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 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.

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.

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 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 in my opinion, they 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.)

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. It helps to have tiny pinky fingers, and even then sometimes I need to ask a client to shift their jaw to the 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.

People are not aware that there are jaw muscles here! I’m touching in a place where people never get touched. 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.

It’s not that these other intra-oral practitioners mentioned above (at least in these two clients’ experiences) have nothing to offer. I’m not familiar with all of them, but chiropractors, Rolfers, and massage therapists have all helped me.

But 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.

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 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.


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.

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.

Screen Shot 2018-05-30 at 8.44.49 PM

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.


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.