The Link Between TMJ Disorder and Nighttime Clenching

Stacy’s Note: This is a guest post written by Lee Weinstein, inventor of the SleepGuard biofeedback headband. Lee has designed hospital medical equipment for Hewlett Packard, and has taught electrical engineering at MIT.

For many people,  TMJ symptoms stem from habitual teeth clenching during sleep.

You may have heard of the term “sleep bruxism”, which includes both clenching and grinding. Everyone who grinds his or her teeth clenches as part of the grinding, but not everyone who clenches grinds. The grinding part causes tooth wear, but most of the problems of TMJ Disorder come directly from the clenching.

In this article we’ll take a look at three main things:
1. Why clenching causes so much more damage than chewing.
2. How diverse symptoms such as migraines, jaw pain, neck pain, TMJ joint problems, loose teeth, receding gums, and root canals can all come from clenching.
3. How nighttime clenching becomes a habit (and why the clenching habit remains even when you remove the original cause).

1. Why does clenching cause more damage than chewing?

All the joints of our bodies are designed to withstand much larger forces briefly than they can sustain over a longer period of time. When a runner runs on pavement, it is not unusual for his or her ankles and knee joints to sustain brief shock forces of 400 pounds for a few hundredths of a second each time a foot hits the pavement. When you chew a piece of meat, it is not unusual for your teeth to sustain a brief pulse of force of over 100 pounds for a tenth of a second on each chew. But…the protective tissue in our joints that cushions these blows can only do so briefly.

The protective tissue in our joints has many of the same qualities as Silly Putty. If you ever played with Silly Putty as a kid, you know that if you make it into a ball, you can bounce it. During the brief shock force of the bounce, it behaves like rubber, but if you squeeze it for even half a second, it mashes like dough. When something is resilient when you squeeze it briefly but mashes when you squeeze it longer, that property is called “thixotropic”. The thixotropic protective tissue in our temporomandibular joint and around the roots of our teeth gets mashed and accumulates damage when we clench for more than a couple of seconds at a time. That’s why clenching can cause so much more damage than grinding.

2. The many and varied consequences of clenching

Now lets look at the different consequences of that protective tissue being damaged.

Consequences of clenching:
Bacteria gets between teeth and the jaw (which leads to loose teeth, receding gums, an abcess, or some combination of these problems)
Jaw pain, clicking and popping
Nerve damage
Headaches, migraines, tinnitus

When the protective tissue that bonds teeth into the jaw is damaged, one bad consequence is that bacteria can get between the teeth and the jaw, and this can lead to loose teeth, receding gums, an abscess that requires a root canal procedure, or some combination of these problems.

When the protective tissue in the temporomandibular joint is damaged, many things can go wrong. The joint can become painful. The geometry of the joint can change so that clicking and popping can occur. But because the trigeminal nerve runs through that joint, as protective tissue in the nerve becomes damaged, many more things can go wrong.

When the trigeminal nerve gets mashed from clenching, direct pain may result, and in addition sympathetic and parasympathetic nerve fibers can carry signals to the brain that can bring on headaches or migraines. Facial pain, muscle pain, and ringing in the ear are also common effects.

3. How nighttime clenching becomes a habit

The way we build a habit is that over time we build a neural association (connection) in our brain between something we see or hear or feel and an action we take in response. We build good habits this way (like stepping on the brake when tail lights light up in front of us), and we sometimes build bad habits this way (like fingernail biting in response to stress).

Building a nighttime clenching habit looks like this:

 

 

Once the habit is in place, the original disturbance or intention that put the habit there can go away, and the habit remains.

An established habit looks like this:

Each time we use a neural pathway, it gets strengthened. This happens physically at the synapses between neurons. So as the habit gets more entrenched, this neural “path through the forest” may begin to look more like a road or a highway.


Do you grind or clench? Have you had any success trying to stop it? Share your experiences with us in the comments below.


 

About The Author

Stacy

Stacy is the Founder & Executive Director of TMJ Hope. After being mauled by a dog, she experienced severe jaw pain that was not relieved by conservative treatments. After several surgeries, she had TMJ total joint replacements in 2006.

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7 Comments

  • annedreshfield

    Reply Reply June 6, 2011

    Excellent graphs, Lee. It’s interesting to see how this destructive cycle perpetuates itself.

  • tisme

    Reply Reply October 29, 2011

    is a bad clencher and is suffering teeth issues finally research etc is being done into this issue. hopefully intime to save my teeth am currently suffering gingivitiis not from a lack of brushing

  • Tracey Anne Evans

    Reply Reply February 24, 2013

    I have tmj. And I,very had it for 15 years now.  I got lots of headaches but only discovered that it was tmj about 3 years ago. I live on pain killers and I,m constantly in pain. It is making me feel miserable.  No relief at all. I don’t,t eat properly only soft food and. No cold drinks.  I can,t yawn properly anymore. I have been told there is no cure. The rest of my life will be ruled by this condition. I wish I,do never bitten my nails or chewed gum. If there is anyone out there who can offer me any advise or help me please comment on here. Tracey Evans

    • Tami Gaul

      Reply Reply February 24, 2013

      Hi Tracey , I have it as well not for as long as you have mine is a little over a year and a half. but I am in constant pain as well no relief I have been to doctors dentists specialists you name it I have tried it even accupuncture and stress hypnosis. I am very depressed and frustrated I have little quiality of life . I worked very hard to loose weight some years ago and have kept it off now I am gaining weight because I do not or can not eat foods that are healthy because they are too hard or chewey.I am a clencher and do it day and night I can not stop or relax my jaw no matter what i do . I just wanted you to know that there are people that understand . I do not leave the house for days sometimes and I feel this is destrying my life and my relationships as well. I do not even take pain pilss I do not want to . so I only take Ibuprofen and way to much of it around 2,000 mil a day an it does not even take the edge off so much anymore because my body is amune to it now.I have spent over 7,000 to feel worse I do not have insurance . I would be willing to pay anything if it worked .I wish I had an answer for your or even a suggestion but I just wanted to give you some support . People do not understand this unless they have it . best wishes to you and all of us suffering everyday  Tami Gaul

    • Beth Wallace

      Reply Reply June 2, 2013

      I can only share some of my experience with you because I have only touched some of what you are describing. Mine just got, temporarily, a lot worse and I thought I was going to die from the pain from the headaches it was so bad (pulsating behind one of my eyes)! What helped me is the fact I do wear a bite plate at night (just a pharmacy one) and that minimizes the clenching and grinding. I also popped my TMJ joint back into place because it came our of place. The most important thing has been yoga- slowly. I did 20 minutes after a long absence and actually felt all of the tension leaving my neck. It was wild, and I haven’t had a headache since. I saw my dentist and he said we are going to stick with that for now until things get worse. I hope that helps!

  • Teena Riley-Braun

    Reply Reply February 24, 2013

    Ive had tmj since childhood and now its so bad im in constant pain, soft foods only no yawning, its hard to open my mouth wide enough to brush my teeth  🙁 I also suffer headaches and chronic migraines with neck pain, my dentist wants to adjust my teeth to change my bite but this could make it worse, I have no idea what to do anymore and I dont think people understand how this affects us, I wake every morning with my jaw hurting and clicking really bad so im guessing i clench during the night as well as the day, I have an overbite as well so maybe its too complex???

  • Seth

    Reply Reply December 23, 2015

    Hello all. I am so so sorry to hear of so many people suffering with the same crap I am. I wouldn’t wish this on my worst enemy. It’s constant pressure and pain in my temples and in the cheek muscle. I also experience pain behind my right eye and my right nostril is often so stopped up in the mornings I can’t get a single bit of air to pass through it. My jaw pops and I cannot open it all the way. I went to a chiropractor for 4 months and I swear it only made it worse. I went to the dentist and dropped $300 on a bite plate and that SOB didn’t help a bit. The worst part about it is it’s impossible to describe to anyone who doesn’t have it, they think you’re just a big baby. It’s half way comforting to know you guys have the same problem, but Lord help us there’s no way I can live the rest of my life this way. I’m only 20. I’m praying for you all!

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