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 teach clenchers an alternative to clenching as well as the above information to stop grinding.

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. 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: Learn to treat your own issues on Zoom.

I am now offering Self-Treatment for TMJ Issues on Zoom, in case you are interested in learning to work in your own mouth to relieve your jaw issues.

You’ll share your symptoms and history, address your habits and other contributing factors, learn to release tension and stress from your system, and … learn to work in your own mouth, with guidance from a seasoned manual therapist who can speak your language.

The upside: You’ll save money, get a brief video recapping the intraoral skills to help you practice and integrate these skills, acquire several other skills that will help you relieve your own TMJ issues for the rest of your life, and have the confidence that you got this — NEXT!

How hard is it? If you’re not afraid to get your clean fingers wet or wear medical gloves, and if you can tell the difference between touching something hard and touching something soft, and if you are willing to go slowly with sensitivity, you can do it.

It’s often a revelation.

There’s no need to learn anatomical language. I can share that if you like, but most of the instructions are like this: ”slide the side of your index finger down your bottom molars on the opposite side…”.

Click to schedule your session.

What have you got to lose?

Policies

Welcome.

I’m here to do my best for you. In this line of work, we are always seeking more health. You are too, or you wouldn’t be here. I look forward to working together.

Please read through my policies. I’m happy to answer any questions you have.

Appointments

Bodywork sessions are by appointment only. You may schedule your own appointment online. You may also contact me first (preferably scheduling a free phone consultation) if you have any questions.

Please try to arrive 5 minutes early to decompress before your session. If possible, allow yourself some down-time after your session to integrate.

Your appointment time is reserved exclusively for you. I send a reminder email and text 48 hours in advance of your start time.

If you need to reschedule, please be kind and do so as soon as possible. You may reschedule online or by emailing, texting, or leaving a voicemail for me.

If you miss an appointment with less than 24 hours of notice, you will be responsible for full payment for the session.

Rates

Initial appointments and 90 minute sessions: $165.

Follow-up appointments/60 minute sessions: $135.

Multi-session packages and subscriptions are discounted by 10 percent.

Payment

When you schedule yourself online, you prepay with a credit card.

If you prefer to pay with cash, check made out to MaryAnn Reynolds, or a cash app, I will need to schedule your session for you.

Special instructions for American Express cards: enter the card number minus the last digit. Then enter the four-digit CVV code. Then enter the last digit of the credit card number. If this doesn’t work, try another type of card or ask me to send you a payment request in PayPal or Venmo.

I accept Health Care Savings Account and Flexible Spending Account cards.

Tips are not accepted. I do appreciate feedback (both positive and about how I can improve), and spreading the word to others in person or in writing about a good experience is deeply appreciated.

I do not work with insurance companies, but if you request a receipt, I can provide one after your session(s) that you can submit to your insurance company or HCSA/FSA plan for reimbursement.

Packages

Multi-session packages are discounted by 10 to 20 percent.

Packages never expire, and they are non-refundable. If you buy a package and cannot use all the sessions, you may request a gift certificate for the balance. 

If you would like to request a package or gift certificate not listed on my Scheduling link, please contact MaryAnn at 512-507-4184.

Mask policy

When Austin/Travis County is in Stage 4 or 5, masks are required at all times throughout the office suite and in my private office, regardless of vaccination status.

The only exception is during the intraoral portion of TMJ Relief sessions, when you will need to unmask. I will give you some antiseptic solution (Listerine or a 1% peroxide solution or salt water) to rinse your mouth with before proceeding.

In Stage 3 or below, you may be unmasked if you feel safe doing so, and I will ask you if you are comfortable with me unmasking. (I’m vaxxed and boosted.)

I run a Winix air filter at all times when I am working. It more than meets the highest CDC and WHO recommendations.

If you have a sore throat, fever, or other symptoms of illness, please reschedule your session.

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 teach clenchers an alternative to clenching as well as the above information to stop grinding.

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. 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: choose a practitioner who works on your lateral pterygoids

Recently I’ve had two clients come in for TMJ relief sessions who have previously seen multiple practitioners who worked inside their mouths. Between them, they have seen chiropractors, chiropractic neurologists, Rolfers, dentists trained by the Las Vegas Institute (LVI), and/or other massage therapists.

These clients both told me, “No one has ever touched me there,” after I worked on releasing tension in their lateral pterygoid muscles.

That surprised me.

These small muscles are hard to access, being nearly surrounded by bones (cut away in the image below so you can see the two-headed muscle) and not directly accessible on everyone, being overlaid by the temporalis tendon and the medial pterygoid.

You can get close enough to make a difference, however.

I learned a lot from Gil Hedley’s dissection videos, Muscles of Mastication.

In my opinion, the lateral pterygoids are often the keys for releasing jaw tension and also for relieving clicking and popping noises. Notice that the upper head is attached to the articular disc that separates the temporal bone and the mandible —the two bones of the TMJs.

When this disc does not move smoothly with the bone when the jaw opens and closes, clicking, popping, and sometimes grinding can occur.

anatomy of the jaw muscles

It’s not that the other jaw muscles don’t contribute. They do. I’ve found tension in the temporalises, trigger points in the masseters, and taut bands in the medial pterygoids.

I usually save the lateral pterygoids for last when working on someone’s internal jaw muscles, because they are harder to access and can also be very sensitive. It helps to have tiny pinky fingers, and even then sometimes I need to ask a client to shift their jaw to one side so I can reach them.

Sometimes I can’t reach them on the first visit, but any release of tension in this area near the joint is therapeutic.

Most of my TMJ clients are not aware when they come in that there are even jaw muscles here! The masseters usually get all the glory, and I’m touching a place that never gets touched. No wonder this area can be sensitive.

When I get on or near a lateral pterygoid, it can be a revelation. “That’s the place!” they exclaim when I remove my finger.

Once I get there, I don’t need to stay long to make a difference. I invite my TMJ clients to move their jaws after I work on each muscle. More often than not, releasing tension in this muscle creates a sense of spaciousness around the joint.

If jaw pain and tension are your major complaint, and you’d like a sense of spaciousness in your jaws (if you can even imagine how great that would feel), find a practitioner that works on the lateral pterygoids, or come see me if you can.

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


What to do if you have jaw issues? I offer a 30-minute in-person TMJ assessment 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 Assessment plus TMJ Relief session in person in Austin, Texas. The assessment serves as an intake, so I have a better idea of what your issues are and how we’ll measure progress. Your assessment 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.