Make the Most of Your Mouth

Teeth Grinding and Bruxism: Ask the Dentist

Dentist Steven E. Roth, DMD, answers questions about how to prevent and cope with teeth grinding, or bruxism.

Question:

I had a root canal done 2 months ago and everything seemed to go fine. But now I have a severe pain and the bottom of my inside gum line right below the tooth that is extremely sensitive to touch. I thought maybe it's a cut or sore but I can't see anything. I grind my teeth at night as well. Any suggestions?

Answer:

Since it has only been 2 months since your root canal, I would return to the doctor as soon as possible for an evaluation. Teeth grinding may have triggered the soreness, but it could also be a lingering infection or a fractured tooth.

Question:

I've been living with pain in my gums for over a year on and off. I've had three root canals. X-rays show nothing, my gums bleed sometimes when brushing, but he says I don't have gum disease. I am a grinder, I have TMJ for sure, I have a bite plate, and I take a muscle relaxer at night to help along with a prescription pain reliever, and can't get rid of the pain. It’s so overwhelming; it’s beginning to make me depressed.

Answer:

It sounds like there may be many things going on at once. You need to have your dentist perform a complete and comprehensive exam, and then she can come up with an accurate diagnosis. You will then be on your way to solving the problem.

Question:

I bite my inner cheeks at night while I’m sleeping. How can I stop doing this so the sores will heal?

Answer:

It's tough to stop. But I have found that when my patients wear their custom form-fitted night guards, they will stop biting their cheeks.

Question:

I have TMJ, and I think I was grinding my teeth the other night while sleeping, and my cheek got caught in the middle of it. I have been in massive pain, the left side of my face is swollen, my ear and throat hurt, and I can barely open my mouth. I have to force my toothbrush between my teeth. I haven't really been able to eat either for a couple of days. Is all this caused by the TMJ, or could it be an abscess? What can I do?

Answer:

This could be an abscess, a sore muscle, an injured jaw joint, a blocked salivary gland, or worse. You need to see a dentist as soon as possible to find out what is wrong and get a diagnosis!

Question:

I grind my teeth at night. I have a fracture in one of my teeth and I have also noticed that the enamel near the roots of some of my teeth seems worn out. What can I do to keep this from getting worse?

Answer:

Several steps should be taken. See your dentist for a complete exam and diagnosis. Discuss the need for a protective bite splint that can help you. The root wear may be unrelated or related to acid erosion. Get to the dentist!

Question:

My jaw has been popping and making a clicking noise but with no pain. I’m not sure how to describe it. Could it be due to me grinding my teeth?

Answer:

Seventy percent of the United States population have a TMD, temporomandibular disorder. Thirty-five percent of the U.S. population have actual damage in their jaw joints. Of these, 70% will adapt favorably and 30% will have major problems later in life. So see the dentist, get an accurate diagnosis, and then you will know!

Question:

Can you get dental implants if you grind your teeth?

Answer:

Yes, but a very specific design will help maintain those implants and a night guard appliance may need to be worn.

Question:

I am a 74-year-old woman, and for years I have often bitten the inside of my cheek. This is very painful when it happens, and it seems that the area must be swollen since this continues to happen. Is there anything that can be done to my teeth in that area to mitigate against this?

Answer:

It’s tough to stop. But I have found that when my patients wear their custom form-fitted night guards they will stop biting their cheeks.

Question:

Can grinding your teeth at night cause neck pain?

Answer:

Yes, and a neck problem can contribute to jaw pain and grinding. The bottom line is to get to the dentist for an exam and diagnosis.

Question:

One of my fillings came out overnight. I guess because I was grinding my teeth. I tried to fill it back in with temporary filling material, but the hole is quite big. How dangerous might it be if I can't go to dentist as soon as possible?

Answer:

The filling most likely fell out due to tooth decay underneath the filling. This can lead to a toothache, an abscess, premature loss of the tooth, a vertical fracture, and many other problems. Get to a dentist as soon as possible.

Question:

I can’t afford several hundred dollars to replace my mouth guard. Is there anything inherently wrong with using one of the drugstore ones that you boil and bite, just until I save the money to replace the prescription one?

Answer:

Several research studies have shown that the store-bought soft appliances increase muscle activity and grinding, which can make the problem worse! An accurate, well-designed appliance is custom fitted to your teeth, your bite, your specific bite problem, and they are more comfortable.

Question:

My dentist says that I have small chips in my teeth caused by grinding my teeth at night. Could this be true?

Answer:

Yes it can, we see it all the time. Grinding is a slow, insidious process that will frequently show up as small chips in the teeth, but can later break teeth and/or wear them until they are much smaller. Some patients end up having their entire mouths restored when the problem could have been solved much earlier and much simpler with a night guard appliance and conservative treatment.

Question:

Are there special things you should do to protect your teeth when you have braces but grind your teeth?

Answer:

Most patients in braces that continue to grind can wear a special nighttime appliance to protect their teeth. I would discuss this with the orthodontist treating you with braces.

Question:

My 7-year-old son grinds his teeth at night. He fell and now his two front teeth are loose and one of them has started turning a brownish color. Should I be concerned?

Answer:

The trauma from the fall is a separate issue from the grinding. Grinding in children is usually normal. The discolored tooth is from bleeding inside the tooth. This must be looked at by a dentist as soon as possible.

Question:

I broke a tooth due to bruxism, and now a dentist says that I need a root canal or extraction. He says that I have an abscess but I have no dental insurance. Is there any way I can get treatment?

Answer:

I recommend calling the local dental society, a hospital-based program, or pay your own way if it is affordable. These types of problems tend to get worse over time.

Question:

I recently was messing around with some friends and ended up with a pebble thrown at my top front left tooth. It has been about a day and a half since the incident and I still seem to be experiencing pain and sensitivity to cold or hot fluids and when pressure is applied. It also seems to hurt on its own a bit without me doing anything to provoke it. I’m trying not to grind my teeth at night, but that’s hard to do. What else should I do?

Answer:

It is not possible to stop oneself from grinding. It is also possible that you have nerve or pulpal damage in the traumatized tooth. I recommend seeing a dentist as soon as possible.

Question:

I have a fracture in one of my teeth. I also grind my teeth. What can I do to keep my tooth from getting worse?

Answer:

I would see your dentist as soon as possible. Have a full-mouth, complete examination done and an accurate diagnosis. Fractured teeth typically need crown restoration and bite appliances to protect the rest of the teeth from grinding.

Question:

My daughter bit into her tongue pretty bad. Apparently she was grinding her teeth and caught her tongue. Should she see a dentist or a doctor?

Answer:

Great question. Clearly you have to deal with the trauma to the tongue. I would have the dentist evaluate the tongue and treat it as necessary. He or she can then evaluate your daughter’s grinding and bite appliances.

Thank you for joining us for Ask the Dentist. Be sure to check in on May 12 at 1 p.m. ET when we’ll discuss children's oral health. Sign up if you’d like an email reminder the day before the event.