Painful jaw clenching may be TMJ disorder

Dear Dr. Roach: I have developed the habit of unconsciously clenching my jaw during the day. I tend to worry about things and have trouble turning off enough to relax. I actually don’t mind clenching my jaw, since it offers some relief. But now my jaw hurts on one side when I chew food, and sometimes I have trouble opening my mouth wide enough to take a bite of food. Sometimes my jaw clicks, and I worry that if can somehow open my mouth wide enough, it will get stuck there. I also have developed a mild earache that comes and goes on the side where the pain is. I’m worried that I have caused damage to my jaw. Can you help me? — J.S.B.

Answer: Jaw clenching during the day is something many do, and if you watch people carefully, you will observe it in people you know. It can be a reaction to stress or anxiety, or it may simply be a habit people have during concentration. It can, in some cases, be a manifestation of a medical condition, such as Parkinson’s disease, or related to medications, especially ones used for psychiatric conditions. Tooth clenching, or grinding, goes by the medical name of bruxism, and while it commonly happens during sleep, some people, like you, have awake bruxism.

It’s pretty clear from your description that you have temporomandibular joint disorder, a group of conditions that all manifest with problems in the joint where your lower jaw attaches to your skull, just in front of and below the ear.

Given your clear association of the jaw clenching with worrying and being unable to relax, it would be best to treat those first. There are behavioral treatments and other types of non-pharmacologic treatments, like working with a licensed therapist or counselor. You also should have a regular visit with your dentist, if you haven’t recently. In the short term, an anti-inflammatory medication, like ibuprofen or naproxen, may provide relief.