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: reducing daytime clenching

A new follower of my Facebook business page is working on reducing her daytime clenching.

Along with any kind of helpful stress-reducing practice (4-7-8 breathing, yoga, meditation, epsom salt baths, etc.), you can retrain your jaw and mouth muscles to be more relaxed.

Actually, you can retrain your entire nervous system to be more relaxed — and this may take several years of dedicated effort, including finding less stressful work along with committing to yoga, breath work, and/or meditation practices and other lifestyle changes. I plan to write more about resetting your nervous system in the future.

So for today, one step at a time: how to relax your jaw and mouth muscles when you experience daytime clenching.

The first step is to notice when you are clenching or grinding and deliberately move your teeth apart.

Next, do this to relax your tight jaw muscles: Circle the tip of your tongue on the biting surfaces of your teeth (upper and lower) 5 times in each direction. Gradually add some repetitions each time, up to 15, to help release the muscle tension of clenching by exercising the jaw muscles and tongue.

Then gradually reduce the number of repetitions to whatever it takes to loosen up.

Follow this by working to develop a new habit, because that’s what clenching is, a habit: Visualize a coffee stir stick turned sideways between your upper and lower teeth in front. That’s as far as you need to move your teeth apart.

Imagine your lower jaw hanging loosely from its hinges. Close your lips. You can give your jaw muscles a massage.

Let your tongue flatten and soften so the outer edges protrude slightly into the spaces between your upper and lower molars. Let the tip of your tongue rest gently behind your upper teeth.

This is the new relaxed resting position when you are not using your mouth. If you unconsciously begin to clench again, you will bite your tongue, and that will remind you to move your teeth back apart. (This was passed on to me by a yoga student of Maria Mendola in Tucson, and I want to give her credit.)

At first you will need to practice this a LOT and it will seem tiresome. Keep doing it anyway. Some days will be easier than others.

You may become aware that your clenching is related to suppressing speech. There are so many reasons we might do this: bad boss, difficult situation, consequences you don’t want, etc. Find a way to let those words out, even if just on paper. Discover your own truths.

Seek help if this level of change seems overwhelming.

When you have practiced unclenching and relaxing your mouth enough, one day you will notice that you did it without thinking about it. The old clenching habit may return under stress, but you’ve got the resources now to put it firmly back in the past.

If you can master this one simple change in habits, you can do almost anything. I’m wishing you success.