Sleep bruxism and temporomandibular joint disorders, or TMJ disorders, are often downright painful. Sufferers can be plagued by adverse effects such as tooth wear, sore jaw muscles, facial pain, earaches, headaches, and other painful symptoms. Experts may not fully understand the causes of bruxism, but they do know that several medications list teeth grinding among their possible side effects. If you're dealing with teeth grinding and jaw clenching, being aware of medications that cause bruxism may help you in your search for effective treatment for your condition.
Medications That May Cause Teeth Grinding
The number and variety of medications that can cause teeth grinding might surprise you. As Healthline explains, a psychotropic drug is any drug "that affects behavior, mood, thoughts, or perception. It’s an umbrella term for a lot of different drugs, including prescription drugs and commonly misused drugs." Of course, prescription medications and recreational drugs aren't the only potential troublemakers. Familiar natural substances can also cause issues.
Antidepressants are the most common culprits of teeth grinding as far as prescription medications are concerned. Not all antidepressants include grinding as a side effect, and not everyone who takes this type of medication will experience this issue, but if you take a selective serotonin reuptake inhibitor (SSRI), you should be aware of this possibility. Reviews of case reports reveal the following SSRIs may cause bruxism:
- Paroxetine (Paxil)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Venlafaxine (Effexor)
According to The Journal of the American Dental Association, the problematic grinding is likely caused by the way that SSRIs affect chemicals in the body. They suppress a neurotransmitter called dopamine. Dopamine is involved in motor activity. In fact, the tremors and movement disorders in Parkinson's disease are believed to be a result of decreased dopamine levels. If doctors don't want to change the dosage or medication, they may be able to stop the bruxing by adding a second antidepressant, buspirone, to the mix. Many patients have found success using buspirone to resolve bruxism.
Antipsychotics are another group of drugs that have the potential to cause bruxism. The Australian Dental Association indicates these medications can cause involuntary movements in the face and jaw, including teeth grinding and jaw clenching, as a result of their inhibitory effects on the brain's dopamine receptors. Instead of limiting the amount of dopamine available like SSRIs do, these drugs interfere with the brain's ability to receive it.
ADHD (attention deficit hyperactivity disorder) is typically treated with Adderall and other stimulant medications. Stimulants act on the central nervous system, prompting more muscle movements and interfering with sleep. For some people, this is a recipe for sleep bruxism.
Medications for Parkinson's disease are a bit of a gray area and more research is required to make a definitive conclusion on its impact. Bruxism is common in Parkinson's patients, and L-dopa has been linked with the condition. However, this study finds no reason to blame the dopaminergic medication. Perhaps the best thing Parkinson's patients can do is maintain communication with their health care team as they work together to manage both their Parkinson's and their bruxism.
Assessing the effects of recreational drugs can be especially tricky. After all, these illicit drugs aren't regulated or studied like their legal peers. However, it is no secret that most recreational drugs have negative impacts on oral health. Methamphetamine, cocaine, and ecstasy are all stimulants, which are known to trigger teeth grinding. Similar to ADHD drugs, they affect the central nervous system. However, dosages and quality aren't controlled. This sets the stage for greater risk of teeth grinding.
There are some natural substances that you might not consider drugs that can trigger bruxism: caffeine, alcohol, and tobacco. As this study indicates, each of these substances can cause teeth grinding independently. Both caffeine and the nicotine found in tobacco are stimulants, so it's hardly surprising that they can act on the nervous system to trigger muscle activity in the jaw. Alcohol isn't a stimulant, but a 2016 study discovered that drinking it before bed doubled the risk of sleep bruxism. This may be because of interactions with neurotransmitters in the brain.
How to Treat Bruxism from Medications
If you suspect that a medication is the cause of your bruxism, don't just stop taking the medication. After all, you have been prescribed that medication for a reason. Instead, make an appointment with your doctor to discuss what needs to be done. The advice you'll be given will depend on your situation:
- You may be able to switch medications.
- Your doctor may adjust the dosage of your medication.
- In some cases, lifestyle changes may be suggested. You may be encouraged to limit your caffeine consumption, stop using tobacco products or recreational drugs, or avoid alcohol before bed. Since bruxism is linked to stress, your doctor may also advise you to take steps to reduce or manage your stress. They might suggest exercising or meditating.
- If your medication is needed to manage your health condition, your doctor might suggest wearing a mouthguard to protect your teeth.
Using a mouthguard is easy and effective. These simple devices are a commonly recommended treatment for both sleep (nocturnal bruxism) and awake bruxism. They are also commonly referred to as occlusal splints or night guards. When worn consistently, they form a physical barrier between the teeth, preventing dental damage from grinding and jaw pain from clenching. Using a mouthguard consistently can help you avoid extensive dental treatment like restorations in the future. Some mouth guards can even help treat other conditions and sleep disorders like TMJ disorder and sleep apnea.
Bruxism can be a serious threat to your oral health. If you suspect that a medication may be having a negative impact on your dental care, seeking the appropriate treatment is vital. Instead of stopping the medication, reach out to your health care team for guidance. If they suggest using a mouthguard, be sure to check out the selection at Pro Teeth Guard. We have a full selection of affordable, custom-fit mouthguards available in our online store. Our night guards are made in a professional dental lab using professional materials and processes. They're effectively the mouthguards that you would receive from a dentist, but at a fraction of the price.
- ADA Writing Staff. (2019). PharmaAdvice: Drug Induced Bruxism. The Australian Dental Association. https://www.ada.org.au/News-Media/News-and-Release/Latest-News/PharmaAdvice-Drug-induced-bruxism
- Axtell, B. (2020). Drug Abuse and Your Mouth. WebMD. https://www.webmd.com/oral-health/drug-abuse-mouth
- Bertazzo-Silveira, E., Kruger, C. M., Porto De Toledo, I., Porporatti, A. L., Dick, B., Flores-Mir, C., & De Luca Canto, G. (2016). Association between sleep bruxism and alcohol, caffeine, tobacco, and drug abuse: A systematic review. Journal of the American Dental Association (1939), 147(11), 859–866.e4.https://doi.org/10.1016/j.adaj.2016.06.014
- Ghoshal, M. (2019, November 6). What is a Psychotropic Drug? Healthline. https://www.healthline.com/health/what-is-a-psychotropic-drug
- JADA Writing Staff. (2000). Study Shows Link Between Antidepressants, Bruxism. The Journal of the American Dental Association. https://jada.ada.org/article/S0002-8177(14)63437-1/fulltext#relatedArticles
- K. Rintakoski, J. Kaprio, Legal Psychoactive Substances as Risk Factors for Sleep-Related Bruxism: A Nationwide Finnish Twin Cohort Study, Alcohol and Alcoholism, Volume 48, Issue 4, July/August 2013, Pages 487–494,https://doi.org/10.1093/alcalc/agt016
- Lobbezoo F., Ahlberg, J., Manfredini D., & Winocur, E. (2012). Are bruxism and the bite causally related?. Journal of oral rehabilitation, 39(7), 489–501. https://doi.org/10.1111/j.1365-2842.2012.02298.x
- Verhoeff, M.C., Koutris, M., van Selms, M.K.A. et al. Is dopaminergic medication dose associated with self-reported bruxism in Parkinson’s disease? A cross-sectional, questionnaire-based study. Clin Oral Invest 25, 2545–2553 (2021). https://doi.org/10.1007/s00784-020-03566-0