Sleep is vital for physical and mental well-being, yet an estimated 70 million adults in the U.S. struggle with sleep disorders. Insomnia may be the most widely reported, but the range of sleep disorders is extensive, including many that go unnoticed unless a partner or a professional brings them to your attention.

Interestingly, your dentist could be one of the first people to raise a red flag. While routine dental visits are typically focused on cleaning and cavities, your dentist might also notice signs of something deeper. Flattened, chipped, or worn-down teeth may indicate that you’re unconsciously grinding or clenching your teeth at night, a condition known as sleep bruxism.

According to the National Institute of Dental and Craniofacial Research, sleep bruxism falls into the category of sleep-related movement disorders. It’s not always easy to identify on your own, but symptoms like jaw tightness, soreness upon waking, or increased tooth sensitivity may be telling signs.

In some cases, sleep bruxism is not isolated concern, it can be associated with another sleep disorder you may not even realize you have:

Example, obstructive sleep apnea (OSA).

How Teeth Grinding and Sleep Apnea Might Be Related

Bruxism might seem like a minor annoyance, but its effects can be far-reaching. The Sleep Foundation notes that teeth grinding during sleep can produce as much as 250 pounds of pressure, enough to crack fillings, damage enamel, or even cause tooth fractures.

The physical damage alone is reason for concern. But bruxism also has potential ties to sleep apnea, a disorder in which breathing repeatedly stops and starts during the night due to airway obstruction. A study in the Journal of Clinical Medicine found a notable association between sleep bruxism and mild to moderate cases of sleep apnea, though the link appears weaker in more severe cases.

The exact nature of the relationship is still under investigation. According to this article published in Sleep and Breathing explored three possibilities:

Coincidence – Some individuals may simply have both conditions without a direct connection.

Sleep apnea precedes bruxism – In some cases, teeth grinding may be the body’s response to airway restriction, with jaw movements possibly helping to reopen the airway.

Bruxism comes first – Nerve activity that triggers grinding may contribute to nasal congestion, indirectly leading to airway issues and apnea symptoms.

While researchers are still piecing together the puzzle, if your dentist identifies signs of bruxism, it’s worth looking into whether there’s a sleep-related cause.

What Causes Bruxism and Who Is at Risk?

Several factors can increase the likelihood of teeth grinding during sleep. Among the most common is stress. You may not be aware of it, but emotional tension carried into bedtime can manifest physically through jaw clenching.
Other contributors include:

Medications: Some antidepressants, especially SSRIs (selective serotonin reuptake inhibitors), have been linked to bruxism.

Lifestyle choices: Tobacco use and alcohol consumption are associated with a higher risk of both bruxism and sleep apnea.

Family history: Genetics can influence susceptibility to both conditions.

Anxiety or mood disorders: These are frequently present in individuals with sleep bruxism, indicating a potential psychological component.

It’s also worth noting that children and adolescents may grind their teeth at night due to factors like misaligned teeth, hyperactivity, or stress, though most outgrow it without long-term issues.

Managing Bruxism and Exploring Sleep Apnea

If your dentist observes signs of bruxism, it’s helpful to consider next steps based on the potential cause. For example:

If stress is a suspected trigger, improving your sleep hygiene may be a first step. Establishing a consistent bedtime routine, limiting screen time before sleep, and practicing relaxation techniques can make a meaningful difference.

If you’re experiencing symptoms like loud snoring, gasping during sleep, or excessive daytime fatigue, you may want to pursue a sleep study to check for apnea. While formal sleep studies can be costly, many clinics now offer at-home sleep tests as a more affordable alternative.

Dentists often recommend a custom night guard to protect teeth from further damage. Though this doesn’t address the underlying cause, it can prevent more serious dental complications.

For people experiencing chronic jaw pain or headaches due to bruxism, physical therapy focused on the jaw and neck may help alleviate discomfort.

In cases where CBT-I (Cognitive Behavioral Therapy for Insomnia) is appropriate, research shows it can be effective not only in treating insomnia but also in reducing nighttime anxiety and physical tension that may contribute to bruxism.

When to Involve a Specialist

While your dentist may be the first to notice signs of a sleep disorder, managing conditions like bruxism and sleep apnea often requires collaboration. Depending on your symptoms, a sleep specialist, ENT, or mental health provider may need to be part of the care plan.
The important thing is not to dismiss the symptoms. Chipped teeth or morning jaw tightness might seem like minor nuisances, but they could be indicators of more serious, sleep-related issues.