Treating TMJ issues: restless legs and sleep bruxism

A new clue about bruxism.

A neurology practice noted that of its patients who had restless legs syndrome (RLS), 60% also had bruxism (grinding teeth during sleep). They found that 52% had RLS, bruxism, and migraines.

Do you relate?

The lead neurologist for this study speculated there is a gene that links these conditions.

It gets more interesting. Both restless legs syndrome and bruxism are involuntary movements occurring during sleep. Is bruxism “restless jaw syndrome?”

I’m always happy to see more research about TMJ-related issues, especially because there are so many factors that play a role in jaw dysfunction and pain.

More about bruxism.

Bruxism includes clenching and grinding the teeth. Some distinguish these as “waking bruxism” and “sleep bruxism”.

They may have different causes, in my opinion.

Sleep bruxism, in contrast to daytime clenching, is hard to treat because it occurs when unaware of your behavior and unable to change it.

Waking bruxism is a habit that can change with awareness and practice. I’ve helped many clenchers learn how to relax their mouth position.

Some things I’ve noted about bruxism in my manual therapy practice:

  • Many people don’t know they grind during sleep until a dentist tells them they have damaged teeth.
  • Bruxism often requires expensive dental work: mouthguards or splints to prevent further damage, and crowns to fortify cracked or broken teeth.
  • Sometimes the noise of grinding during sleep is loud enough to wake up family members, and that’s how people learn they have sleep bruxism.
  • People who grind at night often wake up with jaw, face, or neck pain, earaches, and/or headaches.
  • Over time, bruxism can damage the temporomandibular joints, possibly requiring surgery.

Dentists and jaw issues.

Many people expect dentists to be experts on jaw issues, yet their domain is treating the teeth and gums.

Learning about TMJ disorders is not required in dental school.

General practice dentists can prevent further tooth damage with appliances like mouthguards and splints. They can repair existing tooth damage.

Some dentists may try to adjust the positioning of the TMJs, and a few dentists also address airway issues (like sleep apnea, which also may accompany sleep bruxism) in their work.

Dentists do not address stress or tension in the jaw muscles, which contribute so much to jaw pain.

Some dentists and hygienists in the Austin area refer people with jaw pain or issues opening wide to me. (New alternative to manual therapy during the COVID pandemic: my upcoming online course, Self-Help for Jaw Pain.)

Solutions to try.

If you grind your teeth during sleep, it is possible to stop by using hypnotherapy and EFT.

I often recommend a recorded hypnotherapy session for bruxism that’s available on YouTube to listen to before sleep.

I don’t know if it works for everyone, but it’s soothing — I always fall asleep before it ends. Less stress is always desirable.

As mentioned above, dopamine agonists are prescribed for low dopamine levels.

Dopamine is released when your brain is expecting a reward — when you anticipate a pleasurable activity such as eating a delicious meal, spending time with someone you love, or receiving a big check.

It’s sometimes called “the happy hormone” because it affects your enthusiasm, motivation, and focus.

If you suffer from bruxism, before going the pharmaceutical route with dopamine agonist drugs, you may want to consider nutrition — consuming foods or taking supplements that raise your dopamine levels.

In particular the amino acid tyrosine increases dopamine.

I found a few links that may be helpful:

Treating TMJ issues: reducing night grinding

A reader asked about grinding the teeth during sleep (night bruxism). Sleep labs have begun to investigate this. They found that about 1 in 4 people with sleep apnea also grind their teeth while sleeping. When the apnea is treated, the bruxism goes away. So..if you grind, consider going to a sleep lab.

Most people do a little bit of clenching or grinding while asleep.

When is it a problem? When you wake up with jaw or facial pain, earache, headache, or experience difficulty chewing (TMJ disorder). Or perhaps your dentist sees wear and tear on your teeth. Severe bruxism can crack teeth and require expensive dental work.

Why do people grind their teeth at night more than just a little bit? Stress is the main cause and well worth examining. Reducing stress during the day is likely to result in less grinding at night — but no studies have been done on this that I know of.

If you have personal experience, please share.

Body mechanics can also play a role. Posture both while awake and asleep influences your nervous system and can produce or relieve stress and tension. Just as with athletic training, learning and practicing good posture may require special training. The Alexander Technique, the Feldenkrais Method, alignment-based hatha yoga (Iyengar and Anusara), and structural integration bodywork (i.e., Rolfing) may all be of help.

A special pillow that keeps your head and spine aligned can be helpful. See my Self-Care Tools page for information on the Therapeutica Sleeping Pillow, which comes in different sizes based on the distance from your neck to outer shoulder.

Probably the simplest thing you can try is changing your sleep position. If you have night grinding and sleep on your side, try sleeping on your back. It may take some getting used to but may give you some relief.

Night bruxism may be an attempt to realign your cranial bones. Several sessions of craniosacral therapy may help.

If you have night bruxism, what has helped you?