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 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.