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Opinions, Advice, Anyone? Tmj And My Anxiety.

Hi all,

sorry if this has been covered before, but I thought I would post my issue and see if I am crazy or not.

About 4 years ago I woke up one day and my jaw was locked. It had been clicking and popping for a long time, but now it hit this point where I couldn't open my mouth fully. I freaked out and went to the oral surgeon that day. He told me I likely had tmj - he suggested warm compresses, ibuprofen, etc. After a day or two it unlocked but I still had the popping and I was afraid it would lock again. The Dr. Suggested I get a splint, which I did. I was annoyed because it was so expensive and insurance didn't cover it! But oh well...

Not long after this I began seeing a psychiatrist for my life long anxiety that was really beginning to get in the way of normal life and function for me. After a few sessions I began a course of ssris and things were great. Aside from the lifting of my anxiety/worry, I no longer experienced pain in my jaw. I stopped wearing the splint and it sat in my cabinet for a long time.

I went off the medicine in a year or so because I felt better. But about a year and a half later I needed to go back on - my symptoms were coming back and I was worrying about irrational things a lot more. I also experienced physical pain in my neck/shoulder muscles, and...I began clenching my jaw so much that my jaw muscles were sore before I even got to work in the mornings. It started off slowly but within the last month or so, I found myself going through this almost every day. And I am not emotionally anxious - I have no reasons to be worried, at least on the outside. I assumed it was just some physical manifestation of my anxiety coming out. The Dr. Seemed to have no answer for this other than to increase my dosage of zoloft. That was last month. It seems to have helped a bit but i'm still doing the "jaw thing" about 50% of the time.

It dawned on me last night to try wearing my splint again. And lo and behold, this morning, and today, I am not doing the clenching nearly as much and I feel pretty okay in the jaw region.

So, my question (after all that!) is, are tmj and anxiety sometimes related? I naturally assumed it was my anxiety that was causing the clenching, but I had no way of "fixing" it. Maybe the splint (that I thought didn't even really work) is helping me out after all. Am I nuts? I can't figure out why I am doing the clenching, nor can I control it. I tell myself not to do it, which often times makes it worse! I'm just confused and wonder if anyone is in this same situation. Its' not a terribly painful thing, but it certainly is annoying and it brings out my anxiety more when I realize how bad I am clenching.

Thanks for any input and I am sorry for the long winded story! :d
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replied December 15th, 2006
Experienced User
You are not even close to being crazy. Tmj and anxiety (stress) are very much related. I would almost go as far and say that if there was no stress or anxiety in this world, tmj would not have its nasty hold on so many people (long-winded sentence there myself).

You are exactly on the right track with bite splints and ssris. An important tip about the ssris, though (prozac works much better for me than zoloft), there are reports out now that ssris can cause night-time bruxism. What a paradox. They increase seratonin in your body, which helps to relax you but at the same time, can cause clenching.

I was on a low dosage of prozac for several years before the clenching came back. These same reports state that if a very small dose of buspar (and something else I can't remember) will counteract this problem and allow the ssri to work, as it should. (buspar is an old anti-anxiety drug and both buspar (low dose) and ssris can be taken together.) so, I now also take 7.5 mg. Of buspar with the prozac and it has helped tremendously. My tmj (of 26 years) is managed most of the time.

There is no real simple answer to the big question - “why do we clench or grind our teeth when under stress or anxiety?” many believe it has to do with an imbalance in our bites. I agree but there’s more to it, i’m sure. Bite splints probably help because they “balance” the bite and maybe just having something in the mouth says something to our sleeping brains. But they do help especially when you get a well-made bite splint and have it adjusted every once in a while.

I know many people do not like taking anti-d’s. But if they work, take the medication. I am an example of someone who did not take any medication for at least 18 years after waking up one morning with a locked jaw and excruciating pain. Now that I am supposedly mature and wiser, I can say I was stupid. My quality of life during those years was downright miserable, all because of tmj. I missed out on so much. Fighting to stay upbeat was almost more tiring than just showing my misery. I believe that only because of my faith did I get through those years alive. I also rebelled against the opinion that tmj and depression are related. Well, it’s not depression as much as it is stress and anxiety living in this too fast country. Yes, I have a huge anatomical problem with my small lower jaw and bad bite, and played a wind musical instrument semi-professionally for years, which all contributed to my tmj, but keeping my stress level as low as possible makes the biggest difference. I also want to say that posture (especially in front of the computer) also is a big issue with tmj.

You thought you were long-winded, and I tried to keep it short. Honestly. Please know that you are quite normal. What you are doing is good. Now you have to work at lowering your stress and anxiety levels (which everyone has to different degrees). You should probably also have your bite splint looked at to see if it needs any adjusting. Take care.

God bless…
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replied February 2nd, 2009
tmj and possible prozac
I have been a tmj sufferer for the past 10 years. I've done my research,I've tried everything including a bite guard, chiropractor, massage therapist, pain management (trigger point injections, accupuncture) jaw excercises, meditation, breathing and for the past two months I have been having anxiety to the point of panic attacks. I have built up a fear of opening my mouth at the dentist and to eat. I went to my doctor a couple of days ago after a bad panic attack where I didn't want to go to work or be around anyone. He gave me Xanax and if that doesn't work he told me to try Prozac. I'm still deciding. The only thing I know is, I don't want to live with these fears anymore.
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