What Is Bruxism? Signs, Causes, and Real Stories From People Who Have It

People who have bruxism tend to find out by accident.

A dentist notices wear and tear during a routine checkup. A partner mentions clacking and grating noises throughout the evening. A routine morning headache and/or jaw pain.

This article explains what bruxism actually is, what causes it, how to tell if you have it, and what to do about it. You'll hear from real enCore customers - people living with bruxism in all of its forms and levels of severity.

What Is Bruxism?

Bruxism is the medical term for the involuntary grinding, clenching, or gnashing of teeth. It is classified as a parafunctional oral behavior — meaning it has nothing to do with normal behaviors like chewing or speaking. It tends to happen during sleep, during concentration or stress, and often without the person having any awareness of it.

The condition is far more common than most people realize. Research estimates that around 22% of the global adult population experiences bruxism in some form — roughly 1 in 5 adults. Sleep bruxism affects men and women roughly equally, but awake bruxism is somewhat more common in women. It tends to peak between ages 20 and 40 before gradually declining.

Despite its prevalence, it remains significantly underdiagnosed — in large part because so many people who have it aren’t aware of it.

Sleep Bruxism vs. Awake Bruxism: Two Different Conditions

The two distinct forms of bruxism require different approaches for managing them.

Sleep Bruxism

Sleep bruxism most commonly occurs during the lighter stages of the sleep cycle, specifically during its moments of brief partial awakenings. The jaw muscles contract rhythmically — producing the grinding sounds that sleeping partners often notice. The person sleeping through it has no awareness of the force they're generating.

This unconsciousness is part of what makes sleep bruxism so damaging. When awake, protective reflexes modulate how hard you bite down. When asleep, those reflexes are largely absent. According to Johns Hopkins Medicine, sleep bruxers can apply up to 250 pounds of force per episode — far beyond what normal chewing produces (20 to 40 pounds).

Sleep bruxism affects an estimated 8 to 10% of adults and is most common in the 20–40 age range.

Awake Bruxism

Awake bruxism is actually more common than sleep bruxism, affecting an estimated 22 to 31% of adults. It involves clenching or grinding while conscious. It is most common during concentration, stress, physical exertion, and in response to emotional distress. It tends to involve more clenching than grinding. Since it doesn't result in the audible sounds of sleep bruxism, it tends to go even more unnoticed.

Many people have both awake and sleep bruxism. The cumulative load of this grinding at night and clenching throughout the day compounds damage to teeth, muscles, and joints.

What Causes Bruxism?

Causes of bruxism are multifactorial — several contributors tend to interact with each other. In most people, there is no single cause. Research has identified the following as the most common:

Stress and Anxiety

It is the most commonly cited driver, and the most consistently supported by research. The jaw responds to psychological stress through muscle tension, and that tension can persist into sleep and manifest throughout the day. People with higher stress levels, anxiety disorders, and difficulty regulating emotional tension have significantly higher rates of bruxism.

enCore customer, Kara Bush, has clenching that is specifically triggered by stressful dreams:

"I clench only during stressful dreams and I involuntarily slam my jaw closed while falling asleep — which cracked a molar."

Stress doesn't just correlate with bruxism — it can drive it to levels that cause acute structural damage in a single episode.

Sleep Disorders and Sleep Architecture

Sleep bruxism is closely tied to sleep health. Episodes almost always cluster around transitions between sleep stages and the microarousals that punctuate normal sleep. When sleep cycles are disrupted — by stress, irregular schedules, alcohol, or underlying sleep disorders — grinding frequency tends to increase.

The relationship with obstructive sleep apnea (OSA) is particularly significant. Research indicates that 33 to 50% of people with OSA also have sleep bruxism. The leading hypothesis is that teeth grinding and clenching represents the airway struggling to reopen. If you grind your teeth and also snore heavily and wake frequently, sleep apnea is worth discussing with your doctor.

Genetics

Bruxism runs in families. Studies consistently find that 21 to 50% of people with sleep bruxism have a close family member who also has the condition. 

Pamela Rurak and her daughter both suffer from bruxism:

"I have been a grinder for years — headaches, jaw pain — and as soon as I had my mouthguard made it all went away. It's incredible. My daughter has TMJ and I told her about this guard and it changed her life."

Medications and Substances

A number of medications are associated with elevated bruxism. Selective serotonin reuptake inhibitors (SSRIs) — a class of antidepressants including fluoxetine, sertraline, and paroxetine — are among the most commonly implicated. Stimulants, antipsychotics, and certain other psychotropic drugs also appear in the research.

Lifestyle substances play a role as well. Heavy caffeine consumption, alcohol (particularly in the hours before sleep), and tobacco use are all associated with increased grinding frequency. Alcohol is commonly misperceived as a sleep aid but actually fragments sleep cycles — which can in turn increase grinding activity during the night.

If you've noticed your grinding started or worsened significantly after beginning a new medication, that connection is worth raising with the prescribing doctor.

Signs and Symptoms: How to Tell if You Have Bruxism

Because so much bruxism occurs during sleep or below the level of conscious awareness, the symptoms are often the first sign something is happening. Here's what to look for.

Morning Jaw Pain and Stiffness

The most consistent and recognizable symptom of sleep bruxism. The masseter and temporalis muscles have spent hours in sustained, high-force contraction. In the morning they feel like any overworked muscle after prolonged intense exercise — sore, tight, and fatigued. This feeling typically eases through the day, which is one of the distinguishing patterns of sleep bruxism.

Janice Kotouch, 62, has lived with severe bruxism for years:

"I have had TMJ and terrible grinding for many years. I actually have chipped several teeth by grinding. I cannot sleep — even napping in the car — without my guard."

Headaches, Especially Upon Waking

Temple headaches and general morning headaches are among the most frequently reported and most commonly misattributed symptoms. The temporalis muscles responsible for much of jaw movement extend across the temples, and their chronic overuse produces tension that radiates as headache pain. Many people spend years treating the headache without identifying the grinding as its source.

Craig's case is striking in its specificity:

"I have to wear one or I will get intense migraines. This guard has reduced my headaches by at least 90%."

Ninety percent reduction in migraines. From a night guard. The mechanism is direct: protect the jaw, relieve the muscle tension, stop the headaches that tension was causing.

Leigh Fagerstrom was dealing with the full cluster — headaches, neck pain, and jaw pain together:

"I'm a lifetime grinder/clencher at night. Headaches, neck pain, jaw pain and TMJ is awful."

The neck pain detail is worth noting specifically. The muscle chains connecting jaw, neck, and shoulder mean chronic jaw overuse frequently manifests as upper body tension — something often misattributed to posture or general stress.

Tooth Sensitivity That Worsens Over Time

As enamel is gradually worn away, the dentin layer beneath becomes progressively more exposed. Dentin is rich in microscopic tubules connected to the tooth's nerve, making it highly sensitive to temperature, pressure, and sweet foods. Sensitivity that's been developing or worsening over time — particularly without an obvious cause like a new cavity — is a strong signal of bruxism-related enamel loss.

Markendaya Ferry's dentist had stopped telling him he needed a guard while his teeth were quietly deteriorating:

"My dentist said I didn't need one and that they were very costly, but my teeth were cracking and were incredibly sensitive to hot and cold sensation. Over the past month the sensitivity in my back teeth has decreased significantly and my jaw no longer aches."

Visible Wear, Flattening, or Chipping

Dentists often spot bruxism before patients do by examining the biting surfaces of teeth. The signs are distinctive: surfaces that appear flat or shortened, front teeth that have thinned or chipped at the edges, and a general loss of tooth height that accumulates over years.

The guard itself also becomes evidence. Terri Richard saw her grinding habits reflected in the marks pressed into her guard.

David Summerville's grinding is severe enough that it reveals itself materially:

"I can shred a soft guard in a week."

Clicking, Popping, or Limited Jaw Movement

Clicking, popping, or grating — and restricted range of motion can indicate stress on the temporomandibular joint. When accompanied by pain or difficulty opening the mouth fully, these symptoms describe temporomandibular disorder (TMD) - the downstream consequence of a jaw joint that has been chronically overloaded.

Kimberly Brown's TMJ symptoms had progressed to the point of being unable to open her mouth normally:

"I have TMJ, so frequently wake up with jaw pain, severe popping and even not being able to open my mouth all the way."

Grinding Sounds During Sleep

The most obvious indicator — and the one accessible via a bed partner or family member. Tooth-on-tooth grinding during sleep can be surprisingly loud. Andrea Johnson's husband heard the change the first week she started wearing her guard:

"My husband tells me that I sleep quietly now without grinding, I don't wake up with jaw pain or sensitive teeth."

The silence was the evidence. The grinding had been audible enough that its absence was immediately noticeable.

Ear Pain or Fullness

The temporomandibular joint sits directly adjacent to the ear canal. Problems in or around the joint can present what feels like an earache, a sensation of pressure or fullness in the ear, or ringing (tinnitus). These are regularly mistaken for ear infections.

Allison Gilvezan listed it among a cascade of symptoms driven by years of unaddressed grinding:

"My dentist told me that I'd ground down my back teeth from years of bruxism, and because of that my jaw was off balance, causing bad headaches and ear aches and all sorts of awful things."

How Bruxism Is Diagnosed

There is actually no single definitive test. Diagnosis is primarily clinical - based on a combination of symptoms, examination findings, and history.

Dental examination is the most common path. A dentist checking for bruxism will look for characteristic wear patterns on tooth surfaces, palpate the jaw muscles for tenderness, evaluate bite alignment, and ask about symptoms including morning jaw soreness and headache patterns. For most people, this clinical picture is sufficient.

Erich Kertzscher's diagnosis came during a routine dental appointment at age 60:

"I was told by my dentist that I should consider a mouth guard as it was determined that I do grind my teeth. Even at 60 years old he stated that it would help me in the future."

Patient-reported symptoms are central to diagnosis. Key questions your dentist or doctor may ask: Do you wake up with jaw pain? Do you get morning headaches? Has your tooth sensitivity worsened? Has a partner heard grinding sounds? Do you notice yourself clenching during the day?

Bed partner observation is genuinely valuable clinical data. If someone has told you they can hear you grinding, that information belongs in your dental history.

The guard itself as a diagnostic tool. For people who are unsure whether they grind, wearing a guard and examining it after a few nights can be revealing. Marks, indentations, and visible wear on the guard surface are direct physical records of what the jaw was doing during sleep. 

The Causes You Can Actually Influence

Since bruxism is multifactorial, there are several contributing factors you can meaningfully address:

Stress management is consistently the most impactful intervention. Exercise, consistent sleep schedules, mindfulness practices, and professional support all reduce the psychological load that feeds grinding. This doesn't eliminate bruxism for most people, but it often reduces its frequency and severity.

Caffeine and alcohol consumption — particularly in the hours before sleep — both correlate with increased nighttime grinding. Reducing or eliminating evening caffeine and limiting alcohol can have a direct effect on grinding activity.

Daytime awareness is specific to awake bruxism. Many people find that once they start paying attention — checking in with their jaw periodically during high-stress tasks, practicing keeping teeth slightly apart during the day — they begin catching and interrupting clenching habits they hadn't previously registered. The natural resting position for the jaw has lips closed and teeth slightly apart.

Medication review. If grinding started or significantly worsened after a new medication, that's worth raising with the prescribing doctor. 

What Treatment Actually Looks Like

Bruxism doesn't have a single cure, but it can be managed. For most people, the approach involves protection, behavioral modification, and occasionally professional intervention.

A custom night guard is the most universally recommended first-line treatment. It doesn't stop the grinding behavior — it stops the grinding from causing damage. The guard absorbs and redistributes forces that would otherwise act on enamel and joints, creating a sacrificial layer that wears in place of teeth.

The quality and fit of the guard matters considerably. A guard that doesn't fit well can create uneven bite pressure that exacerbates jaw muscle tension rather than relieving it. Carlene Shifflet, who worked in dentistry for years, was skeptical about what an online lab like enCore could produce:

"I worked in dentistry for years and expected to receive a cheap copy of a bite guard. However, I'm beyond thrilled with the guard you made! It fits better than the one I lost a few years ago, which was made by my dentist."

Better than the dentist-made one. From a dental professional who knew exactly what to compare it against.

Leigh Fagerstrom puts it even more directly:

"Encore night guards are a fraction of the price of the guards I've gotten from my dentist and work BETTER."

Stress reduction as a complement to guard use can reduce grinding frequency over time. CBT, relaxation techniques, and consistent sleep hygiene are the most evidence-backed approaches.

Physical therapy targeting the jaw and surrounding muscles is valuable for people who have developed significant jaw pain or limited movement alongside their bruxism.

Botox injections into the masseter muscles reduce grinding force temporarily and are sometimes used for severe cases where other approaches haven't provided sufficient relief.

Choosing the Right Guard

Not all guards are equivalent for bruxism management. Here's how the types break down:

Soft Guard — Comfortable and cushioning; ideal for light clenchers and first-time guard wearers.

Hard Guard — The most durable and typically preferred for moderate to heavy grinders. Rigid surface distributes force evenly without compression. 

Hybrid (Dual-Laminate) Guard — Soft inner layer for comfort, hard outer shell for durability. Often the optimal combination for consistent nightly use without compromising protection. 

Ultra Thin Guard — Retainer-style, minimal bulk. Best for lighter grinding, daytime clenching.

Not sure which type fits your situation? Our guard selection guide walks through the decision based on your grinding severity and preferences.

What enCore Guards Are, and Why It Matters

enCore has been manufacturing custom dental night guards for over 30 years — supplying dental labs and dentist offices for decades before making the same product available directly to patients.

Every guard is made from a dental impression of your specific teeth, produced by trained dental technicians in our FDA-registered, ISO 13485 and 9001 certified facility, from 100% BPA-free, FDA-approved materials.

enCore customer, Debra Ferrell spent 45 years as a dental assistant:

"I was a dental assistant for 45 years and I can tell you that you will pay at least 4 times this amount in an office. And there is NO difference. I made them myself in the office. Why pay those prices?"

Amy Hefley's dentist now recommends enCore directly to her patients:

"My dentist NOW refers her patients to Encore due to the quality of the guards."

Every guard is backed by a 100% satisfaction guarantee on fit. HSA and FSA cards are accepted at checkout. Explore our full collection here.

This article is for informational purposes only and is not a substitute for professional dental or medical advice. If you suspect you have bruxism or are experiencing jaw pain, tooth sensitivity, or related symptoms, please consult your dentist or healthcare provider for a proper evaluation.