Bruxism can occur during the day or at night. Stress can be a significant factor, either in moments of acute tension or during sleep, when elevated levels of stress hormones may still circulate after a difficult day, says Cohn. Habits like alcohol and tobacco use hike the likelihood, too. “Smokers are about twice as likely to grind their teeth as nonsmokers,” says Cooper. Certain medications—like some antidepressants and antipsychotics—can also increase the risk.

Conditions that affect the central nervous system, like dementia, Parkinson’s disease, or stroke, can cause or exacerbate bruxism. And it often goes hand in hand with temporomandibular joint (TMJ) disorders, which cause pain around the jaw. Finally, there’s obstructive sleep apnea (OSA), where the upper airway becomes repeatedly blocked during sleep, leading to numerous breathing pauses at night. This can cause people with OSA to “unconsciously overcompensate and grind their teeth as they thrust their jaw forward to open the airway,” says Manar Abdelrahim, DDS, a dentist at Cleveland Clinic. (If you’re told you have OSA, ask about being evaluated for bruxism.)

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