What are the Possible Causes of Bruxism?

Bruxism (pronounced: BRUK-siz-um) is a condition where the patient grinds, gnashes, or clenches their teeth. Individuals with bruxism may unconsciously clench their teeth while awake (also known as awake bruxism) or may grind and clench their teeth during sleep (also known as sleep bruxism).

Sleep bruxism is classified as a sleep-related movement disorder. Those who grind or clench their teeth during sleep are also more likely to develop other sleep disorders like sleep apnea and snoring.

Mild cases may not require bruxism treatment. However, in severe cases, bruxism treatment is highly recommended. Left unattended, the condition can lead to headaches, jaw disorders, damaged teeth, and other problems.



Doctors have yet to fully understand what causes bruxism. However, it is believed that bruxism is a combination of genetic, physical, and psychological factors.

  • Awake bruxism – may be the result of feeling certain emotions like stress, anxiety, frustration, anger, or tension. It can also be a habit during deep concentration or a coping strategy.
  • Sleep bruxism – a sleep-related chewing activity that’s often associated with arousals during sleep.



The most prevalent signs and symptoms of bruxism include:

  • Teeth clenching or grinding (in most cases, often loud enough to disturb sleeping partners)
  • Chipped, fractured, loose, or flattened teeth
  • Worn tooth enamel (with the deeper layers of the tooth exposed)
  • Increased sensitivity or tooth pain
  • Neck, jaw, or face soreness or pain
  • Pain that resembles an earache
  • Dull headaches that originate in the temples
  • Sleep disruptions


Risk Factors

The following can increase one’s risk of developing bruxism:

  • Age – bruxism is common in young children but eventually goes away by adulthood
  • Stress – increased stress and anxiety may lead to teeth grinding. So can frustration and anger
  • Personality type – a personality type that’s competitive, hyperactive, or aggressive can also increase one’s risk of developing bruxism
  • Medications and other substances – bruxism can be a rare side effect of some medications like antidepressants. Using recreational drugs, drinking alcohol and caffeinated beverages, and smoking tobacco may also increase one’s risk of developing the condition.
  • Other disorders – bruxism may also be linked to some medical and mental disorders like dementia, Parkinson’s disease, gastroesophageal reflux disorder (GERD), night terrors, epilepsy, attention-deficit/hyperactivity disorder (ADHD), and sleep apnea.



In mild cases, bruxism may not have any serious complications. In severe cases however, it may result to:

  • Damage to the jaw, teeth, restorations, and crowns
  • Tension-type headaches
  • Severe pain in the jaw or face
  • Disorders to the temporomandibular joints (TMJs)



If the dentist suspects the patient has bruxism, the cause of the condition is determined by asking the patient about their general health, daily routines, medications, and sleep habits.

  • To assess the extent of the condition, the dentist may look for:
  • Tenderness in the muscles of the jaw
  • Apparent dental abnormalities like missing, chipped, flattened, or broken teeth
  • Any damage to the underlying bone and inside of the cheeks and teeth (usually through X-rays)
  • If the condition is determined to be related to major sleep issues, seeing an Ear, Nose and Throat (ENT) and snoring specialist may be recommended.
Dr. Gerald Tan



Snoring - Has anyone ever mentioned you snore loudly?

Tired - Do you often feel tired, fatigued or sleepy during the daytime?
Observation - Has anyone ever observed you stop breathing during your sleep?
Blood Pressure - Have you got high blood pressure?
BMI - Are you overweight?
Age - Are you over 50 years old?
Neck - Is your neck circumference greater than 40cm?
Gender - Are you male?


Do you feel refreshed when you wake after 7 hours sleep?

Has anyone in your family ever been diagnosed with Obstructive Sleep Apnea?
Have you been diagnosed or are you being treated for depression?
Have you been diagnosed with type 2 diabetes?
Do you wake often during the night to go to the bathroom?
Do you suffer with headaches upon waking?


For each situation listed below, circle a number from 0 to 3 that best reflects how likely you are to fall asleep. Be as realistic as you can.

0 – No chance of falling asleep 1 – Slight chance of falling asleep     2 –Good Chance of falling asleep 3 – High chance of falling asleep

Sitting and reading
Watching TV
As a passenger in a car for an hour
Lying down in the afternoon
Sitting and talking to someone
Sitting quietly after lunch without alcohol
In a car stopped while in traffic
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