Shivering and teeth chattering? You’re probably cold. This is what we most associate with chattering teeth.

Stressed out? Trying to overcome an addiction? Your teeth can chatter in these situations, too. There are many other cases where you might be surprised to notice that chattering teeth are a symptom or even an indicator of an underlying cause.

We’ll explore the most common causes of teeth chattering and what you can do about it.

This is the classic cause of teeth chattering.

It all has to do with shivering. Shivering is a warming process that automatically kicks into gear when your internal body temperature starts dropping below the normal range of 97.7 to 99.5°F (36.5 to 37.5°C).

You’re probably familiar with 98.6°F (37°C), but a “normal” body temp can have a wide range. Dropping below your normal body temperature is called hypothermia.

When you shiver, all the muscles throughout your body are involuntarily tensing up (contracting) and relaxing at high speeds. This rapid muscle movement helps warm up your body tissues. This in turn raises your internal body temperature closer to normal.

Body muscles that may involuntarily tense include those in your face and jaw, like the temporomandibular joint (TMJ) muscles. These muscles attach the jaw to the skull, which is the same area involved if you have TMJ disorder and your jaw get stiff or locked.

Your jaw twitches and spasms when these muscles contract and relax. This results in knocking your upper and lower sets of teeth together, causing chattering.

Teeth grinding, known as bruxism, is a common symptom of stress, anxiety, and panic. This kind of teeth grinding can result in teeth chattering as well.

A 2010 study on bruxism in 470 people found that anxiety and depression were consistently linked to teeth grinding. This can cause your teeth to chatter while you’re stressed or anxious.

Teeth chattering linked to bruxism stemming from anxiety or panic disorders is becoming even more common over time.

A 2014 review of studies from 1955 to 2014 on bruxism found that the increasing prevalence of stress, emotional disorders, and feelings of not keeping up with work was correlated to a rise in cases of bruxism.

It’s not exactly clear what causes teeth chattering in these cases. But it might be related to the muscle spasms and tremors that are sometimes symptoms of these conditions.

Some medications can cause teeth chattering as a side effect. Antidepressant and antipsychotic medications are known to cause bruxism and teeth chattering. Selective serotonin reuptake inhibitors (SSRIs) are one example.

Another medication, sertraline (Zoloft), can cause bruxism and teeth chattering because it interacts with neurons in your brain that react to high levels of serotonin and a deficit in dopamine.

Others that may cause teeth chattering include fluoxetine (Prozac) and paroxetine (Paxil).

Shivering and teeth chattering are both possible symptoms of drug or alcohol withdrawal. These are sometimes called drug-induced tremors. In this case, the tremors are induced by not having the drugs.

Shaking and chattering caused by drug and alcohol withdrawal happens because your brain has gotten used to the rush of neurotransmitters like dopamine when you have those substances. It’s become dependent on the high production of dopamine.

When you stop consuming drugs or alcohol, the brain must compensate for the huge reduction or lack of these chemicals. This results in a condition called dyskinesia. This condition causes involuntary muscle movements that can cause facial muscles to spasm and make your teeth chatter.

Shaking has been well documented in people withdrawing from both legal medication and illegal drugs, such as MDMA (known as “molly”), methamphetamines, or cocaine, all of which can cause temporary teeth chattering.

Some cases of teeth chattering have been related to reducing or eliminating caffeine intake. Caffeine is considered a psychoactive drug that affects your brain’s production of neurotransmitters like adenosine and dopamine.

Teeth chattering can sometimes be an early sign of certain neurological disorders, such as oromandibular dystonia (OMD). This condition happens when muscles in your jaw, face, and mouth contract and relax involuntarily.

It’s not exactly known what causes OMD, but it’s been linked to:

  • brain injuries
  • wearing dentures that don’t fit
  • getting teeth pulled
  • injuries in people who carry the idiopathic torsion dystonia (ITD) gene, which can cause spasms that result in your teeth chattering

Parkinson’s disease can also result in teeth chattering. Researchers think that low levels of neurotransmitters like dopamine and norepinephrine, which controls production of dopamine, may be connected to the onset of Parkinson’s. This may be linked to the muscle spasms that cause teeth chattering.

Treatment for chattering teeth depends on the cause. Here are some possible treatments.

Bruxism

Stress, anxiety, or depression

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

Drug or alcohol withdrawal

OMD

Parkinson’s disease

  • drugs to restore dopamine or dopamine regulators
  • surgery to put electrodes in the brain or a pump near your intestines to deliver medication

Teeth chattering that happens when you’re not cold may need your attention. This goes for related cases of teeth grinding, too.

See your doctor if you’re concerned about your teeth chattering, especially if you’ve noticed other symptoms, like muscle spasms in other parts of your body.

Consider seeing a dentist if your teeth have become worn down or damaged by consistent grinding and chattering.

If your teeth chatter when you’re cold, you have nothing to be concerned about if you’re able to get somewhere and warm up soon.

But if they start chattering without a clear cause, you may need to investigate the underlying cause or make some lifestyle changes to reduce how often your teeth chatter or grind.

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