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Health Information | 01/12/2021

Jaw Pain: Temporary Stress or a Joint Disorder?

By  Atrius Health
Psychiatry and Behavioral Health Primary Care
Balancing personal responsibilities, keeping up with loved ones, and staying healthy can be difficult, especially as we face the COVID-19 pandemic. For many people, it’s common for stress and anxiety to manifest through physical symptoms. Sometimes, this stress can cause you to clench or grind your teeth, which can lead to more serious issues if left untreated. Teeth grinding or clenching, known as bruxism, is a common condition that affects the mouth, teeth, and jaw. Symptoms of teeth grinding and clenching include:
  • Dull, achiness in your teeth or tooth sensitivity
  • Headache starting at the temples
  • Pain or fullness in your ears, as if from an earache
  • Soreness when you touch your jaw or face
  • Damage to your teeth – worn enamel, cracks, or chips
Over time, excessive teeth grinding and clenching can lead to temporomandibular joint (TMJ) disorders, which increase the severity of the symptoms above and cause jaw stiffness, shifting, or locking and pain on one or both sides of the mouth. TMJ disorders and teeth grinding affect the temporomandibular joint which connects the jawbone to the skull and acts as a sliding hinge. This joint is incredibly important to overall health and is what allows you to talk, eat, and perform other essential activities. If left untreated, TMJ disorders can cause long-term problems that may require surgical intervention.

Causes & Diagnoses

While stress is an important factor in both teeth grinding and TMJ disorders, their causes and diagnoses vary case by case. Generally, there are two types of teeth grinding: daytime teeth grinding and nighttime teeth grinding. Daytime teeth grinding typically occurs during periods of high stress or anxiety. This condition is fairly common and affects 15 to 20 percent of adults. Nighttime teeth grinding goes beyond limited periods of stress and is linked to issues like sleep apnea, hyperactivity, or acid reflux. According to the American Sleep Association, nighttime teeth grinding affects as many as one in 10 adults. Additionally, both daytime and nighttime teeth grinding are known side effects of some anti-depressant medications and can be related to tobacco, caffeine, alcohol, and drug use.

To diagnose daytime and nighttime teeth grinding, your doctor will examine your teeth to find signs of extreme wear. They will also ask you about pain, headaches, or other symptoms. TMJ disorders are caused by numerous factors and underlying conditions, including long-term teeth grinding, arthritis, jaw injury, and certain connective tissue diseases. Other factors that may impact TMJ disorders include poor neck posture, poor diet, lack of sleep, and the use of orthodontic braces. While TMJ disorders can be difficult to diagnose, your doctor will likely examine your jaw, check for swelling, and observe its range of motion. Additionally, the diagnosis might require dental x-rays, a CT scan, or an MRI to further investigate the cause of pain. If your jaw pain doesn’t respond to non-invasive procedures, a doctor may use a TMJ arthroscopy to evaluate you and determine the next steps for treatment. This outpatient procedure involves inserting a small camera into the joint space to observe the area’s function and overall health.

Implications & Treatments

Teeth grinding and TMJ disorders both lead to jaw, mouth, and teeth discomfort or sensitivity, but treatments vary depending on the severity of the case. Some cases require no treatment and go away on their own, while others require a combination of medications and therapies. While night guards can prevent damage to the teeth and mouth, they do not stop you from grinding. Therefore, it’s imperative to treat the underlying cause of the condition. This may include:
  • Taking medications such as muscle relaxers
  • Switching anti-depressant medications or receiving a prescription for them for the first time
  • Developing behavioral strategies such as identifying potential triggers, stress management, relaxation training, and more
In severe circumstances, certain TMJ disorders may require surgery such as joint aspiration, which involves injecting fluid into the joint to reduce inflammation and pressure; open-joint surgery to remove bony growths or excess tissue; or other procedures. Overall, maintaining a healthy lifestyle and prioritizing your mental health are the best ways to prevent and treat teeth grinding and TMJ disorders. It may seem difficult to reduce stressors in your life, but the medical benefits are clear. For many, reducing stress and anxiety could be as simple as taking a brisk walk, eating a healthy diet, or meditating. And while teeth grinding can seem like a minor issue at first, you should contact your Atrius Health provider if you start to experience persistent discomfort. With teeth grinding and TMJ disorders, early intervention is the key to maintaining a healthy jaw and minimizing pain.
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About The Author

Atrius Health

Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for adult and pediatric patients at more than 27 medical practice locations in eastern Massachusetts. By establishing a solid foundation of shared decision making, understanding and trust with each of its patients, Atrius Health enhances their health and enriches their lives.

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