How to end night teeth grinding? Mouthguards just treat the symptom...
August 12, 2015 6:23 PM   Subscribe

I've been grinding my teeth for years - but in the past year it has gotten dramatically worse. So much so that I'm now in pain (jaw) and my new dentist tells me that something must be done. Is there an alternative to night mouth guards? Are there any real solutions? More details inside...

Problem 1: I wear an upper retainer (kind of large) every night.
Problem 2: I gag kind of easily. I have some mild PTSD from taking the imprints for those retainers.
Problem 3: My life is stressful (I'm in a company that's not doing so well, getting married, just bought a house I can't really afford, that requires a ton of repairs I can't really afford)
Problem 4: I tend to be a stressful/anxious person.

I feel that night mouth guards are only treating the symptoms, are there ways to stop grinding? I've tried meditating before I go to sleep - that doesn't seem to help. Has anyone ever been able to successfully stop grinding?
posted by Mushroom12345 to Health & Fitness (31 answers total) 22 users marked this as a favorite
Has anyone ever been able to successfully stop grinding?

Well, not me. When I'm stressed or overtired, I grind.

If my mouth guard is only treating the symptom then I'm okay with that actually. It gets rid of the headache, the jaw ache and makes my dentist happy. Addressing stress is a good thing, but I wouldn't expect it to completely rid you of the grinding habit.
posted by 26.2 at 6:39 PM on August 12, 2015

I almost posted this same question here a few years ago. Instead, I succumbed to late night Googling, and before I knew it, I was test-driving a biofeedback headband. It seemed like the only product available that was really addressing the unconscious/subconscious root of the behavior. I think it was worth the money just to have the experience of trying to change my lizard brain.

I wrote an extensive review of it over the course of that year. I won't link to it here, but it's very easy to find on Google. Summary: An interesting experiment, but the device's design flaws (and my narrow forehead) prevented me from continuing the test beyond a year. Even though my grinding events supposedly decreased, I was still doing damage to my molars because I stopped wearing my mouthguard during that year and the few events I did have were still causing wear on the surfaces. Alas, I am still very much a bruxist, and went back to the custom-made bite guard from my dentist.

Perhaps if you have a wider forehead the headband would work better for you than it did for me...
posted by oxisos at 6:47 PM on August 12, 2015

My understanding has always been the opposite, that mouth guards treat the problem but don't necessarily treat the symptoms! (In other words they prevent more damage to your teeth but you still get a sore jaw and everything because you're still grinding.) So if you've stopped the symptoms, hopefully that's in addition to having stopped the damage.

Are you using the kind of guard that just goes over your front teeth? If so, don't. When I use those, I somehow find a way to grind my back teeth together. My dentist insists that's nearly impossible, but many times I've woken up with those back teeth touching. I can't do it when I'm awake, but somehow my sleeping brain finds a way.

Maybe you should try hypnosis, either self-hypnosis or seeing a hypnotist. Short of that, I don't think there's much you can do beyond using a guard and meditating.
posted by Ursula Hitler at 6:48 PM on August 12, 2015

Are you taking any medications? Teeth grinding can be a pretty common side effect of some medications.
posted by girl flaneur at 6:48 PM on August 12, 2015 [2 favorites]

Re-frame this in your head. The grinding IS the problem. The symptoms are headaches, jaw pain, eventual TMJ issues, and severely damaging your teeth (causing huge, expensive, painful dental problems down the line). The night guard treats the problem.

I am a super low stress person and I still clench my teeth at night. My problem is I'm a tooth-clencher. My night guard stops that from being a problem.
posted by phunniemee at 7:05 PM on August 12, 2015 [8 favorites]

I agree with the others - wearing a mouthguard is super important. I have a soft plastic one and a hard plastic one (I had an allergic reaction to the soft, and my mom runs a dental office, so we tried both. The allergy seems to have gone, so I wear the soft because it works better). Both go over all of my top teeth.

There are two things I do to treat jaw pain that doesn't resolve with nightguard + advil:

1) I find the knots in my cranial muscles and work them out (my partner's mother is a massage therapist, and helped me figure out how to do this, so YMMV)

2) I use a trick I found online a while ago. Basically, put your hand below your chin and open your mouth so that you're pushing against your hand with a slight force. Keep that going for 8 seconds, then rest. Repeat four times. That apparently tells your jaw muscle to switch from one default position (closed) to the other default position (open) and therefore releases tension. It works pretty well for me.

But nightguard + advil is a good starting point.
posted by guster4lovers at 7:14 PM on August 12, 2015 [9 favorites]

Klonopin interrupts grinding for a lot of people. My neurologist prescribed it to me as part of treating a headache I've had for over twenty years. The problem for me has been is finding a dose that interrupts the grinding without leaving me excessively foggy & fatigued. This is one of those situations where the original problem has to be pretty bad to make the medication side effects worth while, but I'll throw it in the pot for you.
posted by not that girl at 7:39 PM on August 12, 2015 [2 favorites]

The grinding is a symptom of my stress/anxiety.
Definitely wear the mouth guard, but you need to solve your stress and anxiety problems to make this go away.
Anti anxiety meds are a good start.
posted by littlewater at 8:00 PM on August 12, 2015 [1 favorite]

Datapoint: I am a big time tooth grinder, and my wife reports that I rarely grind my teeth when I go to bed early, am well rested in general, and when I'm not stressed out.

So...if any of that happens to apply to you too, try to be less stressed out (good luck), get enough sleep, and don't stay up late.
posted by Salvor Hardin at 8:00 PM on August 12, 2015 [1 favorite]

>I have some mild PTSD from taking the imprints for those retainers.

The mouthguard is much smaller and less intrusive than the mold used to make the mouthguard! The mold had to be huge and full of alginate goo to coat and imprint all of your teeth, whereas the mouthguard only needs to cover the bite surfaces. They don't feel the same at all, in my experience.
posted by pseudostrabismus at 8:04 PM on August 12, 2015 [1 favorite]

Sleep bruxism. Might want to ask your MD about sleep issues.
posted by Cuspidx at 8:25 PM on August 12, 2015

If you're not already, consider the following:

- consume less caffeine, refined sugar, alchol, etc.
- exercise
posted by aniola at 10:07 PM on August 12, 2015 [2 favorites]

There are also muscles inside the back of your mouth that you can massage.
posted by aniola at 10:08 PM on August 12, 2015

It's pricy but I had a friend buy a grindcare electric shocker thingy. He said it was the only thing that worked but he was giving himself migraines so he went to that length!
posted by pairofshades at 11:06 PM on August 12, 2015

Been there. I feel your pain.

I did stop grinding. It took about a year for me to learn.

The two things that helped me were:
(1) a very low dose of Flexeril, a prescription muscle relaxant that helped take the initial pain away. It also made me aware of which muscles were tensing up, and how to tell myself to relax them;

(2) Yoga, specifically the "downward dog" position. If I do that before bedtime, and at night if I wake up from grinding, that releases the tension in my neck/jaw and stops the grinding.

I also co-sign aniola's comment about caffeine, alcohol, and sugar. Cutting these things out will relieve your anxiety.

Hang in there, there are solutions.
posted by amy27 at 11:12 PM on August 12, 2015 [5 favorites]

I went to a university TMD center to have a splint made. As part of the treatment, they insisted that I go to a face/neck physical therapist as well as a health psychologist in order to reduce or stop the grinding. I really wish I had, but at the time I couldn't afford it.

I was surprised at how effective the self care was. This is what I remember:

1. No caffeine.
2. Sleep on your back (or on your side with a pillow between the legs). This one sounded strange, and was difficult for me, but surprisingly helpful.
3. No large jaw movements, no popping, etc.
4. Relax the jaw during the day. Any time you notice yourself tensing...relax!!
5. Soft foods. No gum.

For me, managing my anxiety has been key. I wore a splint at night for years, but now I only need it during times of high stress.
posted by hannahelastic at 2:55 AM on August 13, 2015 [3 favorites]

How long have you been wearing the mouth guard? Do you wear it every time you sleep (every night, every nap)?

It took me a several months to get used to mine, but now I notice my jaw relaxing as soon as I put it in. It seems that with time, my body has subconsciously recognized the guard as a cue to relax. I'll even wear it during the day when I feel myself getting all worked up about something.

So, maybe give it more time?
posted by SuperSquirrel at 6:49 AM on August 13, 2015

I grind my teeth, lifelong grinder, before I started wearing a nightguard I had almost daily headaches and it hurt to eat hard foods, my teeth were super sensitive. My last dentist was also a grinder and developed an upper guard that doesn't go all the way to the last teeth so it's less intrusive but still effective, I like it a lot more than the guards I had before. I agree it takes time for the effects to kick in so sticking with wearing it is key.

I've heard of TMJ being treated with botox injections, that might be a short-term aid to stop the jaw pain but I've never done it.

Nthing reducing stimulants, medications, and learning about stress reduction and retraining your patterns of holding tension. For me yoga has been very helpful if I do it daily and not just when things get bad. I find if I'm going through a stressful period I grind a lot more and hold that tension through the day.
posted by lafemma at 6:50 AM on August 13, 2015

It's not clear from your question...are you actually using a bite guard? Every night? I'm not sure if your issue is that the bite guard doesn't work, or you just don't like the idea of wearing it.
posted by radioamy at 7:08 AM on August 13, 2015

I asked this question a few years ago. The answers, and some more poking that I did, made me decide against the treatment.

I've gone without a guard since then. I try to stretch my jaw as much as possible when I feel stressed before bed. Basically I yawn as wide as possible, and hold it as long as possible, then repeat a few times. (I'm going to start trying guster4lovers exercise too.) My new dentist is pushing for me to get another nightguard, but I'm resisting because the guard makes me clench and I wake up with sore muscles.

There is physical therapy for bruxism. I'm already doing a lot of PT for other issues now, but when I'm done with that I plan to ask my dentist about it.
posted by hydrophonic at 7:54 AM on August 13, 2015

Yes there are ways to stop grinding and yes, people do stop grinding, but Grinding comes in all shapes and sizes, and has a number of causes, so not every method works for every patient.

If your grinding is stress induced, then managing your stress is a good strategy, and also has other health benefits.

Pharmaceutical treatments exist, but are usually short term and almost always have side-effects.

There are different types of appliances that are used to manage bruxism (nighttime grinding), one of which is an inhibitor, designed to break the clenching habit. it is much smaller than a full coverage appliance, so may be less gag inducing for you. There are also guards that go over lower teeth, also better for gaggers.

Your dentist should be able to design something appropriate, or refer you to someone who can.
posted by OHenryPacey at 7:56 AM on August 13, 2015 [1 favorite]

I have gotten rid of my teeth grinding (at least for 1-2 years at a time) by seeing an osteopath and working on all bone and muscular tension issues in my body including the ones I didn't weven know I had.

Osteopathy is a gentle form of muscle manipulation which helps you to change old patterns of posture and movement. The teeth grinding is often connected to entirely different problems, e.g. for me it was a stuck pubic bone (probably from a biking accident 15 years!!! ago) and tension on one thoracic vertebrae.

If you look for an osteopath, please check for his / her education, membership in reputable organizations and general reputation as it is not a protected profession (at least not here in Germany) and there are some crooks out there.
posted by Fallbala at 8:31 AM on August 13, 2015 [1 favorite]

I've been reading recently about tongue tie and lip tie. One of the symptoms or side effects of these conditions is grinding the teeth. So you may want to be evaluated by a dentist or ENT who specializes in these conditions, and if you have them consider having a revision done (note, this is far more commonly done on infants so you may need to dig a little to find relevant information for adults). Crainiosacral therapy (CST) and chiro are recommended as side-by-side treatments as well.
posted by vignettist at 8:43 AM on August 13, 2015

Looks like the Grindcare electric shock thingy is no longer an option.
posted by aniola at 10:18 AM on August 13, 2015

I knew someone who paid attention to health & wellness and who basically said the MOJO TMJ appliance was the One True Answer.
posted by aniola at 10:21 AM on August 13, 2015

Do you snore? If so, you may have sleep apnea, which a CPAP machine will help take care of. It also almost completely eliminated my nighttime clenching. I was almost as bad as you - I'd wake up every morning with a massive jaw ache from all the clenching, but in my case, that was caused by the stress of not sleeping. The CPAP has changed my life completely, and if you have any suspicion that you're a snorer or might have apnea, go get a sleep study done ASAP.
posted by pdb at 2:17 PM on August 13, 2015 [1 favorite]

If you're concerned about the gag reflex, there are nightguards you can buy on Amazon that do not require big mouth-filling imprints to be made. And they're pretty cheap to boot.
I've never stopped grinding. Been meditating for years. Better to wear the guard than have even more tooth problems.
posted by ch1x0r at 5:51 PM on August 13, 2015

A friend of ours is an itinerant massage/yoga expert, and taught me the trick that I use when I'm extra-stressed and need to prevent my teeth from grinding, or unlock my jaw after a bad night: Massage the medial pterygoid muscles.

The medial pterygoid is one of the muscles that helps close your jaw. The other two jaw-closing muscles, the temporalis and the masseter, are mostly outside of your mouth, and they're the ones most people massage when trying to ease the jaw.

The pterygoid gets left out because it's inside of the jaw. You can reach it by sliding a finger into your mouth, along the inside of your cheek, until you hit the ridge of muscle curving from your skull down to your jawbone, back behind your molars. Massage it by sliding your finger up and down along the muscle, or by bracing your thumb outside your cheek and squeezing. Do this equally on both sides.

I often do this for about a minute before bed if I know I've had a high-stress day. Of course, that's in addition to things like meditation, conscious relaxation, and planning my life for lower stress.

Diagrams showing these muscles, and more info about what they do:
posted by sibilatorix at 10:21 PM on August 13, 2015 [3 favorites]

Craniosacral massage was incredibly effective for me. I found one visit stopped my grinding for months.
posted by john_snow at 6:48 AM on August 14, 2015

Response by poster: I bought one of the OTC amazon ones - unfortunately it turns out most of them are not really compatible with the retainer I have to wear. ARGGHGHHGHGHG
posted by Mushroom12345 at 9:13 PM on August 14, 2015

Try an Aqualizer. It should be able to maneuver around the retainer just fine.
posted by phunniemee at 6:00 AM on August 15, 2015

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