Decreasing Teeth Clenching and TMJ Pain

compiled by Kathy Somers
Stress Management and High Performance Clinic
519 824-4120, ext. 52662

• books
• cassette tapes
  
• tips on decreasing jaw clenching, jaw tension and jaw pain

TIPS on DECREASING JAW TENSION and DISCOMFORT...

Addressing and resolving the suspected causes of teeth clenching or jaw pain as much as possible is the first place to start.  It is important to determine if jaw joint or “temporomandibular joint” (TMJ) difficulties are related to malocclusion of the teeth.  Malocclusion on its own is usually not a factor, however when combined with emotionally distressful situations it may be significant.  TMJ difficulties may be a result of arthritis, motor vehicle accidents, trauma to the jaw, facial tics, chronic pain, or depression.  Antidepressants such as serotonin selective re-uptake inhibitors (or “SSRIs” e.g.. Prozac, Paxil, Zoloft) are known to increase night time teeth grinding.  Common events which trigger temporomandibular dysfunction (TMD) include high stress situations, lowered stress threshold (due to abuse, family dysfunction, traumatic events, etc.), and stressful interpersonal dynamics.

HELPFUL HINTS :

• practice good postural habits, especially "chin tucks" to avoid protruding the jaw
• make every effort not to strain the ligaments of the jaw unnecessarily
• keep your teeth slightly apart to avoid clenching
• do not eat foods that require prolonged chewing  (e.g.. popcorn, tough meat, bread crusts, gum)
• cut all food into small pieces to avoid opening mouth wide
• avoid pressure on the jaw during sleep;   sleep on your back if possible
• diminish stressful interpersonal dynamics;  take assertiveness training 
• develop skills for better managing frustration, overactive emotions, and anger
• decrease critical inner self-talk
• inquire to see if a dental device (like a night time mouth guard) would be helpful.  For some people this keeps their teeth apart and prevents clenching and grinding.  For other people it gives them something to bite down on and increases the clenching or grinding, which in turn escalates jaw tension and pain.
  
• inquire to see if physiotherapy (therapy and special jaw exercises) would be helpful.    Uppgaard's book (listed above) describes some of the exercises currently used in physiotherapy  to help decrease jaw tension and pain.
• practice relaxing the muscles of the eyes, forehead, temples, jaw, neck and shoulders   (e.g.. use facial muscle Progressive Muscle Relaxation, physiotherapy exercises, or Feldenkrais exercises.  If you tend to grind your teeth during the night, avoid list making or planning for tomorrow in the hours prior to bed, and do facial relaxation in bed at bedtime.)
• use differential muscle relaxation (muscle scanning) throughout daily activities to release any jaw tension during activities
  

If you would like training in these relaxation techniques, consider taking the Relaxation and Stress Management Skills Training Program or teach yourself with relaxation books, cassettes or CD's .  To lessen jaw tension, also investigate the possibility of using biofeedback to further develop your skills in muscular relaxation of the jaw, neck, and shoulders.

HABITS TO AVOID :

• wide yawns, opening wide to sing,  testing the joint or "playing with" your jaw
• chewing gum, sucking on candy, or chewing tough, crunchy or hard foods (carrots, apples, etc.)
• biting food with your front teeth
  
• biting your nails, lips, cheeks, pens/pencils
• chewing on one side of the mouth only
• frequent licking your teeth or lips with your tongue
• holding objects between your teeth or pushing your tongue against your teeth
• closing your mouth and using jaw tension to hide braces, a splint, malocclusion, missing teeth, etc.
• jutting the chin forward to make the jaw look more strong or attractive (a “Sunday bite”)
• clenching or grinding your teeth, especially when angry, tense, running, etc.
• cradling the telephone between your ear and shoulder
• eating, reading or watching television in bed
• resting your chin and/or cheek in the palm of your hand when lying on one side or sitting

(Let me know other resources that would be good additions to this list by e-mailing me at ksomers@uoguelph.ca .)

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