TMJ Relief: Some medications cause jaw clenching

I have recently become aware that some widely used pharmaceutical medications 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. I’m sure you’ve heard of Prozac (fluoxetine). Here are some other SSRIs:

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

In addition, antipsychotics like Haldol are said to cause bruxism. Symbyax, which is Prozac plus the antipsychotic Zyprexa (fluoxetine + olanzapine), is also on the list.

In general, if you take any medications in these categories and you are clenching or grinding your teeth, talk to your doctor about alternatives: psychotropics, dopamine agonists, antihistaminergics, and psychostimulants.

Cigarette smoking, caffeine, alcohol, and recreational drugs all may increase the risk of bruxism, studies have found. 

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).

I know one integrative MD in Austin who offers it, and your insurance may cover it for depression. To learn more, please connect with Oak Hill Wellness Center. They even offer a free TMS consultation.

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

One more bit of info: I had a new TMJ Relief patient who was taking an SSRI for depression. I treated her and gave her the info above, but unlike others I’ve treated, she didn’t notice a difference at the end of the 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 an SSRI and have jaw pain, one of my TMJ Relief sessions (or even better, the 5-sessions-in-4-weeks program) can help, and meanwhile you can be investigating alternatives.

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?