What is bruxism and what risks does it pose?

Last updated on: 5 Aug, 2026

Do you wake up with jaw pain? Do you hear grinding noises at night? These symptoms may indicate bruxism – the uncontrollable clenching or grinding of the teeth. 

This condition affects millions of people worldwide and can have serious consequences. Correct diagnosis and treatment are particularly important when planning dental treatment and the placement of dental implants.

Dr Radoslav Simeonov, Chief Dentist at the Dentatime dental implant clinic in Sofia, explores the links between dental implant restoration and a bruxism splint, as well as the negative consequences of bruxism.

What is bruxism?

Bruxism is the medical term for the unconscious clenching or grinding of the teeth. This condition can occur both during the day and at night.

Constant grinding and pressure lead to serious dental damage and problems with the jaw. The process occurs during the deep sleep phase. This explains why many people are unaware of their problem and do not seek dental help.

Types of bruxism

Specialists divide bruxism into two main types based on when it occurs. Daytime bruxism is characterised by clenching the teeth whilst awake. It is usually the result of some form of concentration, with stress and bruxism being closely linked in this case. Control is possible as the person is conscious.

Nocturnal bruxism occurs during sleep. Those affected often learn of their problem from their partner or during a routine check-up at the dentist. This type is more destructive due to the lack of conscious control.

Causes and symptoms

The main causes of bruxism are varied and often interrelated.

Psychosomatic causes

Psychosomatic causes play a leading role in the development of the condition. Emotional tension manifests physically through the clenching of the jaw muscles. The most common symptoms of stress include anxiety, insomnia and irritability.

Mental disorders

Mental disorders such as depression, anxiety and obsessive-compulsive disorder increase the risk. Imbalances in neurotransmitters and bruxism have been scientifically proven.

Physical factors

Certain physical factors are also among the common causes of teeth grinding. Misaligned teeth, bite problems and jaw joint issues can trigger the condition. Orthodontic treatment is sometimes required to correct these issues.

Characteristic symptoms of the condition

The various symptoms of bruxism vary depending on its severity. The most common sign is jaw pain, particularly in the morning upon waking. A typical finding is hypertrophy of the muscles in the jaw area, where the muscles become firmer and enlarged due to constant tension.

Headaches, neck and ear pain often accompany the condition, as does increased tooth sensitivity to hot and cold. The combination of tension and bruxism often creates a vicious circle of symptoms.

Complications

The consequences can be many and varied. It is advisable to seek a solution to the problem as early as possible.

Damage to the teeth

Prolonged bruxism leads to progressive wear of healthy tooth enamel. This process is irreversible and requires specialist dental treatment.

Fractures, cracks and chipping of parts of the teeth are possible. Existing fillings, crowns and dentures are particularly vulnerable. Loose teeth are a serious complication.

Increased sensitivity to hot, cold and sweet foods is a common consequence. In severe cases, root canal treatment or extraction may be necessary.

Joint and muscle problems

The condition of the jaw deteriorates with untreated bruxism. Temporomandibular disorders (TMJ syndrome) may develop.

Pain and stiffness in the jaw joints restrict normal function, and opening the mouth becomes painful and limited. Chronic spasm of the masticatory muscles leads to constant pain, and the muscles become hardened and painful to the touch.

Overall impact on health

Sleep disturbances lead to chronic fatigue, reduced productivity and a significant deterioration in quality of life. Mental health also suffers. Chronic pain can exacerbate depression and anxiety, creating a vicious circle.

How is bruxism diagnosed?

There are various ways to diagnose the condition.

Clinical examination

The standard diagnosis of bruxism begins with a detailed medical history. The dentist asks about symptoms, habits and family history, whilst an examination of the oral cavity reveals characteristic signs of wear. A periodontist can detect changes in the tissues surrounding the teeth and check the condition of the jaw muscles for tension and tenderness.

How is bruxism treated?

There are various ways to treat the condition.

Mechanical protection methods

Fitting protective splints is the most effective method of protecting the teeth. These are custom-made devices, individually crafted from precise impressions of each patient’s teeth.

The manufacturing process begins with taking precise impressions of the upper and/or lower jaw. The splint is then fabricated in a dental laboratory from a special acrylic plastic or thermoplastic material. This material is extremely wear-resistant.

Protective mouthguards are mainly worn at night, creating a physical barrier between the upper and lower teeth. This prevents direct friction, which leads to wear of the tooth enamel and establishes the link between stress and bruxism.

Regular use of the splints not only protects the teeth but also helps to bring about a lasting change in habits. Patients gradually learn to relax their jaw muscles and reduce the intensity of clenching. This is an important part of the overall prevention of bruxism.

Medication-based approaches

Muscle relaxants are prescribed for short-term use in acute cases. They reduce spasms and pain in the jaw muscles. Botulinum toxin is injected directly into the masticatory muscles. This reduces clenching strength by 30–40%, with the effect lasting around 9 months.

The advantages of this method include a rapid onset of effect and no need to wear a night guard. The procedure is particularly suitable for patients who cannot tolerate night guards or have a strong gag reflex.

With regular use, botulinum toxin helps to prevent bruxism in the long term, as the muscles ‘learn’ not to contract so intensely. Furthermore, normal chewing and speech functions are not impaired.

Summary

Bruxism is a serious condition that requires professional dental care and a comprehensive treatment approach. 

Early diagnosis and appropriate therapy prevent severe complications affecting tooth enamel and jaw structures. The combination of appropriate treatment and addressing any underlying psychosomatic causes yields the best results. 

Do not underestimate the symptoms of bruxism and seek specialist help at the first signs. Dentatime Dental Clinic offers professional diagnosis of bruxism and a personalised treatment plan using modern methods. 

Appropriate treatments and therapeutic approaches are administered under strict medical supervision to prevent bruxism and its complications.