treatment combines protecting the teeth with managing what drives the habit. In most cases the foundation is an occlusal splint: a rigid acrylic appliance custom-made from an impression or scan of your teeth and adjusted by the dentist. It does not stop bruxism from happening, but it takes the force instead of your teeth and restorations and spreads the load more evenly. The splint needs regular check-ups, because it wears, and it should not be replaced by soft, ready-made guards, which are not adjusted to your bite.
Habit control matters especially for awake bruxism. The rule of thumb is: lips together, teeth apart, tongue relaxed. Some people use phone reminders or stickers on the computer to check several times a day whether they are clenching. Cutting back on caffeine, alcohol and smoking, especially at night, and keeping a healthy sleep routine usually help. When stress and anxiety weigh heavily, exercise, relaxation techniques and psychological support are part of the treatment, not a side note.
A sleep assessment comes in when there are signs of loud snoring, pauses in breathing, unrefreshing sleep or daytime sleepiness. In these cases, bruxism may be linked to sleep apnea, and referral for a medical sleep evaluation is part of the care. It is also worth reviewing with the prescribing physician whether any medication you take might be contributing, but never stop a medication on your own.
Restoring the wear comes after the teeth are protected. First the force is controlled, with a splint and habit changes; then what was lost is rebuilt, with composite, veneers, crowns or, in extensive cases, a planned rehabilitation. Doing the cosmetic work before protecting the teeth raises the risk of chipping or fracture. People with veneers and bruxism usually need to wear the splint at night on an ongoing basis and keep up with maintenance.
Some situations call for other professionals, such as a physical therapist when there is muscle or joint pain, and a physician when a sleep disorder is suspected. In selected cases, other approaches may be discussed during the assessment, always based on individual indication. The response to treatment varies from person to person, and follow-up over time is what allows the plan to be adjusted.
How do I know if I have bruxism?
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The most common signs are worn or chipped teeth, a tired or sore jaw on waking, morning headaches, sensitivity without cavities and someone hearing you grind at night. People who clench during the day often only notice once they start paying attention. Confirmation comes from a clinical exam.
Can bruxism be cured?
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There is no single cure, but it can be managed. The goal of treatment is to protect the teeth and restorations, reduce the factors that drive the habit and ease symptoms such as muscle pain. In some people bruxism decreases a lot over time; in others, follow-up is ongoing.
Will a night guard stop me from grinding?
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Not necessarily. An occlusal splint does not stop bruxism, but it takes the force instead of your teeth and spreads the load, protecting enamel, veneers and crowns. It must be custom-made and adjusted by the dentist, with regular check-ups, because it also wears with use.
Do over-the-counter night guards work for bruxism?
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They are not recommended. Soft, ready-made guards are not adjusted to your bite and, in some people, may even encourage clenching. An occlusal splint is made from an impression or scan of your teeth, in rigid material, and adjusted at the dental office.
Can people with bruxism get veneers?
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Yes, as long as the bruxism is under control and included in the plan from the start. That means protecting the teeth with a splint, assessing the bite and choosing a suitable material and thickness. Wearing the splint at night is usually ongoing after veneers, and regular maintenance is part of the care.
Can bruxism break a veneer or crown?
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It can. The force of clenching and grinding raises the risk of chipping, fracturing or debonding veneers, crowns and fillings, whether composite or porcelain. That is why bruxism is assessed before any cosmetic work and a splint is usually part of the plan.
Does stress cause bruxism?
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Stress and anxiety are among the most strongly associated factors, especially for daytime clenching, but they are not the only cause. Sleep, caffeine, alcohol, smoking, some medications and individual traits also play a part. That is why treatment usually combines protecting the teeth with addressing these factors.
Does Botox fix bruxism?
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Botulinum toxin can reduce the strength of the chewing muscles in selected cases, but the effect is temporary and it does not address the causes of bruxism. It does not replace a splint or habit control, and whether it is indicated depends on an individual assessment of risks and benefits.
