You wake with a locked jaw. Or you catch yourself mid-afternoon with your teeth touching and your jaw tense. You bought a night guard, you wear it every night, and the feeling is still there.

Two things need saying. A night guard protects your tooth. It does not treat your bruxism. And there are two bruxisms, not one.

There are two, and the more common one is not the night one

Sleep bruxism is masticatory muscle activity while you sleep. It is the grinding, the sound your partner hears.

Awake bruxism happens while you are awake. It is not grinding: it is holding your teeth together, clenching lightly and sustaining it, or bracing your jaw while you work, drive or look at your phone. Almost nobody notices.

And here is the figure that changes the conversation:

It makes sense when you look at the clock. Sleep bruxism happens in short episodes through the night. Awake bruxism can run for hours, every day, without a single sound. That is why so many people wear a guard for years and still have pain. The guard is not in the right place at the right time.

Why the guard does not solve it on its own

A guard is a physical barrier. It sits between the arches and takes the force that would otherwise reach the tooth. That is protection, and good protection, at night.

So the guard looks after the structure. The cause is still unanswered. And the question that changes the treatment is a different one: why are you clenching?

What we investigate

The bite and the joint. How your teeth meet when you close, where one contact arrives before the others, the state of the facial muscles. This is dentistry’s direct ground.

Your day. With awake bruxism this is half the work. Which moments you catch yourself clenching in: at the computer, in traffic, in a difficult conversation. That mapping is simple and nobody does it.

Your sleep. Anyone who grinds at night deserves to have their sleep assessed by a physician. Bruxism and apnoea appear together often, though the literature still cannot confirm a relationship between the two in adults. Diagnosing apnoea is the physician’s job. Dentistry handles the jaw, the wear, the bite and, where indicated, the appliance.

What to watch for

Tick what you recognise and bring it to the appointment.

• You wake with a locked or aching jawMostly in the first minutes of the day
• During the day you catch yourself with your teeth touchingAt rest, upper and lower teeth should not meet
• Someone has heard you grinding at nightUsually whoever sleeps beside you
• Headache that starts at the templesOn waking, or building through the day
• Teeth that look shorter, chipped or sensitiveMostly the front ones and the tips of the canines
• Restorations that come loose or crack oftenRepeated load charges the restoration before the tooth
• Tooth marks on your tongue or cheekYou can see them in the mirror
• You snore, or wake without feeling restedReason to have your sleep assessed by a physician

When to seek an assessment

It is worth seeking one if there is visible wear on the teeth, pain in the jaw, face or ear, if you already wear a guard and the symptoms continue, or if there is snoring and sleep that does not rest you.

The aim is not to abolish bruxism by decree. It is to understand what sustains the behaviour and protect the structure while the cause is worked on.

Frequently asked questions