How the Teeth are Affected by Sleep-Related Bruxism

SRB is one of the most common dental conditions and has a profound effect on the teeth…

Sensitive Teeth:

Sensitive teeth are a direct result of the excessive forces placed on the teeth with SRB. The sensitivity is to temperature extremes such as ice water or hot coffee as well as to sweet foods and drinks and can be quite intense. This is one of the most commonly reported symptoms of SRB in all age groups.


Headaches that occur upon waking or even later in the day may be caused by SRB. The masseter and temporalis muscles, the primary muscles associated with SRB refer pain over the eyes and to the temple regions. This is also one of the most commonly reported symptoms of SRB in all age groups.

Excessively Worn Teeth:

With the nightly forces of SRB acting directly on the teeth, they wear down becoming shorter. This disfigures the teeth and exposes the softer underlying dentin of the teeth contributing to tooth sensitivity.

Abfraction Lesions:

Abfraction lesions are notches that form at the gumline. It was believed that this was due to aggressive tooth brushing but this has now been shown to be inaccurate. The side-to-side grinding seen in phasic SRB rocks the teeth and the enamel at the gumline begins chipped off. A notch forces thinning the tooth where it exits the jaw bone. These abfraction lesions can be extremely sensitive to temperatures, sweet foods, and drinks as well as touch. These are a common finding of SRB and can occur in upper and lower teeth on the outside and inside of the teeth.

Cracked Fillings:

With the excessive forces of SRB on the teeth, fillings can break often shortly after being placed. This can be costly and frustrating for both the patient and the dentist who placed the filling.

Cracked Teeth:

With the excessive forces of SRB, the teeth themselves can crack or split. This is extremely painful when it happens as in the image. Often there is simply a crack in the tooth that opens only when biting hard foods (resulting in a sharp pain that resolves immediately). Cracked teeth are very common. If caught early, a crown placed over the crack tooth can save it. Otherwise, the crack can deepen until the tooth splits and must be removed.

Cracked Roots of Teeth:

Sometimes we see that the root of the tooth cracks. This often requires a radiograph (x-ray) to identify. The tooth may feel loose and, if no previous root canal as in the image, are extremely painful. There is usually pain and swelling in the gum tissue around cracked roots and a deep periodontal pocket often forms. In most cases, the affected tooth must be removed.