Why Do Teeth Chatter and What’s the Best Way to Make Them Stop?

Chills and teeth that click together? Most often, that’s a sign you’re cold. That’s the first thing we think of when we picture chattering teeth.

Feeling frazzled or trying to quit an addiction? Your teeth can chatter in those situations as well. There are several other circumstances where you might be surprised to learn that teeth chattering is a symptom or even points to an underlying issue.

Below we’ll review the most frequent reasons for teeth chattering and what steps you can take.

Cold temperatures

This is the classic explanation for teeth chattering.

It all relates to shivering. Shivering is a heat-generating reflex that activates when your internal temperature begins falling below the typical range of 97.7 to 99.5°F (36.5 to 37.5°C).

You’ve likely heard of 98.6°F (37°C), but normal body temperature can vary. When your body temperature drops beneath your usual level, that’s hypothermia.

During shivering, muscles across your body involuntarily contract and relax rapidly. This quick muscle activity helps produce heat and raises your internal temperature back toward normal.

Muscles that may contract involuntarily include facial and jaw muscles, such as those around the temporomandibular joint (TMJ). These muscles connect the jaw to the skull and are the same ones involved when TMJ disorder causes stiffness or locking of the jaw.

When those muscles twitch and spasm, your jaw moves and your upper and lower teeth knock together, producing the chattering sound.

Emotional stress or panic

Grinding the teeth, called bruxism, commonly occurs with stress, anxiety, and panic. This grinding can also present as chattering.

A 2010 study of 470 people found consistent links between anxiety, depression, and teeth grinding. Those conditions can lead to teeth chattering during anxious or stressed states.

Chattering caused by stress-related bruxism appears to be increasing.

A 2014 review of research from 1955 to 2014 reported that rising levels of stress, emotional disorders, and feelings of not keeping up with work correlated with more cases of bruxism.

It isn’t fully understood why chattering occurs in these situations, but it may be tied to the muscle spasms and tremors that sometimes accompany anxiety and panic disorders.

Medication side effects

Some drugs can produce teeth chattering as an adverse effect. Antidepressants and antipsychotics are known to trigger bruxism and chattering; selective serotonin reuptake inhibitors (SSRIs) are one group implicated.

For example, sertraline (Zoloft) can lead to bruxism and teeth chattering by affecting brain neurons that respond to elevated serotonin and reduced dopamine.

Other medications that may cause chattering include fluoxetine (Prozac) and paroxetine (Paxil).

Withdrawal from substances

Shaking and teeth chattering can be symptoms of drug or alcohol withdrawal. These are sometimes termed drug-induced tremors — tremors caused by the absence of the substance.

Trembling and chattering during withdrawal occur because the brain has adapted to surges of neurotransmitters like dopamine when using the substance. It becomes reliant on the high levels of that chemical.

When drug or alcohol use stops, the brain must adjust to a dramatic reduction in those chemicals. This can produce dyskinesia, a condition of involuntary muscle movements that may make facial muscles spasm and cause teeth chattering.

Shaking has been well documented in people withdrawing from prescribed medications and illegal drugs such as MDMA (“molly”), methamphetamine, or cocaine, all of which can temporarily cause teeth chattering.

Some instances of chattering have been linked to cutting back or stopping caffeine. Caffeine is a psychoactive substance that influences brain chemicals like adenosine and dopamine.

Neurological conditions

Teeth chattering can sometimes be an early indicator of certain neurological disorders, such as oromandibular dystonia (OMD). In OMD, muscles of the jaw, face, and mouth contract and relax involuntarily.

The exact cause of OMD is unclear, but it has been associated with:

• brain injuries
• ill-fitting dentures
• tooth extractions
• injuries in people who carry the idiopathic torsion dystonia (ITD) gene, which can provoke spasms that lead to teeth chattering

Parkinson’s disease can also produce teeth chattering. Researchers suspect that reduced levels of neurotransmitters such as dopamine and norepinephrine, which influence dopamine production, may be related to the muscle spasms that cause chattering.

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Treatments for chattering teeth

Treatment depends on the cause. Possible approaches include the following.

Bruxism

• clonazepam (Klonopin) for sleep-related bruxism
• botulinum toxin type A (Botox) injections into the jaw
• occlusal splints or mouthguards

Stress, anxiety, or depression

• medications to reduce chattering tied to anxiety or SSRI-related bruxism, such as gabapentin (Neurontin)
• counseling or therapy to address sources of stress or depression

Drug or alcohol withdrawal

• medications to ease pain and tremors
• withdrawal management drugs like clonidine (Kapvay) or methadone (Methadose)
• gradual tapering off the substance

OMD

• Botox injections into the jaw
• carbamazepine (Tegretol)

Parkinson’s disease

• medications to restore or regulate dopamine
• surgical options such as implanting electrodes in the brain or a pump near the intestines to deliver medication

When to consult a doctor

If your teeth chatter when you’re not cold, it’s worth paying attention. The same applies for ongoing teeth grinding.

See a physician if you’re worried about chattering, particularly if you have additional signs like spasms in other muscles.

Visit a dentist if repeated grinding and chattering have worn down or damaged your teeth.

Bottom line

If your teeth chatter from cold, there’s usually no cause for alarm as long as you can get warmed up quickly.

But if chattering occurs without an obvious trigger, you may need to look into the underlying reason or make lifestyle adjustments to reduce how often your teeth chatter or grind.

If you’re experiencing teeth chattering along with other symptoms of drug or alcohol withdrawal, call the Substance Abuse and Mental Health Services Administration (SAMHSA) national helpline at 800-662-HELP (4357).