Teeth Grinding – Bruxism

Teeth Grinding — Bruxism

Originally published October 2015 · Last updated May 2026

By Clayton A. Chan, D.D.S. — Founder/Director of Occlusion Connections™

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Why Do People Grind (Brux) Their Teeth?

People can grind their teeth. When teeth grinding (bruxism) occurs beyond normal, it can be due to imbalances of structural issues, out-of-balance biochemistry, and/or emotional stressor issues.

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The Role of Muscles and Occlusal Prematurities

Muscles are what drive the teeth-grinding activity. Teeth also send proprioceptive signals to the other opposing teeth when there can be some slight occlusal prematurities present, resulting in the muscles of the jaws to reposition themselves to accommodate the closing of the teeth (the bite) into some comfortable position. If the muscles can’t find a comfortable and stable jaw and occlusal bite position, then the muscles will continue to activate and cause the teeth to grind. This is one aspect of teeth grinding.

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Cervical Neck Muscle Tension and Grinding

Individuals with cervical neck muscle tension and occipital regions behind the head and neck can also exhibit grinding of teeth because these muscles are not stabilized or in a neutral state. Tight muscles need the support of a proper bite to allow the muscle resting length of muscle fibers to maintain a quality of physiologic rest.

When the terminal contact (occlusal) position of the jaws is either over closed or posteriorly positioned relative to an unstrained mandibular position, the muscles will continue to strain, twist, and torque opposing structures, trying to seek a neutral relationship. As long as hyperactivity of these straining muscles continues, the teeth that may be also malaligned or lack vertical support will continue to grind (brux).

GNM Case Study, Male Age 39 – Clencher/Grinder with TMD pain →

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Airway and Sleep Considerations

If there are upper airway nose obstructions and/or tonsillar oral pharyngeal restrictions which affect the tongue — which in return affects the mandibular positioning, as in nighttime sleeping — the mandible can retrude and contribute to nighttime grinding with open-mouth breathing issues. Again, check for occlusal imbalances.

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Pharmaceutical-Induced Bruxism

Prescription medications that are often prescribed to relax muscles, anxiety, or depression issues can also induce teeth clenching and grinding — further exacerbating normal muscle activity. The cycle of hyper muscle activity, occlusal imbalances, and muscle strains will continue.

For a deeper clinical look at how SSRIs, benzodiazepines, and other medications contribute to bruxism, see Medications and TMJ Grinding and Clenching →

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Why Physiologic Mandibular Position Matters

A physiologic mandibular position is key to proper muscle and dental health. Proper vertical, antero-posterior, and frontal/lateral positioning of the mandible to the maxillary arch is very important to maintain an isotonic (neutral) relationship — so teeth don’t continue to wear down or further activate muscles unnecessarily to a level of chronic muscle occlusal activity.

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References

1. Cooper, B: Temporomandibular Disorders: A Position Paper of the International College of Cranio-Mandibular Orthopedics (ICCMO). The Journal of Craniomandibular Practice, July 2011, vol 29, No. 3, pp. 237–244.
2. Fernández-de-Las-Peñas C, Galán-Del-Río F, Alonso-Blanco C, et al. Referred pain from muscle trigger points in the masticatory and neck-shoulder musculature in women with temporomandibular disorders. J Pain. 2010 Dec;11(12):1295–304. PubMed #20494623.
3. Uma Shanker Pal, Lakshya Kumar, Gagan Mehta, Nimisha Singh, Geeta Singh, Mayank Singh, and Hemant Kumar Yadav: Trends in management of myofascial pain. Natl J Maxillofac Surg. 2014 Jul–Dec;5(2):109–116. doi: 10.4103/0975-5950.154810. PMCID: PMC4405950.
4. Tanit Ganz Sanchez and Carina Bezerra Rocha: Diagnosis and management of somatosensory tinnitus: review article. Clinics (Sao Paulo). 2011 Jun;66(6):1089–1094. doi: 10.1590/S1807-59322011000600028. PMCID: PMC3129953.

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Continue Learning

🔹 Understand the Clinical Picture

• Clenching →
• Medications and TMJ Grinding and Clenching →
• Anatomy of the Temporomandibular Joint →
• Lateral Pterygoid Muscle: Its Relevance to Clinical Dentistry →
• Limited Mouth Opening Problems →
• Degenerative Joint Disease →
• Why Repeated Botox Doesn’t Fix TMJ — The GNM Clinical Perspective →

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• Gneuromuscular vs. Neuromuscular Dentistry →
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• TMD Problems That Challenge Dentistry — Four Main Categories →
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Written by Clayton A. Chan, D.D.S. — Founder and Director, Occlusion Connections | Las Vegas, Nevada