Treating TMJ Issues: some medications cause jaw clenching

I’ve learned that some widely used 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. There may be others:

  • 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.

This is a known problem. This link to an abstract of a 2017 journal article for psychiatrists has more. I don’t have access without paying a lot of money, but you can share this link with your psychiatrist if this applies to you, and there may be updates on this topic.

https://pubmed.ncbi.nlm.nih.gov/28492455/

In general, if you take any of these medications and you are clenching or grinding your teeth, talk to your doctor about alternatives. From the abstract: “Alternative classes of antidepressants reviewed include serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, atypical antidepressants, and monoamine oxidase inhibitors. Findings indicate that dopamine agonists and buspirone are currently the most effective medications to treat the side effects of SSRI-induced bruxism, but results regarding the effectiveness of specific antidepressants that avoid bruxism altogether remain inconclusive.” (My italics.)

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 jaws 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 can help.

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 lateral pterygoid muscle) and not directly accessible on everyone, being overlaid by the temporalis tendon and the medial pterygoid.

You can get close enough to influence it, however.

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 (acronym for temporomandibular joints).

When this disc does not move smoothly with the mandible when the jaw opens and closes, clicking, popping, and sometimes a crunching noise 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 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 to get near the muscle and joint.

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 near a lateral pterygoid, it can be a revelation. “That’s the place!” clients 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. 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.

Treating TMJ issues: videos of self-care techniques

If you suffer from jaw pain, you may want to try some of these jaw exercises and self-massage techniques.

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TMJ Exercises & Stretches to Relieve Jaw Pain — Ask Dr. Jo. 3:03. Dr. Jo is a physical therapist who demonstrates four simple exercises.

TMJ Massage: Pressure Points for Relief by MassageByHeather.com. 3:43. Massage therapist Heather Wibbels shows you four acupressure points for jaw pain. You hold them bilaterally for 30 seconds up to 2 minutes. If you’re looking for something you can do without attracting a lot of attention, do these.

Absolute Best TMJ Treatment You Can Do Yourself for Quick Relief. 5:48. “Bob and Brad, the two most famous physical therapists on the internet” (as their theme song goes) show you how to massage your external jaw muscles.

10 Best TMJ Exercises to Stop Pain in Your Jaw. 11:57. Bob and Brad show you the standard relaxed position for your jaw along with several exercises. Start saving popsicle sticks!

TMJ Exercises #1, 11:25. Chiropractor Adam Fields demonstrates exercises for the back of the neck, which is often tight when you have TMD, tongue exercises, and massage, ending with a relaxation exercise. In TMJ Exercises #2, 10:07, he focuses on massaging the muscles that open and close your jaw. He helps you tie the jaw exercises and massage into really good posture — a good habit that will help relieve jaw tension.

Yoga to Release Jaw Tension from Grinding Teeth, Clenching, TMJ. 10:26. Karuna demonstrates self-massage to release jaw tension, including a technique you can do right before you go to sleep that may prevent clenching and grinding while asleep.

I’m interested in hearing back from you about which exercises help you the most. If you’ve found other helpful videos about TMJ self-care, please let me know.