“Do you clench your jaw?” my dentist asked me. At the time, I was about 10 years old. My mother was sitting right by me. Because I couldn’t talk with the dentist’s tools in my mouth, she answered for me: “Oh, no. Does she have my issue?”
Teeth grinding runs in my family. I’m not sure if it’s actually genetic (statistics show that about 15 percent of cases are, whereas 85 percent are acquired) or if it’s some habit that we’ve all unconsciously adopted to emulate each other in the worst way possible. But many of us have been told that we should stop taking out our stress on our teeth, or we’re going to destroy our jaws.
For years, this didn’t actually bother me. The dentists only brought it up occasionally, so I ignored this nebulous issue for almost a decade and a half. But one day, convinced that I had an unrelenting earache, I met with my doctor. After examining my ears, he analyzed different parts of my jaw and concluded that this was no ear infection. He said I most likely had Temporomandibular joint disorder and that I should have my dentist investigate further. He recommended a mouthguard for when I sleep—which did not sound remotely attractive.
“Hold on, tempor-what?” I asked.
“It’s usually referred to as TMJ,” he said. “While there are all sorts of reasons you could be having this, chances are you’re grinding your teeth or clenching your jaw at night—although that’s not always the case. But you clearly have pain in your jaw joint and in the muscles that control jaw movement.”
He was right. As the Mayo Clinic told me later that night, “aching pain in and around your ear” is listed as one of the top symptoms for TMJ disorders. Along with:
- Pain or tenderness of your jaw
- Difficulty chewing or discomfort while chewing
- Aching facial pain
- Locking of the joint, making it difficult to open or close your mouth
Check, check, check, check, and “Oh, that’s what that jaw-clicking sound was?” check. I realized I couldn’t argue with the doc on this one. Mayo Clinic shows that I fell perfectly within the demographic: “TMJ disorders most commonly occur in women between the ages of 20 and 40 but may occur at any age.” As terrible as a mouthguard sounded, I realized that it was time to take some action—or forever face my pain.
According to Dr. David Miyasaki, DMD:
“TMJ disorders can be caused by many things including jaw injury, problems with the bite grinding, neuromuscular problems, genetics, psychological issues, etc. Generally speaking, we call TMJ disorders ‘idiopathic,’ which is a fancy way of saying, ‘We need to do more research because we don’t really understand what causes them yet.’ Stress oftentimes manifests itself as nighttime or daytime grinding, muscle tension, clenching, and other issues. These activities can sometimes lead to a number of jaw, muscle, and joint problems that cause people pain.”
I soon realized that besides generally decreasing anxiety—which can be the root cause for teeth grinding—there really isn’t all that much one can do to prevent it. You just have to proactively take precautions to cope with the issue. In fact, TMJ disorders weren’t even seen as a legitimate medical issue for my insurance plan to cover when I went to a follow-up appointment with my doctor (Hint: Just tell your doctor’s office that it’s a headache issue; insurance will cover that. If you truly have TMJ, you won’t be lying—you do get headaches). Though surgery is possible in extreme cases, it’s a last resort.
While this might not be the best news in the world, TMJ isn’t a serious medical disorder when managed correctly. Symptoms can range from mild discomfort to severe pain. Even if you only feel slight tension in your jaw or one day notice raw skin on the insides of your cheeks, you may suffer from some form of TMJ.
According to the National Institute of Dental and Craniofacial Research, “For most people, pain in the area of the jaw joint or muscles does not signal a serious problem. Generally, discomfort from these conditions is occasional and temporary, often occurring in cycles. The pain eventually goes away with little or no treatment. Some people, however, develop significant, long-term symptoms.” These include your teeth being prematurely worn down, dizziness, and even compromised hearing.
While my TMJ has yet to really go away (it’s been a few years), I’m optimistic that it can be handled, no matter how extreme it may seem. That said, here are a few tips from a TMJ disorder veteran. Some are simple, whereas others might be a bit costly. Depending on how severe your issues are or what’s causing them—as not all TMJ issues stem from stress or even teeth grinding—these tips might work for you, too.
Avoid Chewy Things
If you’ve recently discovered that you have the issue—or if you’re experiencing flare-ups—avoid those chewy candies and gum balls. Dr. Miyasaki notes, “Chewing something sticky will probably not cause problems for a person with a healthy jaw joint. However, for a person with the beginnings of TMJ disorder, it can cause the disc to dislocate and cause jaw locking, clicking, or serious jaw pain.” When my jaw is particularly sensitive, even eating a handful of Swedish Fish or gummy bears can greatly affect whether I go to bed with a headache or not. And while I’ll occasionally help myself to a stick of gum, if it’s a good week, I never let myself chew it longer than five minutes. Otherwise, I start feeling an aching sensation.
Have a Calming Night Ritual
“The teeth should be in direct contact with each other for only about ten minutes per day during chewing activities,” Dr. Miyasaki advises. “At all other times, the ‘healthy’ position for teeth is to be slightly apart with jaw muscles relaxed. While awake remind yourself to relax your jaw if you notice yourself clenching during the day.”
But—what about at night?
When I spoke to my dentist about TMJ, he mentioned that it often came from stress—particularly the psychological stress that stays with you when you’re going to bed. He recommended that I drink one glass of red wine before I start winding down for the evening. And if I got the chance, I should take a quick bath and put on some soothing music. Sounds amazing, right? In reality, my nights are rarely this luxurious. Yet when I do have time to indulge—or if it’s a particularly stressful time—I do notice a difference in how my jaw feels the next morning.
Small, less time-consuming stress relief practices work, too, such as breathing exercises, or even some calming aromatherapy can change the mood of the room; lavender in particular has been shown to have calming effects. And for the times when I’m not drinking wine (for instance, when I’m pregnant or on antibiotics), I’ve found that drinking herbal tea can be just as calming (though less fantastic, if I’m being honest).
Learn Jaw Stretches
I was really optimistic when jaw stretches were first recommended to me—until I realized that the effects weren’t immediate. At first, the stretching did little good other than some temporarily relief. But once I got myself into a consistent, long-term rhythm, I realized that my jaw clicked less, and some of the aches went away. Moreover, as it became a habit, it helped me gauge how my TMJ disorder was doing—as I could tell when my jaw was tighter versus when it was loosening up. The results differ from person to person. So I actually recommend searching YouTube for some specific jaw stretches, such as this one, and explore what feels particularly healing for you.
While one of the more expensive indulgences, finding a massage therapist who has experience in jaw massages as well as upper-body relief was a game changer for me. Clenching one’s jaw causes all sorts of tension in the face and neck area, so TMJ can cause more physical stress—which in turn can cause more nighttime clenching (annoying). If you’re just beginning to tackle TMJ, it’s definitely worth scheduling a few massages until you’re out of the vicious cycle. Dr. Miyasaki says, “Massage therapy can address both the psychological and the physical aspects of the pain. Psychologically, you will be more relaxed, and fewer muscles will be active. Physically, massaging muscles will help to relieve pain in individual muscles, which in turn will help you to relax more.”
Plus, massages can be a good way to help improve your posture, which can also contribute to TMJ, according to studies reported by the U.S. National Library of Medicine: “For example, holding the head forward while looking at a computer all day strains the muscles of the face and neck.” Talk about an awesomely legitimate excuse to indulge yourself.
For muscle-related pain, “which is very common,” Dr. Miyasaki recommends giving yourself a face-muscle massage:
“The muscle that is responsible for most of the force in chewing is called the masseter. To locate this muscle, push your fingers just below your cheek bone on the more depressible part of your cheeks while clenching [your jaw]. You will feel a muscle push out when you do this. This is the masseter. Pressing on this muscle in small circles is a good way to massage it.”
Buy a Mouthguard
A custom-fitted mouthguard was by far my most expensive TMJ-related purchase. Even with insurance, it still cost me hundreds of dollars. However, the difference is phenomenal. While it doesn’t completely stop me from grinding my teeth, it does hinder it. More importantly, it protects my teeth. Severe teeth grinding can cause all sorts of dental problems as you’re gnawing away at your enamel, which protects the inner cores of your teeth. It took me about a week of consistent, disciplined use to not hate it—and almost a month for my body to get completely used to it.
If you don’t want to spend big bucks on a dentist-designed mouthguard, you could opt for an over-the-counter version that’s used during sports. While it won’t be professionally fitted, it will still protect your teeth and inhibit some grinding. However, Dr. Miyasaki warns, “The risks of using over-the-counter nightguards include unwanted (and oftentimes permanent) bite changes due to tooth movement and the fact that bruxism (grinding) has been noted to become worse when a soft or loose mouth appliance is used.” He notes that “some are probably OK for the short term if you are unable to purchase a dentist-made nightguard,” but proceed with caution.
“There is no widely accepted, standard test now available to correctly diagnose TMJ disorders. Because the exact causes and symptoms are not clear, identifying these disorders can be difficult and confusing,” shares the National Institute of Dental and Craniofacial Research. Likewise, with so many different potential causes, it makes sense that there’s not a particular cure-all. Hence, it’s imperative that you initiate your own research, collaborate with your dentist and doctor, and, ultimately try to get to the root of the problem while managing the pain of your symptoms.
“TMJ disorders are very common and diverse, yet they are still not widely understood,” Dr. Miyasaki says. “One thing about TMJ disorders is clear though: A simple TMJ exam from your dentist can shed a lot of light on your condition.”
Photo Credit: Katrina Harrison