7 Things That Happen When You Grind Your Teeth

Your smile can collapse.

One of the biggest complaints Houston cosmetic dentist Guy Lewis, DDS sees among the older patients in his practice is a collapsed smile, usually due to clenching and grinding. However, he has a solution: a smile lift. “If your teeth are so worn down that your face is collapsing, a smile lift can do the trick in fixing both your bite and your teeth length. This procedure alone is so dramatic that it can take 20 to 30 years off your face.”

Teeth can slowly shift and crowd together.

“A side effect of teeth grinding can be crowding or shifting position,” says Sarasota, FL cosmetic dentist Jenifer C. Back, DMD. “The lateral forces of heavy clinching and grinding can cause teeth to shift. This crowding can happen even after teeth have been properly aligned with clear aligners or braces.” 

Enamel wears away, making teeth look shorter and darker.

Not only can grinding wear down dental enamel (the protective layer that shelters dentin), which Beverly Hills, CA cosmetic dentist Laurence Rifkin, DDS says can lead to exposed dentin, but it can also alter the color of the teeth. “When dentin is unprotected, the teeth take on a yellow or orange colors,” Dr. Rifkin explains. “Exposed dentin can also lead to increased potential for cavities.” A lack of enamel can cause the teeth to look shorter, too. “Patients who have lost enamel may need crowns and veneers to help build it back,” adds Dr. Maddahi. 

Los Altos, CA cosmetic dentist Joseph Field, DDS adds that the other issue with grinding is that “once the dentin is exposed, the wear rate compared to enamel goes up three of four times, so the teeth break down much more quickly.” Once this kind of damage has been done, his plan of action is to “implement bonding or veneering techniques to restore the teeth and correct any bite issues.”

Waking up with a headache and sore jaw is common.

If you find yourself waking up to intense headaches and radiating pain or soreness in the jaw and/or lower face, chances are grinding is happening as you sleep. “When you grind, you activate the muscles in your jaw as well as the sides of your head, and even your neck and shoulders. The headaches are the result of constant muscle spasms,” says Beverly Hills, CA cosmetic dentist Kourosh Maddahi, DDS. “Ringing in the ears is another symptom because the tempomandibular joint of the lower jaw is next to the ear.”

Teeth can become sensitive. 

As enamel wears away, teeth are more prone to sensitivity. According to Miami cosmetic dentist Ryan Ziegler, DMD, when sensitivity becomes a major issue, there can be tiny cracks in the enamel in addition to a loss of dentin, which can be painful. To fix it, a night guard can be used and Botox Cosmetic, off-label, can be injected into the jaw muscles to help reduce clenching. “For mild tooth damage, bonding may be used, but in severe cases, full smile rehabilitation with onlays, crowns and veneers may be necessary,” explains Wellington, FL cosmetic dentist Sam Sadati, DDS. 

Teeth can become flat, chipped or broken. 

The force and pressure placed on the teeth while grinding isn’t equally distributed, so the teeth change, and not for the better. “When teeth are not accepting forces longitudinally, the enamel can fracture and weaken the teeth, causing them to chip or break,” says New York cosmetic dentist Jason Kasarksy, DDS. “Grinding (and clenching) can lead to the deterioration of the supporting bone around the roots, causing bone and gum recession. The gum tissue will always follow the bone,” adds Dr. Rifkin.  

It can lead to TMJ (tempomandibular joint problems).

Repetitive grinding can cause the muscles in the lower jaw to lock up. “Grinding causes stress in the two joints of the skull and mandible, leading to inflammation, muscle soreness and sometimes hypertrophy of the muscles, which can make the jawline look wider. Over the long-term, it can destroy bone, cartilage and ligaments of the joints,” Dr. Rifkin says. How the joint opens and closes can become altered, and TMJ—a painful condition that feel as if the jaw is clicking or popping when the mouth opens and closes—can arise. If so, it can usually be treated with an oral appliance and medication.