Background: This paper reports the co-occurrence of heritable anxiety-related disorders and awake bruxism in a family and discusses the heritability of anxiety and implications of awake bruxism as comorbidity to anxiety disorders. Subjects: Ten out of 14 members of an extended family reported having a professionally diagnosed anxiety-related disorder. All individuals with anxiety disorders also showed intraoral signs of wear from bruxism and reported being aware of grinding their teeth while awake. Additionally, three out of the four family members without an anxiety-related disorder did not report grinding their teeth and showed no occlusal wear from bruxism. All of the individuals that were examined were educated about the short-term and long-term complications associated with bruxism, but all of them elected to not have treatment performed. Practical Implications: Anxiety disorders are highly related to suicidal behaviors, particularly in children and adolescents. Additionally, awaken bruxism can often serve as an indicator of anxiety or stress. By recognizing bruxism as a possible manifestation of psychological distress, the dental practitioner may be able to direct patients to life-saving services like psychologists and crisis hotlines when appropriate.