Maybe this sounds familiar. You wake up with a dull ache at your temples and a jaw that feels as though it has been chewing biltong all night. Your partner mentions a grinding noise in the dark. At your check-up the dentist points out a hairline crack and flattened edges on your back teeth, and fits you for a night guard. You wear it faithfully. The teeth are safer now, but the ache is still there in the morning.
What bruxism is
Bruxism is the habit of grinding or clenching the teeth without meaning to. It comes in two forms, and they behave differently.
Awake bruxism is mostly clenching. It tends to appear during concentration, stress or frustration: in traffic on the N1, in front of a spreadsheet, or while helping with homework.
Sleep bruxism happens during the night and involves rhythmic grinding or clenching. The muscles doing the work are the chewing muscles, mainly the masseter at the angle of the jaw and the temporalis at the temple.
Common signs include:
- A sore or tired jaw in the morning
- Dull headaches at the temples on waking
- Worn, chipped or sensitive teeth
- Clicking or discomfort in the jaw joint in front of the ear
What a night guard does, and why the jaw still clenches
A night guard is a sensible and important tool. It puts a layer between your upper and lower teeth so that the enamel is not worn away, and it can spread the force more evenly. If your dentist has prescribed one, please keep wearing it.
What a guard does not do is switch off the muscles. The signal to clench does not come from the teeth. It is thought to come from the nervous system, and the clenching can carry on against the plastic.
A night guard protects the teeth from the clenching. It does not ask why the jaw is clenching in the first place.
Sleep bruxism is now understood mainly as something driven by the brain during sleep. Sleep research suggests that grinding episodes often follow a micro-arousal. This is a brief moment when the brain surfaces towards waking without you knowing it.
Everyone has some micro-arousals. A nervous system that is running on high alert is thought to have more of them. This is the fight-or-flight system, the part of your automatic nervous system that prepares the body for action. When it does not fully stand down at night, sleep may stay shallow, and the jaw may be one of the places where the tension shows.
Several things are linked to bruxism: ongoing stress and anxiety, caffeine, alcohol, smoking, some medicines, and sleep-related breathing problems such as snoring and sleep apnoea.
See your dentist and doctor first
Bruxism should be assessed by a dentist, who can check your teeth and jaw joints and protect them from further damage. It is also worth mentioning it to your doctor, because some causes need medical attention.
Please get checked promptly if you have any of these:
- A jaw that locks, or a mouth that will not open or close properly
- Severe toothache, facial swelling or a fever
- Loud snoring, gasping or pauses in breathing at night, with daytime sleepiness
- Grinding that began after starting a new medicine. Do not stop the medicine; speak to the doctor who prescribed it.
- Jaw pain together with chest pain, shortness of breath or pain down the arm. This is an emergency, so call for help immediately.
Neurofeedback is complementary. It works alongside dental care, your night guard, physiotherapy for the jaw and any medical treatment. It does not replace them.
How neurofeedback may help the nervous system settle
Neurofeedback is a non-invasive form of brain training. Small sensors on the scalp read your brain's electrical activity. Nothing is sent into the brain. When your brain shifts towards a calmer pattern, you receive feedback through a sound or a picture on a screen. The aim is that, with repetition, the brain learns the pattern it is rewarded for.
One rhythm often trained is SMR, short for sensorimotor rhythm. It is a brainwave linked to a physically still body and a quietly alert mind.
There is not much research on neurofeedback for bruxism specifically, so we will not overstate it. The reasoning is indirect: if high arousal drives the clenching, then helping the nervous system to regulate may reduce the drive. Whether that happens in practice has not been well studied. Results vary.
What training looks like
Every client at our Krugersdorp practice starts with a 19-channel brain map, which takes about an hour and a half. Sessions last 45 to 60 minutes and begin with a short check-in. The what to expect page takes you through it.
You may also like our articles on being wired but tired at 2am and on chronic insomnia and sleep spindles, since both deal with a nervous system that struggles to switch off.
Common questions
Can neurofeedback stop teeth grinding?
We cannot promise that. There is little research on neurofeedback for bruxism itself. Training aims to help an over-alert nervous system settle, which may ease jaw tension for some people and make no difference to grinding for others. It is a complementary approach, and results vary.
Should I stop wearing my night guard?
No. Keep wearing your night guard for as long as your dentist recommends. It protects your teeth from damage that cannot be undone. Neurofeedback works on the nervous system side of the problem and can be done at the same time. Any decision about the guard belongs with your dentist.
My child grinds their teeth at night. Is that a problem?
Teeth grinding is quite common in children and many outgrow it. It is still worth mentioning to your dentist, and to your doctor if your child also snores, breathes through the mouth or seems very tired during the day. If stress or anxiety seems to be involved, you are welcome to contact the practice and ask whether brain training may be worth considering.
A tight jaw may be the body's way of saying it has been on guard for too long. If your dentist has seen you and you would like to work on the nervous system behind the clenching, you are welcome to get in touch with Irine to talk about it.
- bruxism
- teeth grinding
- tmj
- jaw clenching
- stress
