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.

Coming soon! A class for dental offices

I have been taking a fantastic class called NLP+Presentations. The first part was this past weekend, and the second part will be in mid-February.

I’m working on a presentation for dental offices. It will be an hour max, so it could be a lunch-and-learn or a training offered to staff early or late in the workday.

I probably don’t need to tell you that some people complain of jaw pain after receiving dental work.

Dental professionals need to accommodate them by offering frequent breaks from wide-open mouth position — some even use devices to keep the mouth cranked wide open.

Dental offices also experience cancellations when someone’s jaw pain has flared up and they can’t even imagine holding their mouth open for dental treatment.

In fact, dental professionals are often the first health care professionals to let someone know that their clenching and/or grinding habit is damaging their teeth.

Although they offer orthotic devices to protect teeth and/or try to realign the TMJs, and they can usually repair the tooth damage they encounter, they don’t work on the biggest cause of jaw pain — myofascial tension. In fact, most dentists receive little or no training in the jaw — their domain is teeth and gums.

As a massage therapist, my domain is the myofascial realm of muscles and soft tissues. I work on postural issues, shoulder and neck tension, decompression of cranial bones, and do intra-oral work on all four internal jaw muscles — as gently as possible.

I can help dental offices help their patients, and I believe we can work well together.

If you think your dentist might be interested in this free training, please connect us. I’ll be offering trainings starting in late February.

Choose a practitioner for intra-oral TMJ therapy that works on the lateral pterygoids

So far I’ve had two clients come in for TMJ relief sessions who have previously seen multiple practitioners who worked inside their mouths.

They’ve seen chiropractors, chiropractic neurologists, Rolfers, dentists trained by the Las Vegas Institute (LVI), and/or other massage therapists.

These two clients both told me, “No one has ever touched me there,” after I worked on their lateral pterygoids.

These are small and hard to access muscles, and in my opinion (and my main TMJ teacher’s opinion), they are most often the key muscles to address to release jaw tension.

anatomy of the jaw muscles

It’s not that the other jaw muscles don’t contribute. They do, and in roughly 10% of the TMD cases I’ve worked on so far, one of the medial pterygoids is the problem child.

The external jaw muscles — the masseters and temporalises — also play a role in jaw tension but are never (that I’ve seen in 5 years) the biggest cause.

In other words, 90% of the time when people have jaw pain from muscle tension, the lateral pterygoids are the biggest culprit.

It’s not that these other intra-oral practitioners have nothing to offer. I’m not familiar with all of them, but chiropractors, Rolfers, and massage therapists have definitely helped me.

But if jaw tension and pain resulting from jaw tension is your major complaint, and you’d like a sense of spaciousness in your TMJs (if you can even imagine how great that would feel), go to a practitioner that works on the lateral pterygoids.

Click here to book a free 30-minute consultation.

Other things that distinguish my work:

  • I work as gently as possible.
  • I never make any sudden moves.
  • My sessions start with full body alignment to get you relaxed and progress toward the intra-oral work at the end.
  • I offer you legal hemp oil to relieve anxiety, pain, and inflammation before working in your mouth. It’s not required, but some clients really like it.
  • I offer single TMJ Relief sessions as well as a TMJ Relief Program consisting of 5 sessions in 4 weeks for lasting change, along with education and support for habit change and self-care.
  • I created a Facebook group, Word of Mouth: Resources for Jaw Pain/Dysfunction, for people who want to work on their jaw issues.

I hope this information helps you at least ask informed questions when choosing a practitioner to relieve your jaw tension and pain.

Massage therapy for jaw pain

The January/February 2019 issue of Massage & Bodywork (magazine for massage therapists) includes the article “Temporomandibular Joint Disorders: Biting Off More Than We Can Chew”. It’s full of information about the anatomy, pathology, demographics, contributing factors, symptoms, and treatment options for TMJD. The author is Ruth Werner, who wrote A Massage Therapist’s Guide to Pathology.

The article mentions that many dental professionals enthusiastically recommend massage therapy as an early intervention for TMJ disorders, which are often accompanied by dysfunction elsewhere in the body — the shoulder girdle, pelvis, and feet, for example.   Regular massage therapy sessions can also help relieve pain and tension in the external jaw muscles.

The author states, “The [internal] pterygoid muscles require more specialized skill… Work inside the mouth carries some serious responsibilities… It’s not for beginners, and it’s not for dabbling. When things go wrong in this joint, problems can reverberate through the whole body… [Massage therapists working inside the mouth should] get advanced training…

“Intraoral massage may trigger unintended responses… Emotional release in response to work in and around the mouth is also a strong possibility. It is critical that massage therapists be mindful of their scope of practice and respectful of their clients’ processes if this happens. Massage therapists must be prepared to be present, nonjudgmental, and appropriately supportive for this kind of event. Once again, it’s not for dabblers. If you want to do this work, get appropriate training.”

After reading this, I feel good about what I do. Massage therapists trained to work inside the mouth mostly follow three paths of advanced training: craniosacral therapy (like me), neuromuscular therapy, and structural integration (aka Rolfing).

Also, not all craniosacral therapists or neuromuscular therapists work with the internal pterygoid muscles, so be sure to ask beforehand if that’s what you expect. That was part of my training with Ryan Hallford, not (so far) with the Upledger Institute.

Also, I’m thanking the Upledger Institute for my training in SomatoEmotional Release as well as past experience and research in trauma recovery.

I’m grateful to see that treatment for TMJ disorders by licensed massage therapists is getting media attention, and that TMJD itself is getting more recognition. The TMJ Association recently announced that the National Institutes of Health have agreed to do more research. It’s very much needed — practitioners know what we don’t know, and it’s a lot.

Free consultation for TMJ issues

I’m please to announce I’ve added a new service. If you have jaw pain or dysfunction and are wondering if I can do anything for you, please schedule a free 30-minute consultation.

A lot of people, including dentists, are not aware that appropriately trained massage therapists can work on relieving your TMJ issues that are due to muscle tension or trauma. 

Screen Shot 2018-05-30 at 8.44.49 PMI’ll ask about your symptoms and your history. I’ll also evaluate your body, including your neck and jaw.

Then we can talk about treatment options. If you’ve never had manual therapy for jaw pain and dysfunction, or if you’ve received it previously from a different practitioner, I’ll be happy to tell you what a typical session is like and the typical progression if you are curious about buying a series of sessions.

Please note: What I find once I start working and how well your system responds are variable with bodywork.

I’ve been doing TMJ Relief sessions since 2014. My teacher was Ryan Hallford of the Craniosacral Resource Center in Southlake, TX. I’ve taken his cranial base/TMJ class twice and been a teaching assistant for it when Christian Current taught. In addition, I’ve studied craniosacral therapy with the Upledger Institute.

Please let me know if you have any questions, and don’t hesitate to read the testimonials on my What People Are Saying page.