Treating TMJ Issues: you can learn to stop clenching

In every TMJ consultation that I do, I ask about clenching. I consider it to be an important factor that contributes to jaw tension, which I treat with manual therapy.

Clenching is a habit that people do unconsciously, and most of the people who come to me for TMJ relief consultations and sessions clench and/or grind their teeth, which is called bruxism.

How does this habit start?

Common sense tells us that clenching comes from stress. If you clench, do you do it when you’re feeling relaxed and happy? Probably not!

It seems likely to be a response that represses free speech, or perhaps it started that way and then became a habitual response to stress.

People of all ages past infancy do it, even as young as three, I’ve heard anecdotally.

We’ve probably all experienced an authority figure (parent, teacher, boss, partner, etc.) who doesn’t want to hear what we have to say and who has the power to shut us down — unless we are willing to experience the consequences…which could be getting fired, isolation, abuse, punishment, abandonment, or violence.

We still think the thoughts, we still feel the emotions, but now we also have to shut up and hold our feelings/thoughts in, unexpressed. We feel threatened and want to feel safe. This creates even more stress.

We may learn that clenching our teeth keeps us safe by keeping our mouth shut…but at a cost to our own well-being.

(If you want to get better at interpersonal communication, I recommend Marshall Rosenberg’s Nonviolent Communication approach.)

We have to use our jaw muscles to clench, and overuse of these muscles creates the chronic tension in these muscles that so many with jaw issues complain about.

The pressure of clenching can cause teeth to crack and break. The dental solution is to replace broken teeth with crowns or implants. These are expensive procedures requiring a lot of time in the dental chair with your mouth wide open, which is tough on already chronically tense jaw muscles.

So what’s the alternative?

I teach what I call Relaxed Resting Mouth Position, aka RRMP. It’s very simple:

  • Close your lips and breathe through your nose.
  • Keep your teeth slightly apart.
  • Curl your tongue up so that the tip touches your upper palate behind your front teeth.

If you clench, try it now and see what you notice. How does it feel? How might it feel if it became habitual?

What if this could become your new default relaxed resting mouth position?

You can teach yourself to do this when you’re not otherwise using your mouth.

Any time you want to change a habit, first you need to become more conscious of your behavior. Then you need a healthier alternative to replace the unwanted behavior.

Repetition replaces bad habits with good habits. Enough repetition rewires your neurology.

How can I learn RRMP?

The way I teach it in my office (and now online) is to give people a few coffee stir sticks, 5-7 of them.

They can put one between their teeth, either flat or on edge, so their teeth are slightly apart, and then close their lips with their tongue tip on the roof of the mouth. Not hard at all, just to get a feel for RRMP.

I then advise them to place the coffee stir sticks in the places they habituate: for instance, on the bathroom counter, bedside table, kitchen counter, desk, dashboard, coffee table, by the remote.

Online readers, you can go to a coffee shop (buy a drink, please), take a few, and do this yourself.

Be sure to tell the neat freaks in your household to leave them where they are!

Here’s where the change happens!

The most important part of changing this habit is that whenever you spot one of these coffee stir sticks — and they will get your attention because they look like clutter — ask yourself, ”What am I doing with my mouth?”

This makes you more conscious of your clenching habit.

If you find yourself clenching, immediately switch to Relaxed Resting Mouth Position. Tell yourself how much you look forward to this becoming your new default mouth position!

Do this again the next time you notice a coffee stir stick. And the next, and the next, and the next.

No one knows just how many repetitions it will take for RRMP to become your new habit. It may take 5 times a day for 3 weeks, or more, or less.

But with repetition, increasingly you will find that your mouth is already in RRMP when you see a coffee stir stick and notice what you’re doing with your mouth.

When you’re satisfied that RRMP has become your new default mouth position, you can put the coffee stir sticks away.

Why tongue on the roof of the mouth?

This appears to come from Eastern medicine and practices. I haven’t found anything in Western medicine about it.

In Taoist practices, the two most important meridians regulating the flow of energy in the body are located on our midlines.

The conception vessel runs along your midline on the front of your body, and the governing vessel runs along your midline on the back of your body, coming over the top of your head.

These meridians meet when you place your tongue on the roof of your mouth.

This practice connects these meridians, strengthening your energy, balancing yin and yang, resulting in a state of calm alertness.

Tongue tip on the roof of the mouth is used in meditation, qi gong, tai chi, kung fu, 4-7-8 breathing, yoga, and probably more.


What to do if you have jaw issues? I offer a 30-minute in-person TMJ consultation to gather information and evaluate your issues. I also teach clenchers an alternative to clenching and provide known ways to stop grinding, from those who succeeded.

These habits are major contributors to TMJ issues, and you can change them.

If you’re not in Austin, I can do the above as well as help you learn what to ask about when seeking TMJ relief near you. Just let me know if you need a phone or Zoom consultation.

I offer a combination TMJ Consultation plus TMJ Relief session in person in Austin, Texas, and in Taos, NM, in sumemrs. The consultation serves as an intake, so I have a better idea of what your issues are and how we’ll measure progress. Your consultation is free when combined with your first TMJ Relief session. This is a two-hour session.

To be fair, when you’ve had TMJ issues for a long time, or they are acute, you may need multiple sessions to retrain your system to retain the ease and alignment, along with doing your homework to stop clenching or grinding your teeth.

I offer a package of four TMJ Relief sessions for 10 percent off single sessions, best done a week or two apart. These sessions are 90 minutes and integrate various bodywork modalities — including work in your mouth — so that you feel great when you get off the table. They are best done over 4 to 6 weeks.

If you’re really adventurous, you can schedule a 75-minute Self-Treatment for TMJ Issues session on Zoom where we’ll do an intake and I will teach you how to work on releasing the tension patterns that cause problems, including working in your own mouth. You’ll need clean hands and short nails. It’s really not that hard! Learn more about it here.

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). Eighty-three percent had RLS and migraines, and 52% had RLS, migraines, and bruxism.

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 new research about TMJ-related issues, especially because there are so many factors that play a role in jaw dysfunction and pain.

This may be something to show your doctor, or you may be interested in taking a supplement or adding foods to your diet that help your body produce more dopamine (more info below).

More about bruxism.

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

They may have different causes.

Sleep bruxism, in contrast to daytime clenching, is harder to treat because it occurs when you’re 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.
  • Sometimes the noise of grinding during sleep is loud enough to wake up family members or housemates, 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.
  • Bruxism often results in the need for expensive dental work: mouthguards or splints to prevent further damage, crowns to fortify cracked or broken teeth, and sometimes implants.
  • Over time, bruxism can seriously damage the temporomandibular joints to the point of requiring surgery. It’s so much better to address jaw issues before it gets that bad.

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. It’s an elective.

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

Some dentists may try to adjust the positioning of the TMJs, and a few more recently-trained dentists also address airway issues (like sleep apnea, which 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. Any overworked muscle will tighten, be painful, and perhaps spasm. The jaw muscles are no different. Sometimes they get taut bands within the muscle tissue that limit range of motion.

Working with muscles is the domain of massage therapists.

I receive referrals for TMJ Relief consultations and sessions from some of the best dentists and hygienists in Austin.

Solutions to try.

If you grind your teeth during sleep, it is possible to stop by using hypnotherapy or EFT (tapping).

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.

I’ve also heard from someone who did this that starting a regular meditation practice can reduce or stop bruxism completely over time. There are many types of meditation. If you want to try this, choose a type of meditation that is relaxing and includes body awareness. Mindfulness-Based Stress Reduction is taught online.

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:


What to do if you have jaw issues? I offer a 30-minute in-person TMJ consultation to gather information and evaluate your issues. I also teach clenchers an alternative to clenching and provide known ways to stop grinding, from those who succeeded.

These habits are major contributors to TMJ issues, and you can change them.

If you’re not in Austin, I can do the above as well as help you learn what to ask about when seeking TMJ relief near you. Just let me know if you need a phone or Zoom consultation.

I offer a combination TMJ Consultation plus TMJ Relief session in person in Austin, Texas, and in Taos, NM, in sumemrs. The consultation serves as an intake, so I have a better idea of what your issues are and how we’ll measure progress. Your consultation is free when combined with your first TMJ Relief session. This is a two-hour session.

To be fair, when you’ve had TMJ issues for a long time, or they are acute, you may need multiple sessions to retrain your system to retain the ease and alignment, along with doing your homework to stop clenching or grinding your teeth.

I offer a package of four TMJ Relief sessions for 10 percent off single sessions, best done a week or two apart. These sessions are 90 minutes and integrate various bodywork modalities — including work in your mouth — so that you feel great when you get off the table. They are best done over 4 to 6 weeks.

If you’re really adventurous, you can schedule a 75-minute Self-Treatment for TMJ Issues session on Zoom where we’ll do an intake and I will teach you how to work on releasing the tension patterns that cause problems, including working in your own mouth. You’ll need clean hands and short nails. It’s really not that hard! Learn more about it here.

Treating TMJ issues: portrait of a typical patient

Based on patients I’ve seen for jaw pain since 2013, I created this portrait of a typical patient. And of course, I’ve seen other patients who don’t fit these criteria.

She’s female. It’s been said that women are nine times more likely to suffer from jaw pain.

She first experienced jaw pain in her teen years.

She’s suffered for at least a decade, sometimes two decades or longer.

She clenches and/or grinds her teeth.

A dentist has prescribed an appliance to prevent damage to her teeth. The chances are 50/50 that she uses it as prescribed.

I wish I knew more about this.

Her pain level fluctuates, increasing with stress, and she usually hasn’t gone more than 6 months free from jaw pain since onset.

Her neck and shoulders are tight. Sometimes she has headaches, migraines, or ear pain.

She may also have pelvic alignment issues.

She has sought help from physical therapists, chiropractors, acupuncturists, and/or massage therapists.

She’d like to find lasting relief from her jaw and related issues.

Can you relate? How do you fit this profile, and how are you different?


Treating TMJ Issues: some medications cause jaw clenching

I’ve learned that some widely used pharmaceutical medications can cause jaw clenching and grinding as side effects.

The best known are in a class called SSRIs, selective serotonin reuptake inhibitors, commonly prescribed for depression and/or anxiety.

I’m sure you’ve heard of Prozac (generic name fluoxetine). Here are some other SSRIs that can cause bruxism:

  • Zoloft (sertraline)
  • Celexa (citalopram)
  • Lexapro (escitalopram)
  • Paxil and Pexeva (paroxetine and paroxetine CR)
  • Viibryd (vilazodone)
  • Luvox (fluvoxamine and fluvoxamine CR)

Do not stop taking them without a doctor’s supervision, as you may have withdrawal symptoms, possibly dangerous.

In general, if you take any of these medications and you are clenching or grinding your teeth, talk to your doctor about alternatives: psychotropics, dopamine agonists, antihistaminergics, and psychostimulants, as well as other measures to relieve anxiety and depression.

I recently learned that there’s an alternative to pharmaceuticals for treating depression and other mental disorders. It’s called TMS (transcranial magnetic stimulation) and it works with your brain waves (rather than the chemical approach using particles).

It’s been approved by the FDA to treat depression and migraines, and it’s also being used to treat anxiety, OCD, PTSD, autism syndrome, traumatic brain injuries, ADHD, and more.

You can do a search to find out if it’s available near you.

One more bit of info: I had a new TMJ Relief patient who was taking an SSRI. I treated her and gave her the info above.

Unlike others I’ve treated, she didn’t notice a difference in how her TMJs felt and moved at the end of her first session.

However, she emailed me the next day to tell me that for the first time in a while, she woke up without severe jaw pain and headache.

So even if you are taking one of these SSRIs and have jaw pain, one of my TMJ Relief sessions (or even better, several sessions judiciously scheduled to prevent relapse) can help, and meanwhile you can be investigating alternatives.


What to do if you have jaw issues? I offer a 30-minute in-person TMJ consultation to gather information and evaluate your issues. I also teach clenchers an alternative to clenching and provide known ways to stop grinding, from those who succeeded.

These habits are major contributors to TMJ issues, and you can change them.

If you’re not in Austin, I can do the above as well as help you learn what to ask about when seeking TMJ relief near you. Just let me know if you need a phone or Zoom consultation.

I offer a combination TMJ Consultation plus TMJ Relief session in person in Austin, Texas, and in Taos, NM, in sumemrs. The consultation serves as an intake, so I have a better idea of what your issues are and how we’ll measure progress. Your consultation is free when combined with your first TMJ Relief session. This is a two-hour session.

To be fair, when you’ve had TMJ issues for a long time, or they are acute, you may need multiple sessions to retrain your system to retain the ease and alignment, along with doing your homework to stop clenching or grinding your teeth.

I offer a package of four TMJ Relief sessions for 10 percent off single sessions, best done a week or two apart. These sessions are 90 minutes and integrate various bodywork modalities — including work in your mouth — so that you feel great when you get off the table. They are best done over 4 to 6 weeks.

If you’re really adventurous, you can schedule a 75-minute Self-Treatment for TMJ Issues session on Zoom where we’ll do an intake and I will teach you how to work on releasing the tension patterns that cause problems, including working in your own mouth. You’ll need clean hands and short nails. It’s really not that hard! Learn more about it here.

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.

However, one of the few people I know who stopped grinding their teeth in their sleep said that when they started a regular, daily meditation practice, their night bruxism gradually stopped. 

If you have personal experience, please share. We need these stories! 

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. The Therapeutica Sleeping Pillow comes in different sizes based on the distance from your neck to outer shoulder for side sleepers.

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 bring 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?