Treating teeth grinding in Zurich: causes, consequences and treatment
Grinding and clenching your teeth (bruxism) put strain on the teeth, chewing muscles and jaw joints, often unnoticed during sleep. Typical consequences are worn teeth, muscle tension, facial pain or headaches and even craniomandibular dysfunction (CMD). The first step is therefore to look for the causes: stress, the position of the teeth, sleep apnea or other medical, anatomical or psychological factors. Because these causes often cannot be resolved quickly or easily, a custom-made bite splint is frequently a helpful treatment. If it is not enough on its own, the overactive chewing muscles can additionally be treated with botulinum toxin. Dr. Michael Adler provides both treatments at the Swiss Dental Center at Hardbrücke in Zurich.
Book an appointment · Treatment with a bite splint · Treatment with botulinum toxin
Where grinding comes from
“Battling through life”, “chewing over a problem” or “gritting your teeth and putting up with something”: who doesn’t know these expressions?
Have you ever paid attention to how often your teeth are touching? Really, they should only be in contact for about half an hour a day, because teeth are meant for chewing. Even when swallowing they touch only very briefly, but otherwise not at all. When we grind our teeth at night or are tense all day long, the load often becomes too great. The muscles can become overworked, painful and thicker. And the main chewing muscle already has the largest cross-section of any muscle in the body!
Possible causes
- Stress and psychological strain
- The position of the teeth, for example a bite that is unfavourable for the jaw joint
- Sleep apnea: breathing pauses during sleep can go hand in hand with nocturnal grinding and clenching
- Other medical, anatomical or psychological factors, for example certain medicines
That is why at InterSleep every examination includes the question of breathing during sleep. The online test gives a first assessment.
How the jaw joint works
The jaw joint is the joint of the body with the greatest freedom of movement and lies just in front of the ear. For this reason, earache and jaw-joint pain can easily be confused. Physical and psychological overload can lead to misalignments in the jaw joint and contribute to tension. If the neck muscles are also affected, tension headaches can occur.
A faulty bite, that is, a position of the teeth relative to each other that is unfavourable for the joint, can, during grinding or clenching (whether by day or night), lead to incorrect loading and unphysiological wear. Diagnoses such as craniomandibular dysfunction (CMD) or bruxism are therefore influenced by many factors.
Consequences of teeth grinding
- Worn, flattened or sensitive teeth
- Tense, painful or thickened chewing muscles
- Clicking or grinding sounds and pain in the jaw joint, often mistaken for earache
- Tension headaches, especially in the morning
- In the long term, craniomandibular dysfunction (CMD)
Two treatments that complement each other
Treatment with a bite splint
A custom-made bite splint is often the most important treatment as long as the causes cannot be resolved quickly. It is worn at night and, if needed, during the day, distributes the chewing forces evenly, protects the teeth from further wear and relieves the jaw joints and chewing muscles. It costs CHF 700 to 1,400 including fitting.
Temporalis (temple muscle) and masseter (main chewing muscle).
Treatment with botulinum toxin
If tension, jaw pain or headaches persist despite the splint, the overactive chewing muscles can additionally be treated with targeted injections of botulinum toxin. The muscle then works with less force for several months, and clenching decreases. It costs CHF 630 for the first session and CHF 540 for follow-up sessions (paid by the patient).
Bite splint and botulinum toxin compared
| Bite splint | Botulinum toxin | |
|---|---|---|
| How it works | Protects the teeth, distributes the forces, relieves joints and muscles | Reduces the force of the overactive chewing muscles |
| Suitable for | Any form of grinding and clenching, CMD | Persistent muscle pain, tension or tension headaches despite the splint; markedly enlarged chewing muscles |
| Onset | Protection from the first night | After a few days, full effect after about two weeks |
| Duration | Several years, depending on wear | About three to six months per treatment |
| Effort | Scan, fitting, nightly wear | One session of around 20 minutes, repeated as needed |
| Possible side effects | Initial foreign-body sensation, increased salivation | Temporary pressure sensation, small bruises, weakness when chewing; rarely an uneven smile |
| Authorisation | Established standard dental procedure | Off-label use (application outside the official authorisation) |
| Costs | CHF 700-1,400 including fitting; contribution from basic insurance possible but not guaranteed | CHF 630 first session, CHF 540 follow-up session; paid by the patient |
The two treatments do not exclude each other; they complement each other: the splint protects the teeth, the botulinum toxin takes the force out of the muscles. For most patients who receive an injection, the splint therefore remains part of the treatment.
Which treatment is right?
- Clarify the causes. The first step is to examine what lies behind the grinding or clenching. If a cause can be addressed specifically, such as sleep apnea, that becomes part of the treatment.
- Bite splint. Because the causes often cannot be resolved quickly, the splint protects the teeth in the meantime and relieves the joints and muscles, especially with tooth wear, sensitive teeth, jaw joint sounds and morning tension. The injection does not do this.
- Botulinum toxin in addition. If muscle pain, tension headaches or pronounced clenching persist despite a well-adjusted splint, physiotherapy and relaxation measures, or if the chewing muscles have become markedly enlarged from constant clenching.
- Botulinum toxin alone. Only in individual cases, for example if a splint is not tolerated.
Which treatment makes sense for you follows from the dental examination: teeth, jaw joints and chewing muscles are assessed; sleep, stress and symptoms are discussed. Because grinding during sleep often occurs together with snoring and obstructive sleep apnea, at InterSleep the question of breathing during sleep is part of it. The online test gives a first assessment.
Frequently asked questions about teeth grinding
How do I notice that I grind my teeth?
Common signs are flattened or sensitive teeth, morning tension in the chewing muscles or temples, headaches after waking, and clicking or grinding sounds in the jaw joint. Often a partner notices the nocturnal grinding sound, or the dentist sees the wear marks.
What is the difference between bruxism and CMD?
Bruxism refers to grinding and clenching itself. CMD (craniomandibular dysfunction) is a functional disorder of the chewing system with pain or restricted movement of the jaw joint and chewing muscles. Bruxism can promote CMD; both are assessed during the examination.
Splint, botulinum toxin or both: what is right for me?
The possible causes are clarified first. The splint protects the teeth and is often the most important treatment. Botulinum toxin may be considered in addition if muscle pain, tension or tension headaches persist despite the splint. For persistent muscle symptoms, the combination is usually most effective.
Suspect grinding or CMD? Book an examination appointment at the Swiss Dental Center: book online, phone 043 444 74 00 or via the contact form.
Author: Michael Adler, DMD, MSc – dentist specialising in dental sleep medicine · Last updated: September 2026 · Basis of this page: S3 guideline “Diagnosis and treatment of bruxism” (DGFDT/DGZMK) and current systematic reviews.